Extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome: a m
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(2020) 15:556
SYSTEMATIC REVIEW
Open Access
Extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome: a meta-analysis Wenhao Li1,2†, Chunke Dong1,2†, Hongyu Wei2, Zhencheng Xiong3, Liubo Zhang1,2, Jun Zhou1,2, Yanlei Wang1,2, Jipeng Song2,4 and Mingsheng Tan2*
Abstract Background: Many studies have demonstrated the effectiveness of extracorporeal shock wave therapy (ESWT) and local corticosteroid injection (LCI) for the treatment of carpal tunnel syndrome (CTS), and some studies showed that the effect of ESWT was superior to LCI. We performed this meta-analysis to compare the clinical effects across the two therapies. Methods: Relevant randomized controlled trials (RCTs) comparing ESWT and LCI for the treatment of CTS were searched in electronic database. The Cochrane risk bias tool was used for quality assessment. After data extraction and quality assessment of the included studies, a meta-analysis was performed using RevMan 5.3 software. Mean differences (MDs), odds ratios (ORs), and 95% confidence intervals (CIs) were analyzed. The protocol for this systematic review was registered on INPLASY (202080025) and is available in full on the inplasy.com (https://doi. org/10.37766/inplasy2020.8.0025) Results: A total of 5 RCT studies with 204 patients were included from the electronic database. The meta-analysis results showed that two therapies were not significantly different in terms of visual analog scale (VAS) score (P = 0.65), Boston Carpal Tunnel Questionnaire (BQ) score (P = 0.14), sensory distal latency (P = 0.66), and nerve conduction velocity (NCV) of the sensory nerve (P = 0.06). There were significant differences between the results of motor distal latency (P < 0.0001), compound muscle action potential (CMAP) amplitude (P < 0.00001), and sensory nerve action potential (SNAP) amplitude (P = 0.004). Conclusions: In terms of pain relief and function improvement, the effects of ESWT and LCI are not significantly different. In terms of electrophysiological parameters, LCI has a stronger effect on shortening motor distal latency; ESWT is superior to LCI in improving action potential amplitude. ESWT is a noninvasive treatment with fewer complications and greater patient safety. In light of the heterogeneity and limitations, these conclusions require further research for definitive conclusions to be drawn. Keywords: Carpal tunnel syndrome, Extracorporeal shock wave, Local corticosteroid injection, Meta-analysis * Correspondence: [email protected] † Wenhao Li and Chunke Dong contributed equally to this study and should be considered co-first authors. 2 Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate
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