Effect Of Shock Waves Therapy On Post Natal De Quarvain Tenosynovitis

This randomized controlled trial aims to investigate the effect of extracorporeal shock wave therapy (ESWT) on pain, wrist and thumb range of motion, and upper limb function in postpartum women with De Quervain's tenosynovitis.

Study Overview

• Status: Not yet recruiting
• Conditions: De Quervain Tenosynovitis
• Intervention / Treatment: Device: Shock Wave Therapy; Other: Therapeutic Exercises

Detailed Description

De Quervain's tenosynovitis is a musculoskeletal condition affecting the abductor pollicis longus and extensor pollicis brevis tendons within the first dorsal compartment of the wrist. It is associated with pain, tenderness, restricted thumb and wrist movement, and difficulty performing daily activities. Postpartum women may be particularly affected because of repetitive wrist and thumb movements associated with infant care.

Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment modality being investigated for its potential effects on pain reduction and functional recovery in musculoskeletal disorders.

This study is designed as a prospective randomized controlled trial involving 40 postpartum women diagnosed with De Quervain's tenosynovitis. Participants will be randomly allocated into two equal groups of 20 women each.

The study group will receive extracorporeal shock wave therapy combined with a therapeutic exercise program consisting of tendon gliding, stretching, and strengthening exercises.

The control group will receive the same therapeutic exercise program without shock wave therapy.

Outcome assessments will be conducted before and after the treatment period. Pain intensity will be evaluated using the Visual Analogue Scale (VAS), wrist and thumb range of motion will be measured using a goniometer, and upper limb function will be assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

The study will compare changes within and between the two groups to evaluate the additional effect of shock wave therapy on pain, range of motion, and upper limb function in postpartum women with De Quervain's tenosynovitis.

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

Contacts and Locations

• Study Contact: Name: Mai Kamel Anwar, B.Sc; Phone Number: 01001813906; Email: Maikamel905@gmail.com
• Study Contact Backup: Name: Elham Shahat Hassan, PhD

Study Locations

• Egypt
  • Giza, Egypt
    • Kasr El Ainy University Hospital
    • Contact: Mai Kamel Anwar, B.Sc; Phone Number: 01001813906; Email: Maikamel905@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 35 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

1. Women in the postpartum period of > 6 months following labor
2. Age: Between 25 and 35 years old.
3. Body mass index: Between 25-30 kg / m2
4. Diagnosis: Clinically diagnosed with De Quervain tenosynovitis by an orthopedic specialist or confirmed through clinical evaluation.
5. Pain Severity: Presenting with moderate to severe pain (≥ 4 on the Visual Analogue Scale).
6. Obstetric History: Multipara women (Cesarean section or normal labor)
7. Stage of Condition Chronic stage: symptoms > 6 weeks

Exclusion Criteria:

1. Previous Surgery: History of surgical intervention on the affected wrist or thumb.
2. Skin Conditions: Open wounds, infections, or dermatological diseases at the application site that may interfere with shockwave therapy.
3. Pregnancy: Pregnant or lactating women.
4. Medication Use: Currently taking systemic corticosteroids, anticoagulants, or nonsteroidal anti-inflammatory drugs (NSAIDs) that may influence study outcomes.
5. Pacemaker or Metal Implants: Presence of a cardiac pacemaker or metal implants near the treatment area.
6. Other Physiotherapy: Receiving concurrent physiotherapy treatment for the same condition during the study period.
7. Non-compliance: Inability or unwillingness to attend treatment sessions or follow instructions throughout the study duration.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Shock Wave Therapy + Therapeutic Exercises; Twenty postpartum women with De Quervain's tenosynovitis will receive extracorporeal shock wave therapy (ESWT) in addition to a therapeutic exercise program consisting of tendon gliding, stretching, and strengthening exercises. The exercise program will be performed for 30 minutes daily over four weeks.	Device: Shock Wave Therapy; Extracorporeal shock wave therapy will be applied to the affected first dorsal compartment of the wrist using a radial shock wave device. Treatment parameters will include 1,000 impulses per session, with frequencies ranging from 18 to 21 Hz and pressure settings ranging from 1.4 to 1.8 bar, according to the study protocol.; Other Names: Extracorporeal Shock Wave Therapy (ESWT); Other: Therapeutic Exercises; A structured therapeutic exercise program consisting of tendon gliding, stretching, active range-of-motion exercises, and progressive strengthening exercises targeting the wrist and thumb. Exercises will be performed for 30 minutes daily over four weeks, according to participants' tolerance.
Active Comparator: Therapeutic Exercises; Twenty postpartum women with De Quervain's tenosynovitis will receive a therapeutic exercise program consisting of tendon gliding, stretching, and strengthening exercises for 30 minutes daily over four weeks, without shock wave therapy.	Other: Therapeutic Exercises; A structured therapeutic exercise program consisting of tendon gliding, stretching, active range-of-motion exercises, and progressive strengthening exercises targeting the wrist and thumb. Exercises will be performed for 30 minutes daily over four weeks, according to participants' tolerance.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity Measured by Visual Analogue Scale (VAS)	Pain intensity will be measured using a 10-cm Visual Analogue Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate less pain. Changes in pain intensity will be compared between the study and control groups.	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Wrist Flexion Range of Motion	Change in active wrist flexion range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Wrist Extension Range of Motion	Change in active wrist extension range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Wrist Radial Deviation Range of Motion	Change in active wrist radial deviation range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Wrist Ulnar Deviation Range of Motion	Change in active wrist ulnar deviation range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Thumb Flexion Range of Motion	Change in active thumb flexion range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Thumb Extension Range of Motion	Change in active thumb extension range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Thumb Abduction Range of Motion	Change in active thumb abduction range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Thumb Adduction Range of Motion	Change in active thumb adduction range of motion, measured in degrees using a universal goniometer. The change will be calculated as the post-treatment measurement minus the baseline measurement.	4 weeks
Upper Limb Disability Measured by DASH Questionnaire	Upper limb function and disability will be assessed using the 30-item Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The total score ranges from 0 (no disability) to 100 (maximum disability). Lower scores indicate better upper limb function.	4 weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Hala Mohamed Hanafy, PhD, Professor, Cairo University; Study Director: Sameh Hussien Samir, PhD, Professor, National Research Centre; Study Director: Elham Shahat Hassan, PhD, Ass. Professor, Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): November 20, 2026
• Primary Completion (Estimated): January 20, 2027
• Study Completion (Estimated): January 31, 2027

Study Registration Dates

• First Submitted: November 7, 2026
• First Submitted That Met QC Criteria: November 7, 2026
• First Posted (Actual): November 13, 2026

Study Record Updates

• Last Update Posted (Actual): November 13, 2026
• Last Update Submitted That Met QC Criteria: November 7, 2026
• Last Verified: November 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Muscular Diseases; Tendinopathy; Tendon Entrapment; De Quervain Disease; Therapeutics; Physical Therapy Modalities; Patient Care; Rehabilitation; Aftercare; Continuity of Patient Care; Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Extracorporeal Shockwave Therapy; Exercise Therapy
• Other Study ID Numbers: P.T.REC/012/006319

Drug and device information, study documents

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