BACKGROUND: Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder of the wrist. Nonsurgical treatments eg, laser therapy may cause potential beneficial effects. AIM: To compare the dose dependent effects of low level laser therapy (LLLT) and high intensity laser therapy (HILT) on pain and electrophysiology studies in patients with CTS. DESIGN: Double-blind randomized controlled trial. SETTING: Outpatient physiotherapy clinic. POPULATION: Ninety-eight participants with CTS, aged between 20 to 60 years, were randomly assigned to five groups. METHODS: All participants undertook four standard exercises, with one group serving as exercise-only controls. Patients were randomly allocated to either high or low fluence LLLT or high or low fluence HILT received over 5 sessions. All patients were assessed by visual analogue scale, median compound muscle action potential (CMAP) and sensory nerve conduction studies before and 3 weeks after the interventions. RESULTS: VAS was significantly lower in all groups after 3 weeks (p < 0.05). CMAP latency decreased in all groups. The interaction of group and time (5x2) was significant for pain (p < 0.001), the latency of CMAP (p = 0.001) and CMAP amplitude (p = 0.02). The interaction of group and time was not significant for the CMAP conduction velocity, sensory nerve latency and amplitude (p > 0.05). CONCLUSIONS: HILT with a power of 1.6 W and low fluence of 8 J/cm2 was superior in reduction of pain and improvement of the median motor nerve electrophysiological studies compared to LLLT and exercise-only control groups.

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