Ultrasound-Guided Pulsed Radiofrequency for Carpal Tunnel Syndrome: A Single-Blinded Randomized Controlled Study

Ho, C.L.; Sun, Chia-Hung; Lee, Jiunn‐Tay; Li, Tsung-Ying; Shih, Feng-Mei; Wu, Yung-Tsan

doi:10.1371/journal.pone.0129918

Cited by 31 publications

(50 citation statements)

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“…The median nerve was identified at the pisiform level of the proximal carpal tunnel, with the palm facing upwards, by one physician using musculoskeletal ultrasonography (Neurotherm NT1000, Neurotherm Inc., USA)112324. rESWT was delivered with the Physio Shock Wave Therapy system (Pagani Elettronica, Milano, Italy)11.…”

Section: Methodsmentioning

confidence: 99%

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The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial

Chou

et al. 2016

Sci Rep

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Recently, extracorporeal shock wave therapy (ESWT) has been shown to be a novel therapy for carpal tunnel syndrome (CTS). However, previous studies did not examine the diverse effects of different-session ESWT for different-grades CTS. Thus, we conducted a randomized, single-blind, placebo-controlled study. Sixty-nine patients (90 wrists) with mild to moderate CTS were randomized into 3 groups. Group A and C patients received one session of radial ESWT (rESWT) and sham eESWT per week for 3 consecutive weeks, respectively; Group B patients received a single session of rESWT. The night splint was also used in all patients. The primary outcome was Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) points, whereas secondary outcomes included the sensory nerve conduction velocity and cross-sectional area of the median nerve. Evaluations were performed at 4, 10, and 14 weeks after the first session of rESWT. Compared to the control group, the three-session rESWT group demonstrated significant BCTQ point reductions at least 14 weeks, and the effect was much longer lasting in patients with moderate CTS than mild CTS. In contrast, the effect of single-session rESWT showed insignificant comparison. rESWT is a valuable strategy for treating CTS and multiple-session rESWT has a clinically cumulative effect.

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Section: Methodsmentioning

confidence: 99%

“…The CSA was measured using electronic calipers and calculated three times, and the mean value was used for statistical analysis. The CSA has been reported to have high sensitivity (89%) and specificity (83%) for the diagnosis of CTS112324.…”

Section: Methodsmentioning

confidence: 99%

The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial

Chou

et al. 2016

Sci Rep

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“… Boston Carpal Tunnel Syndrome Questionnaire (BCTQ): The BCTQ is the most commonly used questionnaire in clinical studies for evaluating the symptom severity and functional status of patients with CTS . The symptom severity subscale has 11 questions scored from one point (mildest) to five points (most severe), whereas the functional status subscale has eight questions scored from one point (no difficulty with activity) to five points (cannot perform the activity at all). Cross‐sectional area (CSA): The CSA of the median nerve was measured at the proximal inlet of the carpal tunnel (level with the pisiform bone) by the same physician . Patients held their wrists in the neutral position with their palms facing upwards and fingers in a semi‐extended position.…”

Section: Methodsmentioning

confidence: 99%

Effect of radial shock wave therapy for carpal tunnel syndrome: A prospective randomized, double‐blind, placebo‐controlled trial

Chou

et al. 2015

Journal Orthopaedic Research

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Three recent studies demonstrated the positive effect of extracorporeal shock wave therapy (ESWT) for treating carpal tunnel syndrome (CTS). However, none have entirely proved the effects of ESWT on CTS because all studies had a small sample size and lacked a placebo-controlled design. Moreover, radial ESWT (rESWT) has not been used to treat CTS. We conducted a prospective randomized, controlled, double-blinded study to assess the effect of rESWT for treating CTS. Thirty-four enrolled patients (40 wrists) were randomized into intervention and control groups (20 wrists in each). Participants in the intervention group underwent three sessions of rESWT with nightly splinting, whereas those in the control group underwent sham rESWT with nightly splinting. The primary outcome was visual analog scale (VAS), whereas the secondary outcomes included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), cross-sectional area (CSA) of the median nerve, sensory nerve conduction velocity of the median nerve, and finger pinch strength. Evaluations were performed before treatment and at 1, 4, 8, and 12 weeks after the third rESWT session. A significantly greater improvement in the VAS, BCTQ scores, and CSA of the median nerve was noted in the intervention group throughout the study as compared to the control group (except for BCTQ severity at week 12 and CSA at weeks 1 and 4) (p < 0.05). This is the first study to assess rESWT in a randomized placebo-controlled trial and demonstrate that rESWT is a safe and effective method for relieving pain and disability in patients with CTS. Keywords: extracorporeal shock waves; carpal tunnel syndrome Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy involving the compression of the median nerve in the carpal tunnel. The average prevalence of CTS in the entire population is 3-4%, and it is predominantly observed in females (7% female and 1% male). 1 CTS is characterized by numbness, tingling, pain, or a burning sensation of at least two of the three digits supplied by the median nerve, although thenar muscle atrophy can also occur in the later stages. 2The risk factors for CTS include repetitive wrist stress, obesity, and pregnancy, whereas secondary causes include lesions within the carpal tunnel, metabolic causes, and infection.2 Unlike other progressive diseases, CTS is characterized by remission and recurrence; hence, its prognosis is often uncertain. Although there are many conservative forms of management, such as wrist splint, steroid injections, and therapeutic ultrasound, their effectiveness is typically insignificant or short-lived.3 Moreover, Gerritsen et al. 4 revealed a failure rate of 69% for wrist splinting in patients with CTS after a 12-month follow-up period. Moreover, 60-70% of conservatively treated patients with CTS remained symptomatic after 18 months. Extracorporeal shock waves (ESWs) are defined as a sequence of acoustic pulses characterized by a high peak pressure (100 MPa), fast pressure increase (<10 ns), short duration (...

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“…Protect motor fibers! Also, pulsed RF are reported in the literature that it can be used in treatment of Morton's neuroma [13], coccygodynia [14], pudendal neuralgia [75], vaginismus [76], carpal tunnel syndrome [77], chronic hip pain [78], post herniorrhaphy pain [79], chronic inguinal neuralgia [80], plantar heel pain [81], osteoarthritis [82], intra-articular pain [83], plantar fascitis pain [84], tarsal tunnel syndrome [85], myofascial pain syndrome [86], postamputation phantom pain [87], meralgia paresthetica [88], lingual neuralgia [89] and chronic testicular pain [90].…”

Section: Applications Of Radiofrequency Treatment a Radiofrequency Fmentioning

confidence: 99%

Application of Radiofrequency in Pain Management

Deniz¹,

Bakal²,

İnangil³

2016

Pain Management

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The application of radiofrequency is a treatment for many clinical conditions such as trigeminal neuralgia, complex regional pain syndrome, chronic postsurgical pain, cancer pain, hyperhidrosis and facet joint pain requiring ablation of different nerve locations. In this procedure, a constant high-frequency, high-temperature electrical current is applied to target tissue. Sluijter has achieved significant pain relief using radiofrequency current at a temperature below 42°C that produced strong electromagnetic field with no thermal lesion and referred as pulsed radiofrequency. The use of pulsed radiofrequency is a nonneurodestructive and therefore less painful technique, and it serves as an alternative method to continuous radiofrequency. Many studies have demonstrated favorable outcomes with pulsed radiofrequency compared to continuous radiofrequency.This chapter suggests the use of continuous and pulsed radiofrequency with a minimally invasive procedure for patients with chronic pain as an alternative to surgical treatment and it might be an additional option among nonsurgical treatment methods.

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Ultrasound-Guided Pulsed Radiofrequency for Carpal Tunnel Syndrome: A Single-Blinded Randomized Controlled Study

Cited by 31 publications

References 28 publications

The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial

The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial

Effect of radial shock wave therapy for carpal tunnel syndrome: A prospective randomized, double‐blind, placebo‐controlled trial

Application of Radiofrequency in Pain Management

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