A randomized controlled study of contrast baths on patients with carpal tunnel syndrome.

STUDY DESIGN: Randomized clinical trial. INTRODUCTION: Contrast baths are a treatment modality commonly used in hand clinics. Yet the benefits of contrast baths have been poorly substantiated. Contrast baths have been suggested for the purposes of reducing hand volume, alleviating pain, and decreasing stiffness in affected extremities. PURPOSE OF THE STUDY: To determine the effects of specific contrast bath protocols on hand volume in patients diagnosed with Carpal Tunnel Syndrome. METHODS: Study participants were randomly assigned to one of three treatment group protocols-contrast baths with exercise, contrast baths without exercise, and an exercise-only control treatment group. Study participants were evaluated with hand volumetry, before and after treatment at two different data collection periods-pre- and postoperatively. RESULTS: Data were gathered on 58 participants before Carpal Tunnel Release surgery and on 56 participants after Carpal Tunnel Release surgery, for a total of 114 treatments. The changes in hand volume (the after treatment volume minus the before treatment volume) were analyzed using one-way and multi-way analysis of variance (ANOVA). Although all three treatments resulted in a slight increase in hand volume both pre- and postsurgery, the increase was not clinically significant with regard to hand volumes. Also no significant differences were noted among the three treatments. Specifically, the ANOVA for presurgery differences among treatments had F=0.155 (2 and 55df), p=0.857. The ANOVA for postsurgery difference among treatments had F=0.544 (2 and 53df), p=0.584. CONCLUSIONS: The use of contrast bath treatment has no significant effect on increase or decrease of hand volume in Carpal Tunnel Syndrome patients, pre- and/or postoperatively. LEVEL OF EVIDENCE: 1B.