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Randomized Controlled Trial
. 2021 Jun;133(11-12):568-577.
doi: 10.1007/s00508-020-01785-9. Epub 2020 Dec 22.

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome : A randomized, placebo-controlled pilot study

Christina Gesslbauer  1 , Michael Mickel  1 , Othmar Schuhfried  1 , Dominikus Huber  1 , Mohammad Keilani  1 , Richard Crevenna  2
Affiliations
Randomized Controlled Trial

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome : A randomized, placebo-controlled pilot study

Christina Gesslbauer et al. Wien Klin Wochenschr. 2021 Jun.

Abstract

Background: The carpal tunnel syndrome is the most common entrapment neuropathy in the general population. A conservative treatment should be considered in mild to moderate cases. The aim of this study was to assess the effect of a focused extracorporeal shock wave therapy in the treatment of mild to moderate carpal tunnel syndrome.

Material and methods: In this study 30 patients were randomly assigned into 2 groups. Subjects in the study group received three sessions of focused extracorporeal shock wave therapy, whereas the control group underwent a sham therapy. Patients were evaluated 3 and 12 weeks after treatment. The primary outcome was the visual analogue scale score. Secondary outcome measurements included hand grip strength, Boston Carpal Tunnel Syndrome Questionnaire, SF-36 Health Survey and electrodiagnostic measurements.

Results: A significant improvement of visual analogue scale at week 3 (p = 0.018) and week 12 (p = 0.007) as well as hand grip strength at week 12 (p = 0.019) could be observed in the study group. The study group showed a significantly better sensory nerve conduction velocity at week 12 than the control group, before correcting for multiple testing, and also a significant improvement in distal motor latency of the median nerve at week 12 (p = 0.009) as well as in both questionnaires (SF-36 subscale bodily pain, p = 0.020 and severity symptom scale, p = 0.003). No such improvement was observed in the control group.

Conclusion: Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

Keywords: Conservative management; Median neuropathy; Night splint; Pain management; Treatment outcome.

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Conflict of interest statement

C. Gesslbauer, M. Mickel, O. Schuhfried, D. Huber, M. Keilani, and R. Crevenna certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Figures

Fig. 1
Fig. 1
Application of focused extracorporeal shock wave therapy
Fig. 2
Fig. 2
Confidence intervals for difference in pain (cell means) between baseline (T0) vs. posttreatment (T1) (bottom) and baseline vs. 3‑month follow-up (T2) (top). There is a significant improvement in pain only in the verum group. Despite a visible trend in T2 vs. T0, no difference could be detected between the two treatment groups (columns)
Fig. 3
Fig. 3
Differences in hand grip strength at T0 vs. T1 and T0 vs. T2 in both fESWT and control group showed a tendency of improvement
Fig. 4
Fig. 4
Differences in Boston carpal tunnel syndrome questionnaire (symptom severity scale) at T0 vs. T1 and T0 vs. T2 showed a significant short-term improvement in the fESWT group
See this image and copyright information in PMC

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