• Chih-Ya Chang, Liang-Cheng Chen, Yu-Ching Chou, Tsung-Ying Li, Tsung-Yen Ho, and Yung-Tsan Wu.
• Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
• Pain Med. 2020 Aug 1; 21 (8): 1668-1675.

ObjectivesTo evaluate the combination effect of platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT) for moderate carpal tunnel syndrome (CTS), compared with PRP alone.DesignA randomized, double-blinded, placebo-controlled trial.SettingA single medical center in Taiwan.PatientsPatients diagnosed with moderate CTS.InterventionsAll subjects were administered one dose of ultrasound-guided PRP injection at baseline. After two weeks, one session of rESWT was completed in the intervention group, whereas the control group received one session of sham rESWT. Evaluations were performed at baseline and one, three, and six months post-PRP injection.Outcome MeasuresThe Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was measured as the primary outcome. Electrophysiological study and cross-sectional area (CSA) of the median nerve were used as secondary outcomes.ResultsAll 40 enrolled subjects (male/female: 4/36) completed the study, resulting in an analysis of 32 wrists per group (total: N = 64 wrists). Compared with the control group, the intervention group did not show statistically significantly superior outcomes, except in BCTQs at one month (mean change ± SE = -11.47 ± 1.18 vs -7.06 ± 1.26, P = 0.013) and distal motor latency at three months (mean change ± SE = -0.59 ± 0.09 vs -0.30 ± 0.09, P = 0.031).ConclusionsCombined PRP and one-session rESWT was not superior to PRP alone in treating moderate CTS. Further studies with multiple sessions of ESWT and longer follow-up periods are needed to verify the clinical efficacy of ESWT.© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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