Comparison between two deffirent treatments on carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is defined as an entrapment of the median nerve in the carpal tunnel in the wrist, generally associated with an increase in carpal tunnel pressure. It is the most common peripheral neuropathy in the upper quadrant. CTS is characterized by pain and paresthesia in the distributions of the median nerve, including the palmar side of the first finger, the second and third finger and the radial half of the fourth finger; it also involves a loss of sensitivity, manual dexterity and functionality. High amplitude acoustic waves which focus on a region of the body are mentioned as extracorporeal shock wave therapy (ESWT). The shock waves are characterized by high positive pressure up to 100 Megapascals (MPa), fast peak duration (10 to 30 nano-sec), and short pulse duration (5 microsec). This study was conducted at Al-Najaf teaching hospital. 40 patients (male=9 and female=31) range of their ages (21-60) years with CTS voluntarily participated in the study. Participants were selected from orthopedic and rheumatology clinics in Al-Najaf teaching hospital and randomly divided into two groups, in each group 20 person. Visual analogue scale (VAS), disability of arm, shoulder and hand score (DASH), figure-of-eight shape for hand oedema, Boston carpal tunnel questionnaire (BCTQ), wrist joint range of motion in 4 directions (ROM) and hand grip strength (JAMAR) are used as outcome measurements. A group were treated with ESWT for five sessions (single session per week) and B group were had oral medical treatment (pregabalin, nerubion NISIDs), the follow up has been made after two weeks of interventions. In statistical analysis, there was a highly significant improvement in A group of: DASHS, FSS of BCTQ, SSS of BCTQ, VAS and JAMAR P= 0.001. There were no significant differences in ROM and figure-of-eight shape for hand oedema. In this study we aimed to assess the pain, functional status, symptoms and hand grip strength, we found that there is an improvement in patients whom treated with ESWT more than patients whom took pharmacotherapy.