International Journal of Physiotherapy and Research

Welcome to International Journal of Physiotherapy and Research



Type of Article : Original Research

Year: 2015 | Volume 3 | Issue 2 | Page No. 938-946

Date of Publication: 11-04-2015

DOI: 10.16965/ijpr.2015.111


Hesham Galal Mahran *1, Ashraf Hassan Mohammed 2, Shimaa Nabil Aboelazm 3.  

*1,2 Faculty of Physical Therapy, Cairo University, Egypt.
3 Faculty of Physical Therapy, Misr University for Science and Technology, Egypt.

Corresponding author: Hesham Galal Mahran, Physical Therapy Department for Surgery, Faculty of Physical Therapy, Cairo University, Egypt.


Background: Carpal tunnel syndrome is considered the most common compression neuropathy of the upper extremity. It may lead to work disability and functional impairment. Burns are associated with swelling and eschar which forms a tight band constricting the circulation distally.
Purpose: To investigate the effect of shockwave therapy on the carpal tunnel syndrome post burn.
Subjects: Thirty male and female patients selected with manifestation of carpal tunnel syndrome post burn evaluated by electromyography, patients were divided randomly into two equal groups (A & B); group (A) received shockwave therapy plus traditional physical therapy, while group (B) received only traditional physical therapy. Traditional physiotherapy was applied for both groups, 20 min for session 3times per week for 12 weeks.
Evaluation: Electro diagnostic evaluation was done before treatment, one and three months post treatment.
Results: There were improvement and significant increase in motor and sensory conduction velocities in shockwave group compared to those in the control group (p<0.05), also there were improvement and significant decrease in motor and sensory latencies in shockwave group compared to those in control group (p<0.05).
Conclusion: Extracorporeal shockwave therapy provided a non-invasive, satisfied treatment option for carpal tunnel syndrome post burn.
KEY WORDS: Shockwave therapy, Carpal tunnel Syndrome, Post Burn.



  1. Main, E.K.Goetz, J.E.Baer, T.E.Klocke, N.F.Brown, T.D. Volar/dorsal compressive mechanical behavior of the transverse carpal ligament", Journal of Biomechanics 2012;45:1180–1185.
  2. NINDS, National Institute of Neurological Disorder & Stroke, Carpal Tunnel Syndrome Fact Sheet. 2007.
  3. Emecheta, I. E., K. Azzawi, R. Kettle, and M. I. James. Bilateral carpal tunnel syndrome in wrist burn: A case report.  Burns 2005; 31: 388-9.
  4. Rosenberg D.B.  Neurologic sequelae of minor electric burns. Arch. Phys. Med. Rehabil., 1989; 70: 914-5.
  5. Vemula, Muralikrishna, Francois Berthiaume, Arul Jayaraman, and Martin L. Yarmush. Expression profiling analysis of the metabolic and inflammatory changes following burn injury in rats. Physiol. Genomics 2004; 18: 87-98.
  6. Viera A.J. Management of carpal tunnel syndrome.  Am. Fam. Physician 2003; 68: 265-72.
  7. O'Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003;(1):CD003219.
  8. Fatemah G.The effectiveness of extracorporeal shock wave therapy and wrist splint versus wrist splint for management of carpal tunnel syndrome.Iranania Registry of Clinical trial 2014;102:234-245.
  9. Wang FS, Wang CJ, Huang HJ, Chung H, Chen RF, Yang KD. Physical shock wave mediates membrane hyperpolarization and Ras activation for osteogenesis in human bone marrow stromal cells. Biochem Biophys Res Commun.2001;287:648–65.
  10. Marquez S.  Turley J.J., Peters W.J. Neuropathy in burn patients. Brain 1993; 116(Pt 2):471–483.
  11. Drost, Adriana C., David G. Burleson, William G. Cioffi Jr, Bryan S. Jordan, Arthur D. Mason Jr, and Basil A. Pruitt Jr. Plasma cytokines following thermal injury and their relationship with patient mortality, burn size, and time postburn. J Trauma. 1993;35(3):335–339.
  12. J.L. Ferguson, I. Hikawyj-Yevich and H.I. Miller. Body fluid compartment changes during burn shock in the guinea pig, Circ Shock. 1980;7(4):457–466.
  13. M.C. Kiernan, R.J. Walters, K.V. Andersen, D. Taube, N.M. Murray and H. Bostock, Nerve excitability changes in chronic renal failure indicate membrane depolarization due to hyperkalaemia, Brain 2002;125 (Pt 6):1366–1378.
  14. H. Higashimori, R.C. Carlsen and T.P. Whetzel, Early excision of a full-thickness burn prevents peripheral nerve conduction deficits in mice, Plast Reconstr Surg. 2006;117(1):152–164.
  15. Brddley WG. Disorders of peripheral nerve. 2004; Black Well. Oxford.
  16. Thuile CH and Walzl AS. Evaluation of Electromagnetic Fields in the Treatment of Pain in Patients with Lumbar Radiculopathy or the Whiplash Syndrome. Neuro-rehabilitation 2002;17:63 – 67.
  17. Sunderland SH. Nerves and nerve injuries. 1998;  Edinburgh: Churchill Livingstone.
  18. Svernlov BS, Larsson MB and Rehn KL. Conservative treatment of the cubital tunnel syndrome. J Hand Surg. Eur., 2009;34(2):201-7.
  19. Fan KW, Zhu ZX, Den ZY. An experimental model of an electrical injury to the peripheral nerve, Burns  2005;31(6):731–736.
  20. Higashimori H, Whetzel TP, Mahmood T, Carlsen RC. Peripheral axon caliber and conduction velocity are decreased after burn injury in mice. Muscle Nerve 2005;31(5):610-20.
  21. Wilson M, Stacy J. Shock wave therapy for Achilles tendinopathy. Curr Rev Musculoskelet Med. 2010;26;4(1):6-10.
  22. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012; 20:7-11.
  23. Romeo P, D'Agostino C, Lazzerini A, Sansone VC. Extracorporeal shock wave therapy in pillar pain after carpal tunnel release: a preliminary study. Ultrasound Med Biol. 2011;37(10):1603-8.
  24. Gündüz, Rukiye, Fevziye Ünsal Malas, Pınar Borman, Seher Kocaoğlu, and Levent Özçakar. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis: Clinical and ultrasonographical comparison. Clin. Rheumatol. 2012; 31(5):807-12.
  25. Othman AMA, and Ragab EM. Endoscopicplantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2010;130:1343–1347.
  26. Seok H, Kim SH. The Effectiveness of Extracorporeal Shock Wave Therapy vs. Local Steroid Injection for Management of Carpal Tunnel Syndrome: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2012;92(4):327-34.
  27. Bolt DM, Burba DJ, Hubert JD, Strain GM, Hosgood GL, Henk WG, Cho DY. Determination of functional and morphologic changes in palmar digital nerves after non focused extracorporeal shock wave treatment in horses. Am J Vet Res. 2004; 65:1714–1718.
  28. Mariotto, Sofia, Alessandra C. de Prati, Elisabetta Cavalieri, Ernesto Amelio, Ernst Marlinghaus, and Hisanori Suzuki. Extracorporeal shock waves: From lithotripsy to anti-inflammatory action by NO production. Nitric Oxide. 2005;12:89–96.
  29. Wilson M., and Stacy J. Shock wave therapy for Achilles tendinopathy. Curr Rev Musculoskelet Med. 2010;26;4(1):6-10.
  30. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J OrthopSurg Res. 2012;20:7-11.
  31. Craig K. and Miller A. Extracorporeal Shockwave Therapy (ESWT), an option for chronic tendinopathy management: a clinical perspective. New Zealand Pain Society Publication. 2011; 8–16.


Hesham Galal Mahran, Ashraf Hassan Mohammed, Shimaa Nabil Aboelazm. EXTRACORPOREAL SHOCKWAVE THERAPY FOR POST BURN CARPAL TUNNEL SYNDROME. Int J Physiother Res 2015;3(2):938-946. DOI: 10.16965/ijpr.2015.111




Volume 1 (2013)

Volume 2 (2014)

Volume 3 (2015)

Submit Manuscript