Effect of High-Intensity Laser Therapy on Carpal Tunnel Syndrome Patients: A Systematic Review and Meta-analysis

Abstract

Objective: To provide a strong foundation for the use of high-intensity laser therapy in carpel tunnel syndrome, we conducted a systematic review and meta-analysis to investigate the outcomes of short- and long-term follow-up studies. Design: This is a systematic review and meta-analysis. Results: Sample sizes of included studies ranged from 16 to 98 patients (N = 308). Overall, a significant difference between the treatment and control groups were found across majority of the measures. Studies using a 4-wk follow-up period, however, only found significantly greater benefits for high-intensity laser therapy in visual analog scale compared with placebo (P = 0.0191), transcutaneous electrical nerve stimulation (P = 0.0026), and low-intensity laser therapy 20 J/cm(2) (P < 0.0002), and exercise (P < 0.0001). For improvement in visual analog scale score over a long treatment period, high-intensity laser therapy was also preferred over control group (P < 0.0071). Insufficient evidence exists to determine effect of high-intensity laser therapy on nerve conduction examinations. The only statistically significant differences observed in examinations were in relation to sensory nerve action potential (P = 0.0083) and sensory nerve conduction velocity (P = 0.0468). Conclusions: Moderate evidence exists regarding efficacy of high-intensity laser therapy compared with placebo, high-intensity laser therapy + wrist splint, and exercise in a short period of follow-up time but evidence on long-term follow-up is limited.