Effectiveness of Manual Therapy and Extracoropral Shock Wave Therapy in Patients With Carpal Tunnel Syndrome

Comparative Study of Effectiveness of Manual Therapy and Extracoropral Shock Wave Therapy in Patients With Carpal Tunnel Syndrome

This study aimed to compare the effectiveness of manual therapy and extracorporeal shock wave therapy in patients with mild to moderate carpal tunnel syndrome.

Study Overview

• Status: Completed
• Conditions: Carpal Tunnel Syndrome; Manual Therapy; Extracoropral Shock Wave Therapy
• Intervention / Treatment: Other: Manual therapy; Other: Extracorporeal shock wave therapy

Detailed Description

Carpal tunnel syndrome (CTS), the most common peripheral neuropathy in the upper limb, occurs due to the entrapment of the median nerve at the wrist. Treatment options for CTS consist of wrist splints, physical modalities, local corticosteroid injections, and surgical release.

Extracorporeal shockwave therapy (ESWT) is a noninvasive technique that uses single-pulse acoustic waves. These pulses are generated outside the body and focused on a specific part of the body.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Tanta University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Both sexes.
• Patients with mild and moderate carpal tunnel syndrome (CTS).

Exclusion Criteria:

• Severe cases of CTS.
• History of carpal tunnel release surgery.
• Steroid injection in carpal tunnel in the past 6 months.
• Cases of thoracic outlet syndrome and cervical radiculopathy.
• Pregnant females.
• Systemic rheumatic diseases such as rheumatoid arthritis.
• Hypothyroidism.
• Patients with bleeding tendency.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group 1; Patients were treated by manual therapy in the form of nerve gliding, soft tissue release, and carpal bone mobilization, three sessions per week for 4weeks.	Other: Manual therapy; Patients were treated by manual therapy in the form of nerve gliding, soft tissue release, and carpal bone mobilization, three sessions per week for 4weeks.
Experimental: Group 2; Patients were treated by extracorporeal shock wave therapy. 4 sessions, one week apart, 2000 pulses per session, intensity 1.6 mj/mm, and frequency 8Hz.	Other: Extracorporeal shock wave therapy; Patients were treated by extracorporeal shock wave therapy. 4 sessions, one week apart, 2000 pulses per session, intensity 1.6 mj/mm, and frequency 8Hz.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual analogue scale	A visual analogue scale (VAS) via 11-point numerical pain rating scale (0=no pain to 10=maximum pain) was used to assess the current level of pain and hand discomfort	3 months post-procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Boston Questionnaire	The Boston Questionnaire is a standardized, patient-based outcome measure of symptom severity and functional status in patients with carpal tunnel syndrome. The questionnaire including two parts, namely the symptom severity scales (SSS) and the functional status scales (FSS), is considered a standard tool to evaluate the patients with carpal tunnel syndrome (CTS). The SSS contains 11 questions on different symptoms of hand and FSS comprises of 5 questions assessing the difficulty in performing selected activities. The response to each question was scored from one (mildest) to five (most severe) points. The overall scores for SSS and FSS were calculated as the score sum of all questions.	3 months post-procedure

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Actual): February 19, 2023
• Primary Completion (Actual): November 1, 2024
• Study Completion (Actual): November 1, 2024

Study Registration Dates

• First Submitted: July 10, 2025
• First Submitted That Met QC Criteria: July 18, 2025
• First Posted (Actual): July 20, 2025

Study Record Updates

• Last Update Posted (Actual): July 20, 2025
• Last Update Submitted That Met QC Criteria: July 18, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Wounds and Injuries; Pathologic Processes; Neuromuscular Diseases; Peripheral Nervous System Diseases; Disease; Median Neuropathy; Mononeuropathies; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Syndrome; Shock; Carpal Tunnel Syndrome
• Other Study ID Numbers: 36208/12/22

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No