Efficacy of extracorporeal shock wave therapy for pillar pain after open carpal tunnel release: a double-blind, randomized, sham-controlled study

Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 +/- 1.3 and 6.7 +/- 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 +/- 1.1 and 6.1 +/- 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 +/- 0.9 and 5.1 +/- 1.0, respectively. The ESWT group had a MHQ score of 54.4 +/- 7.7 before treatment and 73.3 +/- 6.8 six months after. The control group had a MHQ score of 54.2 +/- 7.1 before treatment and 57.8 +/- 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.