Evaluation of neural therapy effect in patients with piriformis syndrome.

BACKGROUND: The aim of this study was to explore the effect of neural therapy on pain and functionality in patients with low back pain due to piriformis syndrome. It also aimed to find out any possible links between the clinical changes and demographic features. METHOD: One hundred and two patients were randomly divided into two groups (neural therapy and control). All patients were given stretching exercises for the piriformis muscle. The patients in the neural therapy group additionally received 6 sessions of neural therapy. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were noted before and after the treatment in both groups. RESULTS: The VAS and ODI improved in both groups. However, improvement of the VAS and ODI scores were more obvious in the neural therapy group. The changes of VAS and ODI values did not show any correlations with the demographic features. CONCLUSION: After the neural therapy, the patients with low back pain due to piriformis syndrome may have improvement in both pain and functioning.

The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study.

INTRODUCTION: The aim of this study was to explore the acupuncture effect on the cross-sectional area (CSA) of the median nerve at the wrist in patients with carpal tunnel syndrome (CTS) and, additionally, to identify whether clinical, electrophysiological, and ultrasonographic changes show any association. METHODS: Forty-five limbs of 27 female patients were randomly divided into two groups (acupuncture and control). All patients used night wrist splint. The patients in the acupuncture group received additional acupuncture therapy. Visual analog scale (VAS), Duruöz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were noted before and after the treatment in both groups. RESULTS: VAS, DHI, Quick DASH scores, and electrophysiological measurements were improved in both groups. The median nerve CSA significantly decreased in the acupuncture group, whereas there was no change in the control group. CONCLUSION: After acupuncture therapy, the patients with CTS might have both clinical and morphological improvement.

Ultrasonographic Evaluation of Acupuncture Effect on Common Extensor Tendon Thickness in Patients with Lateral Epicondylitis: A Randomized Controlled Study.

OBJECTIVE: To explore the effect of acupuncture on common extensor tendon (CET) thickness in patients with lateral epicondylitis (LE). Additionally, to identify whether clinical and ultrasonographic changes showed any correlation. METHODS: Forty-one patients were randomly assigned to acupuncture and control groups. Conventional treatment (rest, NSAII, bracing, exercise) methods for LE were applied to all patients. In addition to this, the acupuncture treatment was applied to the acupuncture group. The visual analog scale (VAS) for pain, the Duruoz Hand Index (DHI) for functioning of the affected limb, the pressure pain threshold, and CET thickness (via ultrasound imaging) were assessed before and end of the treatment in both groups. RESULTS: The VAS and DHI scores in both groups decreased. The pressure pain threshold and CET thickness only demonstrated improvement in the acupuncture group. CONCLUSION: These findings show that the CET thickness was reduced after 10 sessions of acupuncture treatment in LE patients.

Doppler ultrasonographic evaluation of the radial and ulnar arteries in hemiparetic patients after stroke.

BACKGROUND: To evaluate blood flow of hand arteries (using Doppler ultrasonography) and sympathetic skin response (SSR) in patients with hemiparesis. METHODS: Fifty-six stroke patients (30 M, 26 F) with unilateral hemiparesis (age 53.5 ± 10.8 years, mean disease duration 12.0 ± 19.1 months) were included. The patients' arm and hand motor functions were assessed according to Brunnstrom's stages. SSR was evaluated bilaterally from median nerves at the wrist level. Radial and ulnar artery blood flow was measured at the wrist in the neutral position. RESULTS: Both radial and ulnar artery volume flow and end diastolic velocity, and radial artery diameter were smaller on the paretic side (all p < 0.0125). Radial artery resistance and pulsatility index were greater on the paretic side (both p < 0.0125). SSR amplitude was lower on the paretic side of patients with right-sided hemiparesis patients (p = 0.009). Hand Brunnstrom's stage was negatively correlated with nonparetic-paretic difference in radial artery volume flow and SSR amplitudes (all p < 0.025). CONCLUSIONS: Hand blood flow was lower on the paretic side and was accompanied by a similar decrease in SSR amplitudes in patients with right-sided hemiparesis.