{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T14:37:22Z","timestamp":1784212642811,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this clinical trial was to compare the outcomes of the application of ultrasound\u2010guided percutaneous nerve stimulation (PENS) targeting the median nerve versus surgery for improving pain and function in women with CTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this randomized parallel\u2010group trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>, NCT04246216), 70 women with CTS were randomly allocated to either PENS (<jats:italic>n<\/jats:italic>\u2009=\u200935) or surgery (<jats:italic>n<\/jats:italic>\u2009=\u200935) group. Hand pain intensity (mean pain and the worst pain experienced) was the primary outcome. Functional status and symptoms severity (Boston Carpal Tunnel Questionnaire, BCTQ) and self\u2010perceived improvement (Global Rating of Change, GROC) were the secondary outcomes. Outcomes were assessed at baseline and 1, 3, 6 and 12\u2009months after each intervention. Analysis was performed with intention to treat with mixed ANCOVAs adjusted for baseline outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analyses showed an adjusted advantage for PENS at 1 (\u0394 \u22122.0, 95% CI \u22122.9 to \u22121.1) and 3 (\u0394 \u22121.4, 95% CI \u22122.3 to \u22120.5) months for mean pain, at 1 (\u0394 \u22122.2, 95% CI \u22123.3 to \u22121.1), 3 (\u0394 \u22121.75, 95% CI \u22122.9 to \u22120.6) and 6 (\u0394 \u22121.7, 95% CI \u22122.8 to \u22120.6) months in the worst pain intensity, and at 1 (\u0394 \u22120.95, 95% CI \u22121.1 to \u22120.8), 3 (\u0394 \u22120.55, 95% CI \u22120.8 to \u22120.3) and 6 (\u0394 \u22120.4, 95% CI \u22120.6 to \u22120.8) months in function. Both groups exhibited similar changes in symptom severity. Both groups reported similar improvement at 12 months in all outcomes. Symptoms and function improved in both groups, with PENS leading to better short\u2010term outcomes than surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This clinical trial confirms that PENS applied with current understanding of pain mechanisms in CTS is as useful as surgery in women with CTS without denervation. The potential placebo effect of both interventions should not be ignored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The application of percutaneous nerve stimulation was more effective at short\u2010term, but similar effective at mid and long\u2010term, than surgery in women with carpal tunnel syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2117","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T08:52:58Z","timestamp":1680079978000},"page":"860-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Ultrasound\u2010guided percutaneous electrical nerve stimulation versus surgery for women with unilateral carpal tunnel syndrome: A randomized parallel\u2010group trial"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3772-9690","authenticated-orcid":false,"given":"C\u00e9sar","family":"Fern\u00e1ndez\u2010de\u2010las\u2010Pe\u00f1as","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos  Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Ortega\u2010Santiago","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos  Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana I.","family":"De\u2010la\u2010Llave\u2010Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos  Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine Tufts University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Pareja","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Quir\u00f3n Pozuelo  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homid","family":"Fahandezh\u2010Saddi\u2010D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Orthopaedic Surgery Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Arias\u2010Bur\u00eda","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos  Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Academy of Orthopaedic Surgeons Work Group Panel. 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