Fifty-five patients with symptomatic carpal tunnel syndrome were randomized to receive 3 sessions of extracorporeal shockwave therapy (ESWT) over 3 weeks or a single ultrasound-guided local injection of corticosteroid. The outcomes of interest included pain on a Visual Analog Scale (VAS), the Boston Carpal Tunnel Questionnaire (BCTQ), as well as distal latency and amplitudes of the sensory nerve action potential (SNAP) and compound muscle action potential (CMAP). Follow up was performed 3, 9 and 12 weeks following the completion of treatment. Results showed significantly favourable VAS pain scores and BCTQ scores in the ESWT group compared to the corticosteroid group at 9 and 12 weeks post-treatment. With the exception of SNAP distal latency at 12 weeks, which was significantly in favour of the ESWT group, there were no significant differences between the two groups in SNAP or CMAP distal latency or amplitude outcomes, at all time-points.