Carpal Tunnel Relief Is Just A Shock Wave Away!


Carpal tunnel syndrome (CTS) is a relatively common disorder suffered by people who use their hands in ways that require repetitive motion throughout the day. Computer work, dentistry, construction, painting and other occupational fields that require repetitive motion, often of the dominant hand, may predispose you to CTS.

Carpal tunnel syndrome is caused by compression of the median nerve in the wrist. Symptoms typically get worse over time. If left untreated, pressure on the median nerve can lead to nerve damage and worsening symptoms.

The Carpal Tunnel

The carpal tunnel is a narrow passageway in the wrist formed by small wrist bones called carpals. The roof of the tunnel is formed by the transverse carpal ligament. The median nerve is one of the main nerves in your hand, originating in your neck, and traveling down your arm and forearm, passing through the carpal tunnel and into your hand. The nerve innervates your thumb, index, middle, and ring fingers, and controls muscles around the base of your thumb.

Nine flexor tendons that bend your fingers and thumb also travel through the carpal tunnel. When the tunnel becomes narrowed or when surrounding synovial tissue becomes inflamed, pressure is exerted on the median nerve, causing pain, numbness, tingling, and weakness in the hand.

CTS Symptoms

Because CTS is an overuse syndrome, symptoms manifest gradually and worsen over time. Symptoms may include:

  • Numbness, pain and tingling in thumb and fingers
  • Transient shock-like sensations in thumb and fingers
  • Pain and tingling that travels up the arm
  • Weakness and clumsiness in the afflicted hand

Nighttime symptoms are common.

Traditional Treatment for CTS

There are several traditional treatment options for CTS, including:

Bracing: A brace or splint, worn during repetitive use activities and at night, keeps your wrist in a neutral position to reduce pressure on the median nerve.

NSAIDs: Over-the-counter pain relievers may help reduce inflammation and ease discomfort for short periods of time.

Activity Change: Discontinuing activities that cause discomfort may lead to complete recovery, but may not be practical if the activity is occupational.

Nerve Gliding Exercises: A physical therapist may prescribe special exercises that help the median nerve to glide more smoothly within the carpal tunnel.

Steroid Injections: Corticosteroids injected into the carpal tunnel can relieve pain and reduce inflammation. However, patients run the risk of structural damage to the median nerve and tendons.

Surgery: Generally used as a last resort, a surgical procedure called a carpal tunnel release relieves pressure on your median nerve by cutting the ligament that forms the roof of the tunnel, increasing the size of the tunnel and decreasing median nerve pressure.

Despite the broad range of traditional treatment options, their efficacy has been shown in many cases to be either insignificant or short-lived.

Extracorporeal Shock Wave Therapy (ESWT)

ESWT is a fairly new and non-invasive technology that uses shockwaves to treat CTS. Shock waves are a sequence of sonic pulses with a high peak pressure, rapid pressure rise, and short duration that are generated outside the body and focused on the carpal tunnel.

A 2013 study by Soek and Kim, published in the American Journal of Physical Medicine and Rehabilitation, set out to investigate the effectiveness of ESWT for the treatment of CTS, and to compare it to that of corticosteroid injections. The study of 36 CTS patients was a randomized controlled trial that compared a single session of ESWT (1000 shots at the maximal tolerable intensity) with one corticosteroid injection.

The study’s authors found ESWT to be as useful as corticosteroid injections for treating CTS, with the added advantage of being non-invasive.


CTS Treatment at NYDNRehab

At NYDNRehab we use a combination of methods to improve the ability of the median nerve to glide within the carpal tunnel and relieve pain. Treatment methods may include:

  • joint mobilization
  • ligament strengthening
  • ESWT (Extracorporeal Shock Wave Therapy)
  • acupuncture
  • myofascial release
  • neurodynamic nerve mobilization technique
  • hydro-dissection of the median nerve under ultrasound guidance

Failure to treat CTS can lead to worsening pain and inflammation, and possible long-term damage to the median nerve. Do not let your CTS go untreated. Contact NYDNRehab today, and begin your journey to full recovery from CTS.

Research in the biological sciences.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
Request Telehealth Request Telehealth Request in office visit Book now