Abstract
To investigate the efficacy of phonophoresis with nonsteroid anti-inflammatory drugs (P-NSAID) and corticosteroids (P-CS) in the treatment for carpal tunnel syndrome (CTS) and to compare the efficacy of phonophoresis with local CS injection (LCSI) and splinting with a 3-month follow-up. 84 hands of 51 patients with CTS were treated by applying LCSI, P-CS, P-NSAID, and wrist splinting. Electrophysiological studies, grip strength, hand dexterity, and sensory recovery of the first three digits were assessed. Duruöz hand index (DHI) was used to assess the functional hand disability. For clinical evaluation, we used Phalen and Tinnel signs. Pain intensity was evaluated by visual analog scale. The LCIS group showed a significant improvement in pain relief and DHI, but this group had significant deterioration in the results of monofilament and pegboard tests. The P-CS group showed improvement in sensory nerve conduction velocity, distal latency, grip strength, and DHI parameters. There was a significant improvement in grip strength, pegboard test, and pain intensity in the P-NSAID group. There was improvement only in pain intensity in the splinting group. We identified marked improvement in the electrophysiological studies in the P-CS group. Splinting had no effect on hand functions, disability, and electrophysiological studies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Saliba S, Mistry DJ, Perrin DH et al (2007) Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing. J Athl Train 42:349–354
Wells PN (1977) Ultrasonics in medicine and biology. Phys Med Biol 22:629–669
Davick JP, Martin RK, Albright JP (1988) Distribution and deposition of tritiated cortisol using phonophoresis. Phys Ther 68:1672–1675
Stratford PW, Levy DR, Gauldie S et al (1989) The evaluation of phonophoresis and friction massage as treatments for extensor carpi radialis tendinitis: a randomized controlled trial. Physiother Can 41:93–99
Byl NN, McKenzie AL, Halliday B et al (1993) The effects of phonophoresis with corticosteroids: a controlled pilot study. J Orthop Sports Phys Ther 18:590–600
Bare AC, McAnaw MB, Pritchard AE (1996) Phonophoretic delivery of 10% hydrocortisone through the epidermis of humans as determined by serum cortisol concentrations. Phys Ther 76:738–749
Kuntz AR, Griffiths CM, Rankin JM et al (2006) Cortisol concentrations in human skeletal muscle tissue after phonophoresis with 10% hydrocortisone gel. J Athl Train 41:321–324
Benson HA, McElnay JC, Harland R (1989) Use of ultrasound to enhance percutaneous absorption of benzydamine. Phys Ther 69:113–118
Franklin ME, Smith ST, Chenier TC et al (1995) Effect of phonophoresis with dexamethasone on adrenal function. J Orthop Sports Phys Ther 22:103–107
American Association of Electrodiagnostic Medicine Quality Assurance Committee (1993) Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 16:1392–1414
Mathiowetz V, Rennells C, Donahoe L (1985) Effect of the elbow position on grip and key pinch strength. Hand Surg [Am] 10:694–697
Ruff RM, Parker SB (1993) Gender- and age-specific changes in motor speed and eye–hand coordination in adults: normative values for the finger tapping and grooved pegboard tests. Percept Motor Skill 76:1219–1230
Duruoz MT, Cerrahoglu L, Dincer-Turhan Y et al (2003) Hand function assessment in patients receiving haemodialysis. Swiss Med Wkly 9:31–32
American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation (2002) Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 25:918–922
Bland JDP (2001) Do nerve conduction studies predict the outcome of carpal tunnel decompression? Muscle Nerve 24:935–940
Dudley Porras AF, Alaminos PR, Vinuales JI et al (2000) Value of electrodiagnostic tests in carpal tunnel syndrome. J Hand Surg 4:361–365
Hagebeuk EEO, de Weerd AW (2004) Clinical and electrophysiological follow-up after local steroid injection in the carpal tunnel syndrome. Clin Neurophysiol 115:1464–1468
Aygül R, Ulvi H, Karatay S et al (2005) Determination of sensitive electrophysiologic parameters at follow-up of different steroid treatments of carpal tunnel syndrome. J Clin Neurophysiol 22(3):222–230
Bronaugh RL, Maibach HI (1991) In vitro percutaneous absorption: principles, fundamentals, and applications. CRC Press, Ann Arbor, p 280
Chang MH, Chiang HT, Lee SS et al (1998) Oral drug of choice in carpal tunnel syndrome. Neurology 51:390–393
Maihofner C, Euchenhofer C, Tegeder I et al (2000) Regulation and immunhistochemical localization of nitric oxide synthases and soluble guanylyl cyclase in mouse spinal cord following nociceptive stimulation. Neurosci Lett 290:71–75
Hsieh YL (2006) Effects of ultrasound and diclofenac phonophoresis on inflammatory pain relief: suppression of inducible nitric oxide synthase in arthritic rats. Phys Ther 86:39–49
Ebenbichler GR, Resch KL, Nicolakis P et al (1998) Ultrasound treatment for treating the carpal tunnel syndrome: randomised “sham” controlled trial. BMJ 7:731–735
Halar EM, Delisa JM, Brozovich FV (1981) Peroneal nerve conduction velocity: the importance of temperature correction. Arch Phys Med Rehabil 62(9):439–443
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Soyupek, F., Kutluhan, S., Uslusoy, G. et al. The efficacy of phonophoresis on electrophysiological studies of the patients with carpal tunnel syndrome. Rheumatol Int 32, 3235–3242 (2012). https://doi.org/10.1007/s00296-011-2171-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-011-2171-9