Comparison of the Therapeutic Efficacy of Extracorporeal Shock Wave Therapy Versus Corticosteroid Iontophoresis in Carpal Tunnel Syndrome: A Prospective Randomized Study

Abstract

To compare the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) and corticosteroid iontophoresis (CI) in patients with carpal tunnel syndrome (CTS). Material and Methods: This randomized prospective study included a total of 72 wrists diagnosed with CTS of 54 patients with a mean age of 42.2±8.7 years (range, 22-59 years). The patients were randomly separated into two groups. Group 1 (n=37) received r-ESWT, and Group 2 (n=35) received CI. Evaluations were made at baseline and at 0, 1 and 3 months after treatment using the visual analog scale (VAS), Boston Symptom Severity Scale (BSSS), Boston Functional Capacity Scale (BFCS), grip strength, and electrophysiological examination. Results: Compared to baseline, the VAS, BSSS, BFCS, grip strength values at the 0, 1 and 3 months after treatment improved significantly in both groups (all p<0.001). However the nerve conduction study results were significantly improved only in r-ESWT group (all p<0.001). When the change levels were compared between the groups, the decrease in VAS (all p<0.001), the improvement in BSSS (p=0.029, p=0.023 and p=0.040, respectively), BFCS (p<0.001, p=0.001 and p<0.001, respectively), grip strength (all p<0.001), sensory nerve conduction velocity (p=0.001, p<0.001 and p<0.001, respectively) and distal motor latency (p=0.001, p=0.001 and p<0.001, respectively) before and at 0, 1 and 3 months after treatment were significantly higher in the r-ESWT group than the CI group. Conclusion: This study revealed that both methods were useful in alleviating pain and improving function in CTS, however r-ESWT seems to be more effective than CI.

Carpal Tunnel Syndrome Resulting From Persistent Median Artery and Bifid Median Nerve: The Critical Role of Ultrasonography

“…The pathophysiology that underlies them is not well understood. Nonetheless, it is stated that nerve edema, decreased blood flow, and congestion of the endoneural and epineural veins play a part [ 1 ]. The patient's medical history, physical examination results, diagnostic testing, and electrophysiological investigations are used to diagnose CTS.…”