Comparison of Radial Extracorporeal Shock Wave Therapy and Local Corticosteroid Injection Effectiveness in Patients With Carpal Tunnel Syndrome

Abstract

ObjectiveThe aim of the study was to compare the effectiveness of radial extracorporeal shock wave therapy and local corticosteroid injection on pain, function, and nerve conduction studies in the treatment of idiopathic carpal tunnel syndrome.DesignA total of 72 patients who were diagnosed as having carpal tunnel syndrome were included in the study. The radial extracorporeal shock wave therapy group received radial extracorporeal shock wave therapy, the local corticosteroid injection group received local corticosteroid injection, and the control group only used a resting hand splint. The patients were evaluated using a Visual Analog Scale–pain, a Visual Analog Scale–numbness, the Boston Symptom Severity Scale, the Boston Functional Status Scale, and handgrip strength tests before treatment 1 and 12 wks after the treatment.ResultsBoth clinical and nerve conduction study parameters improved with all three groups, and this effect continued at the 12th-week follow-up of the patients. The Visual Analog Scale–pain, Visual Analog Scale–numbness, Boston Symptom Severity Scale, and Boston Functional Status Scale scores in the first week after the treatment, as well as Visual Analog Scale–pain and Boston Functional Status Scale scores in the 12th week after the treatment, were significantly lower in the local corticosteroid injection group compared with the other two groups.ConclusionsOur study revealed the success of radial extracorporeal shock wave therapy, splint, and local corticosteroid injection, but symptom relief was greater in the first week and 12th week with local corticosteroid injection.

Effects of Extracorporeal Shock Wave Therapy in Patients with Mild-to-Moderate Carpal Tunnel Syndrome: An Updated Systematic Review with Meta-Analysis

“…Three studies assessing the effect of ESWT after carpal tunnel release were excluded. Finally, 19 RCTs [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] were included in this study (Figure 1). Table 1 shows the detailed characteristics of the included studies.…”

“…Figure 2 summarizes the risk of bias in the eligible studies. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. "+": low risk, "−" : high risk, "?…”

“…Nevertheless, the quality of the evidence was reduced to low due to the possibility of bias, inconsistent outcomes, and imprecision (Table 3). [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. "+": low risk, "−": high risk, "?…”

Synergistic effect of LCI with ESWT on treating patients with mild to moderate CTS: a randomized controlled trial

“…Based on the findings here, patients in both groups had almost similar result in the early stages of follow-up concerning VAS and GSS criteria, while in the final stages, the second group showed better results. In another study [ 24 , 32 ] the comparison with night splint plus local corticosteroid injection and ESWT showed a better symptom relief at 12 weeks with local corticosteroids. Although different performance criteria are applied in this study, the results correspond to that of the available studies.…”

Research progress in extracorporeal shock wave therapy for upper limb spasticity after stroke

“…The occurrence of limb spasticity after stroke is not only related to the high excitability of motor neurons, but also related to the innervation and nerve conduction of muscles. Extracorporeal shock waves can produce nerve block at free nerve endings, neuromuscular junctions and other parts, thus regulating the conduction of nerves ( 64 , 65 ). Ohtofi et al used shock waves to act on rats, and all epidermal sensory nerve fibers degenerated within 1 week, and epidermal nerves regenerated after 2 weeks ( 66 ).…”