Investigation of the efficiency of extracorporeal shock wave therapy at different pressures in the treatment of carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy resulting from compression of the median nerve at the wrist level. The treatment of mild and moderate CTS is conservative, and the treatment of severe CTS is surgery. Extracorporeal Shock Wave Therapy (ESWT), which has been used in the treatment of musculoskeletal diseases in recent years, has come to the fore as a new treatment method in CTS. ESWT is a new treatment method based on the principle of focusing high amplitude sound waves on the desired area of the body and providing treatment there. In the literature, different pressure parameters were used in studies examining the effectiveness of ESWT in the treatment of CTS. Although ESWT has been shown to have a curative effect on CTS, there is no consensus on which pressure parameter is more effective. Therefore, in this study, the effectiveness of ESWT applied at different pressure parameters in the treatment of CTS was examined. In this study, 40 patients with CTS, aged between 18-65, who applied to Kırşehir Ahi Evran University Training and Research Hospital, were included. As an outcome measure; pain assessment, joint range of motion assessment, hand grip strength measurement, pinch strength assessment, Boston Carpal Tunnel Syndrome assessment and electromyography used. Both groups were undergone therapy for 3 days a week for a total of 3 weeks and applied 10 min paraffin, 20 min TENS, 10 repetitions of tendon gliding exercises. In addition, ESWT was applied once a week to both groups (one group at 4 bar and the other at 1.5 bar pressure).The measurements were made before the treatment, after the treatment and at the 12th week after the post-treatment week. According to the findings in our study, it was observed that ESWT reduced CTS symptoms both at low pressure and at high pressure in patients with mild and moderate Carpal Tunnel Syndrome. In the intergroup comparison, a significant effect was found in favor of 1.5 bar only in Range Of Motion (ROM) flexion parameter, and 4 bar in favor of CTS severity, Electromyography (EMG) sensory parameters and Visual Analog Skala (VAS) night parameters.