Comparative Efficacy of High-Intensity Laser Therapy and Radial Shock Wave Therapy in the Management of Mild to Moderate Carpal Tunnel Syndrome; a Randomized Clinical Trial Publisher

Summary: Which physical therapy helps carpal tunnel syndrome? A trial found shock waves and laser gave similar relief, but shock waves aided nerve conduction. #CarpalTunnel #Rehabilitation

Vahdatpour B ; Zare H ; Dastanpoor M ; Masomi H ; Haghighat S
Source: Immunopathologia Persa Published:2027

Abstract

Introduction: Carpal tunnel syndrome (CTS), a prevalent form of peripheral entrapment neuropathy, is typically treated conservatively in cases that are mild to moderate. Although wrist splinting is considered a primary treatment option, physical therapies like extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) have demonstrated effectiveness in alleviating pain and enhancing nerve function. Extracorporeal shockwave therapy facilitates axonal regeneration and decreases inflammation through mechanotransduction, while HILT promotes tissue healing through photobiomodulation. Objectives: This study aims to fill that gap by evaluating the effects of radial ESWT and HILT on pain intensity (visual analogue scale, VAS), functional status (Boston Carpal Tunnel Questionnaire, BCTQ), and nerve conduction metrics (distal sensory latency, motor latency, and sensory conduction velocity) over a 12-week follow-up period. Materials and Methods: This research is a randomized, controlled clinical trial. Sixty participants with mild to moderate idiopathic CTS, allocated equally (30 patients in each group) to two intervention groups; HILT and ESWT. All participants received standard care, including nighttime wrist splinting and oral vitamin B1 supplementation. The HILT group underwent five sessions over two weeks using a Fisioline Device (910-1064 nm wavelength, 1168 Hz frequency, and 4 J/cm2 102 energy), while the ESWT group received three sessions of ESWT (1000 shocks at a pressure of 1.5 Bar and a rate of six pulses per second). Assessments of outcomes were conducted at the beginning, as well as at 4 weeks and 12 weeks.Results: Baseline characteristics, including age, body mass index (BMI), symptom duration, and gender distribution, showed no significant differences between groups (P > 0.05). At 4- and 12-week post-intervention, both groups demonstrated significant within-group improvements in BCTQ scores (total, functional, and symptom severity subscales) and VAS pain scores (P < 0.001). Nevertheless, no meaningful differences were found between the groups at either follow-up time. Electrophysiological parameters [distal sensory latency (sensory nerve action potential (SNAP) latency], distal motor latency [compound muscle action potential (CMAP) latency], and sensory nerve conduction velocity (NCV)) remained unchanged across time in both groups. Conclusion: In our study, HILT and ESWT significantly improved pain, symptom severity, and functional status in patients with CTS. While both modalities demonstrated comparable clinical efficacy, ESWT showed greater improvement in sensory nerve conduction latency. Copyright © 2027 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.