Comparison of the Efficacy of Corticosteroid Injection and ESWT in Patients With CTS
Condition: Carpal Tunnel Syndrome; Tenosynovitis
MeSH terms: Tenosynovitis; Carpal Tunnel Syndrome; Syndrome
Study type: Interventional
Phase: Phase 4

Summary: 
      In this study, the investigators aimed to demonstrate the efficacy of ESWT (extracorporeal
      shock wave therapy) and local corticosteroid injection in patients with carpal tunnel
      syndrome(CTS) compared to participants receiving only splint and exercise therapy. And the
      investigators wanted to show that ESWT, a noninvasive treatment modality, is as effective and
      reliable as local corticosteroid injection, which is the least invasive treatment. Mild and
      moderate CTS patients will be determined according to American Association of
      Electrodiagnostic Medicine (AAEM) criteria. 90 idiopathic moderate and mild CTS patients will
      be included in the study. The participants will be informed about their participation in a
      study and written informed consent will be obtained.The demographic characteristics and
      disease duration of the participants will be recorded.The participants will be randomly
      divided into 3 groups.40 mg of local methylprednisolone (depomedrol) injection will be
      applied to Group 1 once.

      And group 1 will also be given a hand wrist rest splint to use for 3 months, especially at
      night, when not using the hand. ESWT will be applied to Group 2 once a week for a total of 3
      weeks and hand wrist rest splints will be given for 3 months especially at night when it is
      not in use. Group 3 (control group) will be given a hand wrist rest splint to use for 3
      months, especially at night, when not using the hand. The evaluations will be repeated before
      treatment, after the first week after treatment (first ESWT application) and at the 3rd
      month. Hand grip strength measurement will be performed using Boston carpal tunnel syndrome
      questionnaire, visual analog scale and dynamometer.

      Electromyogram (EMG) data will be recorded before and 3 months after treatment. During the
      trial, the routine will not be excluded.
    

Detailed description: 
      In this study, the investigators aimed to demonstrate the efficacy of ESWT (extracorporeal
      shock wave therapy) and local corticosteroid injection compared to participants receiving
      only splint and exercise therapy. And the investigators wanted to show that ESWT, a
      noninvasive treatment modality, is as effective and reliable as local corticosteroid
      injection, which is the least invasive treatment. Mild and moderate CTS patients will be
      determined according to American Association of Electrodiagnostic Medicine (AAEM) criteria.
      Cervical radiculopathy, polyneuropathy, brachial plexopathy, systemic corticosteroid
      treatment, fracture and trauma history of the treated side anterior arm and wrist,
      inflammatory rheumatic disease, pregnant and lactating participants, participants with
      cardiac pacemakers, participants undergoing carpal tunnel syndrome surgery, thoracic outlet
      syndrome, severe atrophy, severe carpal tunnel syndrome, participants who are unwilling or
      unable to participate for any reason, and those who have been decided by the clinician that
      the participants is not in favor of the participants, systemic diseases such as renal
      failure, peptic ulcer, dm, hypothyroidism, coagulation disorder will be excluded.90
      idiopathic moderate and mild CTS participants will be included in the study. The participants
      will be informed about their participation in a study and written informed consent will be
      obtained.The demographic characteristics and disease duration of the participants will be
      recorded. The participants will be randomly divided into 3 groups.40 mg of local
      methylprednisolone (depomedrol) injection will be applied to Group 1 once.

      And group 1 will also be given a hand wrist rest splint to use for 3 months, especially at
      night, when not using the hand. ESWT will be applied to Group 2 once a week for a total of 3
      weeks and hand wrist rest splints will be given for 3 months especially at night when it is
      not in use. Group 3 (control group) will be given a hand wrist rest splint to use for 3
      months, especially at night, when not using the hand. The evaluations will be repeated before
      treatment, after the first week after treatment (first ESWT application) and at the 3rd
      month. Hand grip strength measurement will be performed using Boston carpal tunnel syndrome
      questionnaire, visual analog scale and dynamometer. Electromyogram (EMG) data will be
      recorded before and 3 months after treatment. During the trial, the routine will not be
      excluded.
    

Intervention name(s): local injection; extracorporeal shock wave therapy
Intervention type(s): Drug; Device
Intervention description(s): In addition to the local injection, carpal tunnel brace will be given.; In addition to all ESWT participants, carpal tunnel brace will be given.
Other intervention name(s): local corticosteroid injection; physiotheraphy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: extracorporeal shock wave therapy; corticosteroid injection