Role of anti-inflammatory drugs in the complex therapy of patients with carpal tunnel syndrome

Abstract

Introduction. Carpal tunnel syndrome (CTS) is a neurological disease associated with tunnel mononeuropathies. There are various proven treatment regimens for patients with the use of conservative and surgical methods of treatment. Studies devoted to a comparative analysis of the effectiveness of methods of conservative therapy in patients with CTS are not enough to choose a treatment strategy.Purpose of the study. To study the therapeutic efficacy of wearing a wrist orthosis with and without the use of NSAIDs in the treatment of patients with CTS.Materials and methods. The study involved 40 patients (the average age of the participants was 32.8 ± 4.3 years) with a primary diagnosis of CTS, who were admitted to the neurological department of of the St Petersburg State Budgetary Healthcare Institution “Elizavetinskaya Hospital”, the Department of Medical Rehabilitation of St. Petersburg State Budgetary Healthcare Institution “St. Luke’s Clinical Hospital” in the period from 2017 to 2021. Patients were randomized into two comparable groups for complex conservative treatment and observation for 2 months of the dynamics of neurological symptoms, pain scale, QuickDASH questionnaire and neurophysiological parameters. The first group of patients received NSAIDs (Nimesil), 1 sachet (100 mg of nimesulide) twice a day after meals for 4 weeks, and the second group – NSAIDs with the imposition of a wrist orthosis for 4 weeks.Results. The study involved 40 patients. The average age of the participants was 32.8 ± 4.3 years (range from 20 to 48 years). Neurophysiological indicators in the studied groups at the screening stage were comparable: distal latency of the M-response (DLMO), ms; the amplitude of the negative peak of the M-response, mV; sensory latency (SL), ms and sensory impulse conduction velocity (SSPI), m / s: 5.7, 5.3, 3.5 and 31.8 in the first group and 5.4, 5.5, 3.8 and 32.4 in the second group (p > 0.05 when comparing the corresponding parameters). After the course of treatment, significant changes in the analyzed parameters were revealed (p < 0.05).Conclusions. In patients who received nimesulide and wore a wrist brace, the effectiveness of treatment was higher.

Keywords

• carpal tunnel syndrome
• wrist orthosis
• nsaids
• tunnel neuropathies
• median nerve
• treatment