Comparison of Effects of Ultrasound Therapy and Nerve-Gliding Techniques on Patients with Carpal Tunnel Syndrome: A Randomized Clinical Trial

Abstract

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by pressure on the median nerve in the wrist, affecting 1% to 5% of the population. Treatment options include pharmacologic management, rest, splints, local steroid injections, and physical therapy. Conservative treatments, such as ultrasound therapy and nerve-gliding exercises, can also be effective. Objectives: This study aimed to compare the effects of ultrasound therapy and nerve-gliding exercises on reducing symptoms, improving hand function, and electrodiagnostic tests in patients with CTS. Methods: This randomized clinical trial was conducted on patients with CTS at the specialized physical medicine and rehabilitation clinic at Birjand University of Medical Sciences. The study included 48 patients with CTS, divided into two groups. The ultrasound group received therapy at a frequency of 1 MHz and a current intensity of 1 watt/cm², with each session lasting 5 minutes. The nerve-gliding group underwent 10 sessions of treatment, three times a week. Pain intensity was evaluated using VAS criteria, symptom intensity using the BOSTON Questionnaire, and median nerve latency with EMG-NCS. Results: The study included 48 patients with CTS, divided into two groups. Both groups showed improved severity of symptoms and function scores at the end of the study (P < 0.001). The ultrasound group significantly reduced the sensory and motor median nerve latency scores (P < 0.001 and P = 0.001, respectively), and the pain score diminished significantly in both groups (P < 0.001). Conclusions: Ultrasound and neural-gliding techniques are effective in reducing patients' symptoms and pain intensity in the short term. Additionally, ultrasound can improve electrodiagnostic indicators.