Efficacy of dry needling with the fascial winding technique in reducing the percentage of surgery in carpal tunnel syndrome: A randomized clinical trial

Abstract

Introduction

Numerous techniques for the treatment of carpal tunnel syndrome (CTS) have been described. The present study aims to determine the proportion of wrists with CTS in which the application of DN avoids surgery.

Methods

An assessor-blind randomized clinical trial clinical trial was performed. Eighty-six wrists with diagnosis of mild or moderate CTS and indication for surgery were recruited from a hospital traumatology service. The intervention group was treated with DN, with a frequency of one session/week over six weeks, while the control group did not follow any specific treatment, remaining on the waiting list for the surgery. The main variable was the recommendation for surgery. Other secondary variables included changes in electromyography and ultrasound; intensity of pain; Boston Carpal Tunnel Syndrome Questionnaire (BCTQ); hand dynamometries; and possible adverse effects.

Results

The wrists treated by DN had a reduced risk of needing surgery at 12 weeks by 62% compared to the control group (RR = 0.38, 95% CI[0.2–0.72]), with this value being significant (p-value = 0.003). This group also obtained a significant improvement in the intensity of pain (p-value = 0.006), and in the BCTQ-severity of syntoms scale and BCTQ-functional situation scale (p-value = 0.039 and p-value = 0.019 respectively). Statistical significance was not reached in the dynamometries performed, nor in the results of the electromyography and ultrasound studies. Adverse effects were infrequent or unimportant.

Conclusions

Application of DN to wrists with mild or moderate CTS reduces the need for surgery, and improves the clinical symptoms and functionality of the hand.