Extracorporeal Shockwave Therapy in Pillar Pain after Carpal Tunnel Release: A Prospective Randomized Controlled Trial

Shila Haghighat; Abolghasem Zarezadeh; Saeed Khosrawi; Adele Oreizi

doi:10.4103/abr.abr_86_18

Extracorporeal Shockwave Therapy in Pillar Pain after Carpal Tunnel Release: A Prospective Randomized Controlled Trial

Adv Biomed Res. 2019 Apr 30:8:31. doi: 10.4103/abr.abr_86_18. eCollection 2019.

Authors

Shila Haghighat¹, Abolghasem Zarezadeh², Saeed Khosrawi¹, Adele Oreizi¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Orthopedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: The aim of this study was to evaluate the effect of extracorporeal shockwave therapy (ESWT) on pillar pain after carpal tunnel release.

Materials and methods: In this prospective randomized controlled trial, forty patients with pillar pain for at least 1 month after carpal tunnel release surgery were randomly assigned in two groups. ESWT group received four sessions of ESWT at weekly intervals, and patients in the control group received sham ESWT treatment at the same intervals, involved sound but no energy. At baseline, 1^st month, and 3^rd month, hand function (using Brief-Michigan Hand Outcome Questionnaire) and pain score were assessed and compared between groups.

Results: At baseline, pain score and hand function score were similar in both groups. After 1^st month, pain score in ESWT and control groups was 3.7 versus 4.7, respectively (P = 0.066), and hand function score was 60.7 versus 52.2, respectively (P = 0.032). After 3 months, pain score in ESWT group was significantly lower than the control group (1.6 versus 3.6, respectively, P < 0.0001), hand function score in ESWT group was significantly better than the control group (75.4 vs. 63.7, respectively, P < 0.0001). Trend of decrease in pain score between groups was significantly different, but trend of increase in hand function score was not significantly different.

Conclusion: After ESWT, hand function and pain score in patients with pillar pain improved faster compared to control patients. Hence, ESWT can be used as a safe and effective noninvasive technique in patients with pillar pain after carpal tunnel release.

Keywords: Brief-Michigan Hand Outcome Questionnaire; carpal tunnel release; carpal tunnel syndrome; extracorporeal shock wave therapy; pillar pain.