Methods and materials
paresthesia, thenar muscle weakness, CTS, infection, dysesthesia, Rheumatoid, Tinel, trauma
SYSTEMIC DISEASE, SCAR, PARESTHESIA, MOTOR NEUROPATHY, INFECTION
This is a prospective clinical trial run from February to August 2020 on 47 patient within the 30 to 60 age range with paresthesia, dysesthesia, and thenar muscle weakness, in Akhtar Hospital (Tehran), who tested positive for Phalen and Tinel test. The tests’ outcomes are confirmed by neurophysiological tests (EMG-NCV) for mild to moderate CTS.Severity of CTS is as follows: normal (grade 0); very mild (grade 1), CTS demonstrable only with most sensitive tests; mild (grade 2), sensory nerve conduction velocity slow on finger/wrist measurement, normal terminal motor latency; moderate (grade 3), sensory potential preserved with motor slowing, distal motor latency to abductor pollicis brevis (APB) < 6.5 ms; severe (grade 4), sensory potentials absent but motor response preserved, distal motor latency to APB < 6. 5 ms; very severe (grade 5), terminal latency to APB > 6.5 ms; extremely severe (grade 6), sensory and motor potentials effectively unrecordable (surface motor potential from APB < 0.2 mV amplitude)[The exclusion criteria consist of diagnosis of sensory and/or motor neuropathy other than CTS, previous wrist trauma, surgery for CTS, treatment with ultrasound, ESWT, or local corticosteroid injection, pregnancy, infection at the treatment site, scar burn, and systemic diseases (Rheumatoid arthritis-lupus erythema-scleroderma).The study protocol is subject to the Institutional Review Board and the Ethics Committee of Shahid Beheshti University of Medical Sciences regulations, which are explained to the participants[IR.SBMU.RETECH.REC.1399.1150]. Applying night splints and other oral medications is prohibited during the course, and all patients sign an informed consent. The subjects are labeled and randomly assigned through a random assignment sequence generated by the software to group 1 (sham -ESWT) and group 2(ESWT).