Effect of ultrasound-guided percutaneous electrolysis and nerve stimulation on pain and function in carpal tunnel syndrome: A randomized clinical trial.

OBJECTIVE

To assess the effectiveness of ultrasound-guided percutaneous electrolysis and peripheral nerve stimulation in reducing pain, improving functional capacity, and modifying mechanosensitivity responses in patients with carpal tunnel syndrome compared to a sham intervention.

DESIGN

A multicenter, randomized controlled clinical trial.

SETTINGS: Double center pain clinic.

SUBJECTS: In brief, 46 patients diagnosed, with carpal tunnel syndrome, assigned to an intervention group or a sham group.

METHODS

Both groups received 3 sessions over 4 weeks. Primary outcomes included mean and worst pain intensity. Secondary outcomes assessed functional status and symptoms severity; Boston Carpal Tunnel Questionnaire, Upper Limb Neurodynamic Test 1, grip and pinch strength, two-point discrimination, sensory thresholds, pressure pain threshold and Global Rating of Change Scale. Follow-ups were conducted at 4, 12, and 24 weeks.

RESULTS

Statistically significant intergroup differences were observed for all evaluated variables across follow-ups, except for grip and pinch strength. The intervention group demonstrated significantly greater improvements in pain intensity, functional disability, sensory thresholds, and neural mobility, with large effect sizes ranging from 0.64 to 2.09. Notably, the improvements in pain and function were sustained at 6 months.

CONCLUSIONS

Ultrasound-guided percutaneous electrolysis and peripheral nerve stimulation significantly reduce pain and improve function in carpal tunnel syndrome, offering a promising minimally invasive alternative to standard care.

CLINICAL TRIAL REGISTRATION NUMBER: Effectiveness of an Invasive Physical Therapy Protocol in Carpal Tunnel Syndrome: Randomized Controlled Clinical Trial. Registration number: NCT05527743. Link to full trial record: https://clinicaltrials.gov/ct2/show/NCT05527743 Patient enrollment began on: April 1, 2023.