Pulsed US Versus SWD in Carpal Tunnel Syndrome

April 28, 2026 updated by: MD.Bilgehan Kolutek Ay, Kahramanmaras Sutcu Imam University

Pulsed Ultrasound Versus Pulsed Shortwave Diathermy in Mild-to-Moderate Carpal Tunnel Syndrome: A Randomized Controlled Trial

The goal of this clinical trial is to compare two physical therapy treatments in people with mild-to-moderate carpal tunnel syndrome (CTS). CTS is a condition that causes pain, numbness, and weakness in the hand.

The main question this study aims to answer is:

Does pulsed ultrasound or pulsed shortwave diathermy lead to greater improvement in symptoms and nerve swelling when added to standard treatment?

All participants will receive standard conservative treatment, including a wrist splint and nerve and tendon gliding exercises for three weeks. In addition, participants will be randomly assigned to receive one of the following treatments:

Pulsed therapeutic ultrasound (US) Pulsed shortwave diathermy (SWD) Researchers will measure changes in hand symptoms, pain levels, grip strength, and the size of the median nerve using ultrasound imaging. Assessments will be performed before treatment, and at 1 month and 3 months after treatment.

The primary outcome of the study is the change in median nerve cross-sectional area at 3 months.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity and is characterized by pain, numbness, and hand weakness. Conservative treatment is recommended as first-line therapy in patients with mild-to-moderate CTS and commonly includes wrist splinting and nerve and tendon gliding exercises. Physical therapy modalities are frequently added to improve clinical outcomes.

This randomized, assessor-blinded, parallel-group clinical trial was conducted between March 2025 and Sep 2025. Forty participants with electrophysiologically confirmed mild-to-moderate CTS were randomly assigned to one of two intervention groups. All participants received standard conservative treatment consisting of neutral-position wrist splinting and tendon-nerve gliding exercises for three weeks.

In addition to standard treatment, one group received pulsed therapeutic ultrasound (US) and the other group received pulsed shortwave diathermy (SWD), administered in 15 sessions over three weeks.

Outcome measures were assessed at baseline, 1 month, and 3 months. The primary outcome was the change in median nerve cross-sectional area measured by ultrasonography at 3 months. Secondary outcomes included symptom severity and functional status assessed by the Boston Carpal Tunnel Questionnaire (BCTQ), pain intensity measured by the Visual Analog Scale (VAS), neuropathic pain assessed using the DN4 questionnaire, and hand grip strength measured with a dynamometer.

The study was designed to compare the clinical and structural effects of pulsed US and pulsed SWD when added to standard conservative treatment in mild-to-moderate CTS.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Kahramanmaraş, Turkey (Türkiye)
        • Kahramanmaraş Sütçü İmam University
      • Kahramanmaraş, Turkey (Türkiye), 46000
        • Kahramanmaraş Sütçü İmam University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age between 18 and 65 years
  • Symptom duration of at least 4 weeks
  • Diagnosis of mild-to-moderate carpal tunnel syndrome confirmed by electromyography

Exclusion Criteria:

  • Cervical radiculopathy
  • Brachial plexopathy
  • Thoracic outlet syndrome
  • Previous carpal tunnel surgery
  • Severe carpal tunnel syndrome
  • Pregnancy
  • Malignancy
  • Coagulation disorders
  • Cardiac pacemaker
  • Physical therapy for carpal tunnel syndrome within the previous 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Ultrasound Therapy Group
Participants in this group received pulsed therapeutic ultrasound in addition to standard conservative treatment, including wrist splinting and tendon-nerve gliding exercises for three weeks.
Device: Pulsed Therapeutic Ultrasound
Pulsed therapeutic ultrasound was applied to the volar aspect of the wrist using a frequency of 3 MHz, an intensity of 0.8 W/cm², and a pulse ratio of 1:4 for 5 minutes per session. A total of 15 treatment sessions were administered over three weeks.
Active Comparator: Short Wave Diathermy Group
Participants in this group received pulsed shortwave diathermy in addition to standard conservative treatment, including wrist splinting and tendon-nerve gliding exercises for three weeks.
Device: Pulsed Shortwave Diathermy
Pulsed shortwave diathermy was applied with electrodes positioned parallel to the volar and dorsal aspects of the wrist, centered at the distal palmar crease. Treatment was delivered in pulsed mode at a frequency of 80 Hz and a mean output power of 19.2 W for 15 minutes per session. A total of 15 sessions were administered over three weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Median Nerve Cross-Sectional Area (MNCSA)
Time Frame: Baseline and 3 months
Change in ultrasonographically measured median nerve cross-sectional area (mm²) from baseline to 3 months after treatment.
Baseline and 3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Boston Carpal Tunnel Questionnaire Score
Time Frame: Baseline, 1 month, and 3 months
Change in Boston Carpal Tunnel Questionnaire total score (including Symptom Severity and Functional Status subscales) from baseline to 1 month and 3 months after treatment. Higher scores indicate worse symptom severity and functional impairment.
Baseline, 1 month, and 3 months
Change in Pain Intensity (VAS)
Time Frame: Baseline, 1 month, and 3 months
Change in pain intensity measured by a 10-cm VAS, where 0 indicates no pain and 10 indicates worst imaginable pain, from baseline to 1 month and 3 months.
Baseline, 1 month, and 3 months
Change in Neuropathic Pain Score (DN4)
Time Frame: Baseline, 1 month, and 3 months
Change in neuropathic pain severity measured by the DN4 questionnaire (0-10 scale), from baseline to 1 month and 3 months. Higher scores indicate greater neuropathic pain severity.
Baseline, 1 month, and 3 months
Change in Grip Strength
Time Frame: Baseline, 1 month, and 3 months
Change in hand grip strength measured using a hydraulic hand dynamometer (kg), from baseline to 1 month and 3 months.
Baseline, 1 month, and 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kahramanmaras Sutcu Imam University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 11, 2025

Primary Completion (Actual)

August 15, 2025

Study Completion (Actual)

September 15, 2025

Study Registration Dates

First Submitted

April 16, 2026

First Submitted That Met QC Criteria

April 16, 2026

First Posted (Actual)

April 22, 2026

Study Record Updates

Last Update Posted (Actual)

May 4, 2026

Last Update Submitted That Met QC Criteria

April 28, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BKA-2025-1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to institutional data protection policies and privacy considerations.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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