Efficacy of Single-Session Focused Extracorporeal Shockwave Therapy in Patients with Moderate-Degree Carpal Tunnel Syndrome Versus Steroid Injection Therapy: A Single-Blind Randomized Controlled Trial

Abstract

Objectives: To compare the efficacy of single-session focused extracorporeal shockwave therapy (fESWT) and steroid injection in moderate-degree carpal tunnel syndrome Study design: A single-blind, randomized controlled trial Setting: Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok, Thailand Subjects: Patients with electrophysiological evidence of moderate degree carpal tunnel syndrome. Methods: Thirty-three patients with a combined total of 36 affected hands were enrolled. The mean age was 56.9 (10.68) years. Among the affected hands, 25 were right hands and 11 were left hands. Equal numbers of the thirty-six affected hands were randomly assigned to the experimental group, which received single-session fESWT with energy flux density ranging from 0.03 to 0.10 mJ/mm², 2,000 shocks per session at a frequency 6-8 Hz and the comparative group which received an injection of 10 milligrams of triamcinolone acetonide in 1 milliliter of solution. Outcomes were assessed using the following questionnaires: 1. Visual Analog Scale (VAS) for pain, 2. VAS for paresthesia, 3. Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) scores, and 4. Total Boston Carpal Tunnel Questionnaire (BCTQ). Scores were recorded both before the interventions and at follow-up weeks 4, 8, and 12. Results: There were no significant differences in demographic characteristics between the groups. After treatment, both groups showed reductions in VAS for pain, VAS for paresthesia, QDASH scores, and total BCTQ scores between baseline and weeks 4 and 12 follow-ups, with no statistically significant differences between the groups. Conclusions: There was no evidence indicating a difference in clinical efficacy between single-session fESWT and steroid injection therapy in patients with moderate-degree carpal tunnel syndrome over a 12-week period. Therefore, noninvasive fESWT could be considered an option to which can avoid possible side effects of steroid injection.