Effect of extracorporeal shock wave therapy on different severities of carpal tunnel syndrome

Abstract

Background Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome worldwide. Objective The current work aimed at determining the effect of extracorporeal shock wave therapy (ESWT) on different severities of carpal tunnel syndrome. Subjects and methods Sixty patients with unilateral carpal tunnel syndrome were participated in this study. They were divided into three equal groups according to severity (mild, moderate, and severe). All patients received shock wave therapy one session per week, for 6 weeks. Nerve conduction studies (NCs) were done for the median nerve. Pinch dynamometer was used to measure the degree of lateral pinch power, and Visual Analogue Scale (VAS) was used to assess degree of pain and Ultrasonography analysis measured cross-sectional area (CSA) of median nerve for all patients at the beginning and at the end of the study. Results There was significant improvement (P < 0.05) in sensory conduction parameters, CSA, lateral pinch power, and VAS after shock wave therapy in all groups. Also, there was significant improvement in motor latency, motor, and sensory amplitudes after shock wave therapy in mild and moderate groups only (P < 0.05). In all group samples, results revealed a highly significant correlations (p < 0.001) between peak sensory latency (PSL) with VAS, CSA with motor latency (ML), CSA with PSL, CSA with VAS, CSA with lateral pinch, and ML with lateral pinch. Conclusion It is recommended to use ESWT as a conservative treatment in patients with different severities of CTS, except patients with severe motor affection. Trial registration PACTR201804003293116. Registered on 26 April 2018 as retrospective registration in the pan African clinical trial registry (www.pactr.org).

Effectiveness of ultrasound and median nerve gliding with and without shock-wave therapy in patients with moderate carpal tunnel syndrome

“…ESWT involves vascular endothelial growth factor result in decreasing of local inflammation and release of pressure on the median nerve. Likewise ESWT leads to anti-inflammatory effects through reduction of the levels of calcitonin gene-related peptide and effects on inflammation of the soft tissues around the median nerve 22) . Median nerve gliding exercises leads to widening the carpal tunnel and stretching the transverse carpal ligament, and with therapeutic US leads to reduction of pain, and strength and function improving.…”

“…Shock-way (The Novin, 90 G (Isfehan, Iran) device) was regularly calibrated with probe positioned between the thenar and hypothenar eminences (position of elbow in 90 degrees of flexion and forearm supination) twice a week for two weeks. Shock wave therapy consisting of 900 shocks, 4 bar, 3 to 5 minutes, and 15 Hz 16,22) . Ultrasound (210/ NOVIN/Iran: probe 1 MHz, 1w/cm 2 , pulse width 1 ms (1:4)) with wrist in semi-flexion was applied for five min during five days a week, for two weeks.…”

Medical Rehabilitation Management of Carpal Tunnel Syndrome

“…Pada studi systematic review dan meta-analisis menunjukkan bahwa SWT memperbaiki gejala, fungsi, dan parameter elektrofisiologi penderita CTS (32). SWT direkomendasikan sebagai terapi CTS dengan derajat ringan, sedang maupun berat kecuali terdapat gangguan motorik (33). Gesslbauer dkk.…”

The Impact of Neurodynamic Mobilization and Transcutaneous Electrical Nerve Stimulation on Pain Intensity in Cigarette Company Workers at Risk of Carpal Tunnel Syndrome

“…One of the diseases classified as RSI that can affect cigarette workers is CTS (Carpal Tunnel Syndrome) [1,2]. CTS (Carpal Tunnel Syndrome) is a neuromuscular disease caused by compression or pressure in the median nerve in the carpal tunnel of the wrist that can cause numbness, tingling, paresthesia and nocturnal pain [3]. The prevalence of CTS in the general population is estimated at 1-5%, while in the working population by 5-21% [4].…”