carpal tunnel syndrome
Conditions
Interventions
control group:Ultrasound therapy only
treatment group:Ultrasound combined with electroacupuncture therapy
Sponsors
The First Clinical Medical College of Nanjing University of Chinese Medicine (Jiangsu Provincial Hospital of Chinese Medicine)
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Diagnostic Criteria: The diagnosis was established based on the CTS-6 scale recommended by the American Academy of Orthopaedic Surgeons (AAOS) 2024 Clinical Practice Guideline for Carpal Tunnel Syndrome, in conjunction with electrophysiological examination. The CTS-6 scale includes the following items: 1) Numbness in the median nerve distribution (thumb, index finger, middle finger, and radial half of the ring finger) (3.5 points); 2) Nocturnal numbness (symptoms worsen at night or awaken the patient from sleep) (4 points); 3) Thenar atrophy and/or weakness of thumb abduction (5 points); 4) Positive Phalen's test (wrist flexion induces symptoms) (5 points); 5) Positive Tinel's sign (tapping over the transverse carpal ligament elicits radiating paresthesia) (4.5 points); 6) Loss of two-point discrimination (inability to distinguish two points within 5 mm) (5 points). A total score of =12 points was considered positive. 2. Combined Electrophysiological and Clinical Grading Criteria: This study utilized the Bland electrophysiological grading system (2000), integrated with the standards of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) (2018/2020) and clinical symptoms/signs, to classify carpal tunnel syndrome into four grades: Mild: Intermittent numbness and tingling in the fingers, predominantly nocturnal, without interference with activities of daily living; normal thumb abduction strength, no thenar atrophy; median sensory distal latency 3.5–4.5 ms, sensory nerve action potential amplitude =15 µV; motor distal latency =4.2 ms, compound muscle action potential amplitude =4.0 mV. Moderate: Persistent numbness and pain, impairing fine motor skills and reducing grip strength; mild weakness of thumb abduction (grade 4), slight thenar atrophy may be present; sensory distal latency 4.5–6.0 ms, sensory nerve action potential amplitude 10–15 µV; motor distal latency 4.2–6.0 ms, compound muscle action potential amplitude 3.0–4.0 mV. Severe: Markedly diminished or partially lost sensation, impaired fine motor skills, difficulty holding objects; thumb abduction strength = grade 3, obvious thenar atrophy; sensory distal latency >6.0 ms or absent response, sensory nerve action potential amplitude 5–10 µV; motor distal latency 6.0–8.0 ms, compound muscle action potential amplitude 1.5–3.0 mV. Extremely Severe: Absent sensation in the median nerve distribution, severe hand dysfunction; thumb abduction strength = grade 2, severe thenar atrophy; absent sensory nerve action potential; motor distal latency >8.0 ms or absent response, compound muscle action potential amplitude 6.0 ms, compound muscle action potential amplitude <3.0 mV) were excluded. 3. Age between 18 and 75 years, regardless of gender. 4. Voluntary participation in the study with signed informed consent. 5. Good compliance and ability
Exclusion criteria
Exclusion criteria: 1. Excluding secondary peripheral neuropathies such as diabetic peripheral neuropathy, hypothyroidism, gout, and rheumatoid arthritis; 2. Severe carpal tunnel syndrome confirmed by electrophysiological studies or moderate cases unresponsive to conservative management for three months, typically requiring surgical intervention; 3. Recent hormonal therapy or carpal tunnel surgery within the past three months; 4. Pregnancy or lactation; 5. Coagulation disorders or local skin infections; 6. Severe cardiac, hepatic, or renal insufficiency.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Boston Carpal Tunnel Questionnaire; | — |
Secondary
| Measure | Time frame |
|---|---|
| Visual analogue scale,VAS;Shear wave elastography; | — |
Countries
China
Contacts
Public ContactHaiyang Fu
The First Clinical Medical College of Nanjing University of Chinese Medicine (Jiangsu Provincial Hospital of Chinese Medicine)
Outcome results
None listed