Comparison of Extracorporeal Radial Shock Wave Different Doses On Carpal Tunnel Syndrome: A Preliminary Study

Abstract

BackgroundCarpal tunnel syndrome (CTS) represents the most common focal neuropathy in the upper limb. It occurs due to compression of the median nerve in the carpal tunnel. Various doses of radial extracorporeal shock wave therapy (rESWT) were used in previous studies; however, there is still controversy about the most effective dose of rESWT for treating CTS.ObjectivesTo compare and investigate the effectiveness of different doses of rESWT on the severity of symptoms, function and median nerve conduction velocity in patients with mild-to-moderate CTS.MethodsEighty-three participants (99 affected wrists) were assigned to three groups. Group A received 1000 shocks, Group B received 2000 shocks, and Group C received 1500 shocks. All participants received four sessions of rESWT, once a week over four weeks, in addition to conventional physical therapy. The Boston Carpal Tunnel Questionnaire (BCTQ) was used to investigate the severity of symptoms and functional level. The median nerve sensory conduction velocity and distal motor latency were measured. ANOVA was used for comparison between groups. Statistical significance was set at P < 0.05.ResultsAll groups showed significant improvements (p < 0.001). Group (C) showed the maximal improvement in symptom severity (p < 0.001) and functional level (p < 0.001), as well as the median nerve sensory conduction velocity (p < 0.001) and distal motor latency (p < 0.001).ConclusionThe combination of rESWT (1500 shocks) with the conventional physical therapy effectively reduces symptoms, improves function, nerve conduction velocity and distal motor latency as well in patients with mild-to-moderate CTS.