Efficacy of Focused Shockwave Therapy in Patients with Moderate-to-severe Carpal Tunnel Syndrome: a Preliminary Study

Objective: To evaluate the efficacy of focused extracorporeal shockwave therapy for symptoms and function in patients with moderate-to-severe carpal tunnel syndrome.

Design: A single-blind randomized controlled trial.

Subjects: Twenty-four outpatients with moderate-to-severe carpal tunnel syndrome.

Methods: Patients were randomly allocated into 2 groups: a focused extracorporeal shockwave therapy group and a control group. The focused extracorporeal shockwave therapy group received conservative treatment in addition to focused extracorporeal shockwave therapy with an energy flux density ranging from 0.01 to 0.15 mJ/mm2, a frequency of 4-5 Hz, and 1500 pulses per session once a week for a total of 3 sessions. The control group received only conservative treatment, which comprised gliding exercises for carpal tunnel syndrome, a night wrist splint, and lifestyle modification. The Thai version of the Boston Carpal Tunnel Questionnaire (T-BCTQ), a nerve conduction study, and ultrasonography of the median nerve cross-sectional area were performed before treatment and at 3 and 6 weeks after baseline.

Results: The T-BCTQ symptom and function scores had significantly decreased in both groups, favouring focused extracorporeal shockwave therapy at all time-points. In addition, distal sensory and motor latency were significantly different between the groups at 3 weeks from baseline.

Conclusion: Focused extracorporeal shockwave therapy plus conservative treatment effectively provided short-term improvement in symptoms, hand function, and nerve conduction in patients with moderate-to-severe carpal tunnel syndrome compared with conservative treatment alone.