Treatment of Trigger Fingers Associated with Carpal Tunnel Syndrome by Low-Level Laser Therapy and Specific Hand Massage: A Case Report

Abstract

Low-Level Laser Therapy (LLLT) has been shown to effect in tissue healing and pain reduction. This case report describes the rehabilitation of a 34 year-old female, left-handed patient who had chronic trigger fingers with bilateral carpal tunnel syndrome (CTS). The patient complained of localized tenderness and deep pain in her index and middle fingers. She suffered night awakening from numbness and tingling in both hands. Clinical examination of passive and active movement elicited pain in the wrist which involved stiff action of finger flexor tendon, associated with hand dysfunction. The Phalen’s test was positive. The electrodiagnosis was performed and bilateral CTS of moderate degree was diagnosed. Treatment consisted of LLLT with an energy dose of 2 Joules per tender point and an 18 Joules over the carpal tunnel area with specific hand massage. The hand exercises were prescribed under supervision of physical therapist. The patient received therapy three times per week, for a total of 15 sessions. The degree of numbness was gradually decreased and numeric rating scale decreased from 8/10 to 0/10. The patient reported complete resolution of symptoms that was maintained up to three months of follow-up. This case report emphasizes the importance of LLLT combined with specific hand massage and hand exercise program to promote pain relief in trigger fingers associated with CTS. Further study should be conducted to investigate the combination therapy effects in these patients.