Abstract
BackgroundThis study aimed to evaluate the short-term effect of radial shockwave on the median nerve pathway as a new model method in patients with mild-to-moderate carpal tunnel syndrome.MethodsIn this randomized clinical trial, 60 patients were randomly allocated into three equal groups. The first group received 1500 shocks on the carpal tunnel, the second group received 1500 shocks on the carpal tunnel and median nerve pathways, and the third group was the control group. In all three groups, patients received conventional physiotherapy for ten sessions. In addition, patients in experimental groups received four sessions of radial shockwave. Pain and paresthesia intensity, sensory and motor distal latency were evaluated as primary outcomes. Boston carpal tunnel Questionnaire scores were evaluated as secondary outcomes. Evaluations were performed at baseline, 1 and 4 weeks after the end of the treatment.ResultsPain and paresthesia intensity and Boston questionnaire score significantly decreased in all three groups, but the greater improvement was noted in shockwave groups. Sensory and motor distal latency were only improved in shockwave groups. In terms of clinical and electrophysiological parameters, two groups of shockwaves showed similar results.ConclusionsRadial shockwave combined with conventional physiotherapy is an effective noninvasive treatment for mild-to-moderate carpal tunnel syndrome that produces greater and longer-lasting results than conventional physiotherapy alone. There were no differences observed between utilizing radial shockwave on the carpal tunnel or median nerve pathways on the palmar surface of the hand, in terms of clinical and electrophysiological measurements.Clinical Trial registration number The study was registered at https://fa.irct.ir/user/trial/49490/view (20200706048028N1) in date of 08/24/2021.
Highlights
The compression of the median nerve as it crosses the wrist in the carpal tunnel causes median nerve mononeuropathy, known clinically as carpal tunnel syndrome (CTS) [1]
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The present study revealed that both radial shockwave therapy in combination with conventional physiotherapy (TENS, US, rest splint, and vitamin B1) and conventional physiotherapy alone improved pain visual analog scale (VAS), paresthesia VAS, symptoms severity score (SSS), and functional status score (FSS) in patients with mild-tomoderate carpal tunnel syndrome; radial shockwave could produce greater and longer-lasting results than conventional physiotherapy alone
Summary
The compression of the median nerve as it crosses the wrist in the carpal tunnel causes median nerve mononeuropathy, known clinically as carpal tunnel syndrome (CTS) [1]. According to the American Neuromuscular and Electrodiagnostic Medicine Association, CTS is classified into four categories: mild, moderate, severe, and very severe [5]. Noninvasive interventions such as medication, activity modification, splints, and physiotherapy are preferable to surgery, in mild-to-moderate severity of this syndrome [6]. Extracorporeal shock wave (ESW) therapy, a new therapeutic method for the treatment of mild-to-moderate CTS, has recently attracted more attention [7]. This study aimed to evaluate the short-term effect of radial shockwave on the median nerve pathway as a new model method in patients with mild-to-moderate carpal tunnel syndrome
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