Extracorporeal shock wave therapy and ultrasound therapy improve pain and function in patients with carpal tunnel syndrome. A randomized controlled trial

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25 patients (42 wrists) with mild or moderate carpal tunnel syndrome were randomized to receive one of three conservative therapies: ultrasound (US), cryo-ultrasound (cryo-US), or extracorporeal shock wave therapy (ESWT). The purpose of the study was to evaluate the efficacy of treatments in terms of carpal tunnel symptom relief, and determine if ESWT was more effective than the comparative treatments. ESWT resulted in significantly greater improvements to part 1 of the Levine-Boston questionnaire (for symptom severity) compared to US and cryo-US, but no difference in a VAS for pain, a VAS for parasthesia, or part 2 of the Levine-Boston questionnaire (for functional status) was observed between groups. All treatments were found to benefit Levine-Boston scores up to 3 months after treatment completion and benefit a VAS for parasthesia up to 4 weeks after treatment completion, but none of the therapies significantly affected VAS pain scores at any point.