Laser Acupuncture In Patients With Carpal Tunnel Syndrome

Carpal tunnel syndrome is a series of clinical symptoms caused by the increased pressure on median nerve and flexor digitorium through the tunnel. Clinically, this disease is mainly characterized by numbness and stabbing pain in the thumb, index finger, middle finger and ring finger (three and a half fingers at the radial side) that radiate to the elbows and shoulders. Stabbing pain like pain like electronic shock can be felt in the three and a half finger at the radial side when carpal tunnel is knocked. The symptoms are severe at night and in the morning, alleviated after moving or lifting the hands. Fingers at the affected side may feel distending, stiff and cold with pale or cyanotic color. In the advanced stage, the symptom seen are thenar atrophy, numbness, reduced muscular tension, loss or impairment of sensation in the finger, and dysfunction of palm opposing function. The degree of muscular atrophy is related to the course of disease.Laser acupuncture utilizes low energy to radiate biological tissue, then cause the corresponding effect and enable patients to restore their health with the help of this equipment. The wave of near-infrared and the laser of visible light have many physiological actions and treatment functions to organism and these can be shown by the improvement of partial blood circulation, nervous system function and anti-infection and the promotion of polygenesis of organism, as well as the analgesia function. Low energy laser acupuncture has been applied to the clinical treatment extensively now.Objective: Based on the previous study, this subject aim to investigate the efficacy of laser acupuncture compared with sham laser acupuncture treatment in patients with mild-to-moderate carpal tunnel syndrome (CTS) as measured by subjective symptoms assessment as global symptoms Assessment (GSS); the Kelly assessment.standard and objective changes in nerve conduction studies (NCS) and in a randomized, controlled study, and observed the change of quality of life of CTS patients.Methods:A total of 60 consecutive and prospective CTS patients confirmed by NCS were enrolled in the study. According to the principle of randomization, the CTS patients were divided into 2 treatment groups: 1. the group of laser acupuncture,2. the group of sham laser acupuncture. Specific research methods of each group are:Group of laser acupuncture, adoption point:Neiguan (PC 6), Daling (PC 7). Operation:use Handy laser Trion 150810 (class IIIb lasers,150mW, redlight,810nm wavelength. Direct exposure to the Neiguan and Daling points of the affected hand by use 810nm infrared wavelength laser, the output 150mW low-energy laser. Each points 5 min, a total of 10 min.Group of sham laser acupuncture, adoption point:Neiguan (PC 6), Daling (PC 7).Operation:use the same machine as Group of laser acupuncture. No laser beam output, just direct exposure to red light flashes to the Neiguan and Daling points of the affected hand. Each points 5 min, a total of 10 min.Course of treatment:The treatment lasted of two groups:5 times/week,4 weeks made 1 course of treatment, a total of one course of treatment. Efficacy evaluation:Two groups before and after treatments should be observed with thefollowing aspects:(1) Global symptom score, GSS. (2) Measurement of Motor nerve conduction velocity:â‘ distal motor latency, DML.â‘¡ompound muscle action potential, CMAP.â‘¢motor nerve conduction velocity, MNCV.(3) Measurement of Sensory nerve conduction velocity:â‘ distal sensory nerve latency,DSL.â‘¡sensory nerve action potential, SNAP.â‘¢wrist-palm sensory nerve conduction velocity, W-P SNCV. (4) The Kelly assessment standard was used for efficacy assessment scale with GSS.We enter all data into SPSS13.0 the statistical software for data processing and analysis of statistical data and finally draw conclusions. Result:There was no difference of signification between the two groups of patients in aspect of gender, age, disease duration, syndromes, and other basic information (P> 0.05), suggesting a better comparability among them.After treatment, the distal motor latency(DML) of laser acupuncture group shows significant statistical difference the difference was significant compared with before treatment (p<0.01). It can be consider that laser acupuncture could improvement the distal motor latency obviously.Compared with before treatment,2 weeks ago,4 weeks ago and after 4 weeks compared with 2 weeks, all general symptom score (GSS) of the total score of patients of the laser group were have significant differences (p=0.00). It also show significant differences by compared with sham laser acupuncture group (p=0.00). It can conclusion that laser acupuncture could improvement the symptoms of Carpal tunnel syndrome like pain, numbness, clumsy, nocturnal and so on.Individual index between the two groups after treatment, except the distal motor latency(DML), there were no significant statistical difference in the other aspects. In the fact, the sensory nerve action potential(SNAP) and wrist-palm sensory nerve conduction velocity(W-P SNCV) have an unexpected result-the sham laser acupuncture group have a significant statistical difference. There is twu possible for this happens:(1) Laser acupuncture had little improvement in this indicators except DML. The difference between the two groups of before and after may be due to the self-healing. (2) Laser acupuncture had some improved on these indicators, but the sham laser acupuncture also had some effect on these indicators except DML.After treatment,the efficacy comparison between the two groups were have significant differences (P=0.00). It shows the efficacy of the two groups was significant difference.So that it can be considered laser acupuncture group have more effective than sham laser acupuncture group by comparison the average of Ridit of Laser group (0.6242)> pseudo laser (0.3758).Conclusion: Laser acupuncture has a definite effect on the treatment of carpal tunnel syndrome. For the aspect of laser acupuncture could improved the clinical symptoms, Laser acupuncture can alleviate the suffering of patients with diseases at some extent, improve the quality of life of patients. Compared with the traditional acupuncture, laser acupuncture has a painless, sterile, safe, easy to control and other advantages so that patients could have more acceptable at psychologically. Laser acupuncture can be a good option that used in the Conservative treatment of carpal tunnel syndrome, and this method can be used as adjuvant therapy widely in clinical practice.