Abstract
BackgroundMany studies have demonstrated the effectiveness of extracorporeal shock wave therapy (ESWT) and local corticosteroid injection (LCI) for the treatment of carpal tunnel syndrome (CTS), and some studies showed that the effect of ESWT was superior to LCI. We performed this meta-analysis to compare the clinical effects across the two therapies.MethodsRelevant randomized controlled trials (RCTs) comparing ESWT and LCI for the treatment of CTS were searched in electronic database. The Cochrane risk bias tool was used for quality assessment. After data extraction and quality assessment of the included studies, a meta-analysis was performed using RevMan 5.3 software. Mean differences (MDs), odds ratios (ORs), and 95% confidence intervals (CIs) were analyzed. The protocol for this systematic review was registered on INPLASY (202080025) and is available in full on the inplasy.com (https://doi.org/10.37766/inplasy2020.8.0025)ResultsA total of 5 RCT studies with 204 patients were included from the electronic database. The meta-analysis results showed that two therapies were not significantly different in terms of visual analog scale (VAS) score (P = 0.65), Boston Carpal Tunnel Questionnaire (BQ) score (P = 0.14), sensory distal latency (P = 0.66), and nerve conduction velocity (NCV) of the sensory nerve (P = 0.06). There were significant differences between the results of motor distal latency (P < 0.0001), compound muscle action potential (CMAP) amplitude (P < 0.00001), and sensory nerve action potential (SNAP) amplitude (P = 0.004).ConclusionsIn terms of pain relief and function improvement, the effects of ESWT and LCI are not significantly different. In terms of electrophysiological parameters, LCI has a stronger effect on shortening motor distal latency; ESWT is superior to LCI in improving action potential amplitude. ESWT is a noninvasive treatment with fewer complications and greater patient safety. In light of the heterogeneity and limitations, these conclusions require further research for definitive conclusions to be drawn.
Highlights
Carpal tunnel syndrome (CTS) is the most common and widely studied nerve entrapment syndrome [1], accounting for approximately 90% of all compressive neuropathies [2]
Inclusion and exclusion criteria All studies included in this meta-analysis met the following criteria: (1) published clinical Randomized controlled trials (RCT); (2) patients with a clear diagnosis of carpal tunnel syndrome (CTS), and the age, gender, and nationality were not limited; and (3) extracorporeal shock wave therapy (ESWT) was used as an intervention measure, and CTS was used as a control measure, and complete comparison data between ESWT and CTS could be obtained
After careful full-text evaluation of these studies according to the inclusion and exclusion criteria, 5 RCT studies [11,12,13,14,15] with 204 patients were included in the final comprehensive analysis
Summary
Carpal tunnel syndrome (CTS) is the most common and widely studied nerve entrapment syndrome [1], accounting for approximately 90% of all compressive neuropathies [2]. Many studies have demonstrated the effectiveness of extracorporeal shock wave therapy (ESWT) and local corticosteroid injection (LCI) for the treatment of carpal tunnel syndrome (CTS), and some studies showed that the effect of ESWT was superior to LCI. We performed this meta-analysis to compare the clinical effects across the two therapies
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