Extracorporeal Shock Wave Therapy and Radial Pressure Wave Therapy in Carpal Tunnel Syndrome: A Narrative Review of Clinical Outcomes and Therapeutic Implications

Review Article | Vol 5 | Issue 2 |  July-December 2025 | page: 32-38 | Armando Tonatiuh Ávila García, Karen Chacón Morales, Ana Lilia Villagrana Rodríguez, Daniel Miller Serano, Diego Alberto Rojo Orozco, Diana Hazel Araiza Quintana

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.179

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 05 Aug 2025, Review Date: 18 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Armando Tonatiuh Ávila García [1], Karen Chacón Morales [1], Ana Lilia Villagrana Rodríguez [1], Daniel Miller Serano [1], Diego Alberto Rojo Orozco [1], Diana Hazel Araiza Quintana [1]

[1] Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.

Address of Correspondence
Armando Tonatiuh Ávila García,
Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.
E-mail: atavila@hcg.gob.mx

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and a frequent cause of pain, functional impairment, and reduced quality of life. Although conservative management remains the first-line approach for mild-to-moderate disease, optimal non-invasive treatment strategies continue to be investigated. Extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) have emerged as potential therapeutic alternatives due to their biological effects on nerve regeneration, inflammation, and tissue healing.
Objective: The objective of the study is to synthesize and critically evaluate the current evidence regarding the efficacy and safety of ESWT and RPWT in the management of CTS.
Methods: A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science databases. Studies evaluating the effects of ESWT and RPWT in patients with CTS were included, encompassing randomized controlled trials, observational studies, and systematic reviews. Outcomes of interest included pain intensity, functional status, and electrophysiological parameters.
Results: The available evidence suggests that ESWT and RPWT are associated with significant improvements in pain relief, functional outcomes, and nerve conduction parameters in patients with mild-to-moderate CTS. Both ESWT and RPWT modalities demonstrated clinical benefits, with improvements observed in Visual Analog Scale scores, Boston Carpal Tunnel Questionnaire outcomes, and electrophysiological measures. Across studies, ESWT and RPWT were generally well tolerated, with minimal and transient adverse effects. Comparisons with conventional treatments, including splinting and corticosteroid injection, indicate comparable or superior outcomes for ESWT and RPWT in selected patient populations.
Conclusion: ESWT and RPWT represent promising non-invasive treatment options for CTS, offering meaningful clinical benefits with a favorable safety profile. Although current evidence supports its use in mild-to-moderate disease, further high-quality randomized controlled trials are warranted to establish optimal treatment parameters and long-term efficacy.
Keywords: Carpal Tunnel Syndrome, Extracorporeal Shock Wave Therapy, Radial Pressure Wave Therapy, Median Nerve.`

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