ASSESSMENT OF PHONOPHORESIS OF CORTICOSTEROIDS IN THE TREATMENT OF MILD TO MODERATE CARPAL TUNNEL SYNDROME.

Background: Carpal tunnel syndrome (CTS) is the most commonly diagnosed disabling condition of the upper extremities. Local steroid injections (LSI) are widely used for management of CTS. Phonophoresis is popular method in transdermal medication delivery that may eliminate potential side effects which can occur by LSI. Objectives: To investigate the efficacy of phonophoresis of corticosteroids in the treatment of mild to moderate CTS and to compare it with LSI. Patients and methods: Forty patients with mild to moderate CTS (56 hands) were included in this study and randomly assigned into 2 groups. One group received phonophoresis of 0.4% dexamethasone sodium phosphate (Dex-P) using continuous ultrasound 1 MHz, 5-cm2 probe, 1.0 W/cm2, 10 min/session, 3 sessions/week for 4 weeks. The other group received LSI of 0.4 mg Dex-P using the classic proximal approach. Outcome measures were performed before and one month after treatment and included pain assessment by visual analogue scale, symptoms severity scale and the functional status scale of the Boston Carpal Tunnel Questionnaire, hand grip strength and electro-diagnostic studies (motor and sensory distal latencies of the median nerve). Results: There was a statistically significant improvement in all outcome measures in both groups one month after treatment compared with baseline (P < 0.05). No statistically significant difference was found between the two groups in any outcome measure one month after treatment (P > 0.05). Conclusion:Phonophoresis of corticosteroids could be an effective treatment in mild to moderate CTS and may be an alternative treatment to LSI.