Evaluation du traitement conservateur par ondes de choc radiales pour le syndrome du canal carpien. Etude pilote randomisée contrôlée en double aveugle

Introduction: Few effective therapeutic solutions currently exist for carpal tunnel syndrome (CTS) even though this pathology is common, with potential complications. Radial shock waves (RCW) could provide a new non-invasive and safe therapeutic option. We investigated the effectiveness of radial shock waves for mild to moderate CTS. Method: Fifteen patients (24 SCC) with mild to moderate SCC, confirmed by ENMG, entered a randomized controlled study from September 2022 to June 2023 at Brugmann Hospital. The patients were randomized between an experimental group (15 SCCs) who received OCR, and a control group (9 SCCs) who received sham shock waves. These 2 groups were compared prospectively on the basis of pain using the VAS, symptoms and function using the BCTSQ, and ENMG parameters. The clinical evaluation was done 4-6 weeks after the first OCR session. ENMG parameters were assessed between 1 and 3 months of treatment. The patients and the examiner were blinded to the group they belonged to. All had to wear a night splint for a period of 3 months. Results: Pain using the VAS and the “symptoms severity scale” of the BCTSQ significantly improved in the experimental group after treatment. No significant improvement was found in the control group for clinical variables. Only the average conduction velocity significantly improved in the experimental group compared to the placebo group. Conclusion: OCRs appear to improve pain and symptoms in mild to moderate CTS. Further studies are needed to confirm their effectiveness. The search for predictive factors of response to OCEC must be studied.