Ultrasound therapy adds no benefit to splinting in carpal tunnel syndrome

Therapeutic ultrasound has been suggested as a treatment for carpal tunnel syndrome (CTS), but existing trial evidence is of poor quality and inconclusive.

We conducted a randomized, controlled trial of therapeutic ultrasound in mild to moderate CTS. Forty patients were treated with wrist splints plus either real or sham therapeutic ultrasound and followed for 1 year posttreatment. The primary outcome was change in symptom severity scale score. Secondary outcomes were functional status scale score, nerve conduction studies, and ultrasound imaging of the median nerve.

Both groups showed significant clinical and neurophysiological improvement at 6 and 12 months compared with baseline. There were no significant differences between groups at any time. In a multivariate analysis, the only independently significant predictors of the primary outcome were pretreatment symptom severity and additional treatments during follow-up.

We found no clinically significant benefit from ultrasound treatment for CTS.