Clinical Journal of Pain 2013-04-01

Phonophoresis of dexamethasone sodium phosphate may manage pain and symptoms of patients with carpal tunnel syndrome.

Amir H Bakhtiary, Elham Fatemi, Mitra Emami, Mojtaba Malek

Index: Clin. J. Pain 29(4) , 348-53, (2013)

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Abstract

This study was designed to compare the efficacy of iontophoresis and phonophoresis of dexamethasone sodium phosphate (Dex-P) treatment for mild to moderate carpal tunnel syndrome (CTS).Fifty-two hands in 34 consecutive patients with mild to moderate CTS confirmed by electromyography were allocated randomly into 2 groups. One group received iontophoresis of 0.4% Dex-P and the other group received phonophoresis of 0.4% Dex-P. Phonophoresis (using ultrasound 1 MHz, 5-cm probe, 1.0 W/cm, pulse 1:4, 5 min/session) and iontophoresis (using galvanic current, negative electrode, 2 mA/min, total dose 40 mA for 20 min) was applied over the wrist chin for 10 daily treatment sessions (5 sessions/wk). Measurements were performed before and after treatment and at follow-up 4 weeks later, and included pain assessment by visual analogue scale, electroneurographic measurement (motor and sensory latency, motor and sensory action potential amplitude), and pinch and grip strength.Improvement was significantly more pronounced in the phonophoresis group than in the iontophoresis group for motor latency [mean difference 0.8 m/s; 95% confidence interval (CI), 0.5-1.1], motor action potential amplitude (4.1 mV; 95% CI, 3.0-5.2), finger pinch strength (31.6 N; 95% CI, 15.9-47.3), hand grip strength (27.1 N; 95% CI, 13.5-40.5), and pain relief (2.1 points on a 10-point scale; 95% CI, 1.3-2.9). Effects were sustained in the follow-up period.Phonophoresis of Dex-P treatment was more effective than iontophoresis of Dex-P for treatment of CTS. Further study is needed to investigate the combination therapy effects of these treatments with other conservative treatments in CTS patients.