Terapia con ondas de choque extracorpóreas como alternativa no quirúrgica para el síndrome de túnel del carpo
DOI:
https://doi.org/10.28957/rcmfr.v30n8Palabras clave:
Síndrome de túnel del carpo, Terapia con ondas de choque extracorpóreas, Neuropatía del medianoResumen
Recientemente se han postulado las ondas de choque extracorpóreas como tratamiento para el síndrome de túnel del carpo, el cual ha demostrado ser eficaz, no invasivo y con pocos efectos adversos. Mujer de 49 años con síndrome de túnel del carpo bilateral moderado de tres años de evolución, sin mejoría con el tratamiento convencional y con criterios para manejo quirúrgico. Sin embargo, ante la negativa de la paciente se propone manejo conservador con una sesión de ondas de choque extracorpóreas radiales con 5.000 descargas, a 4 Bar de intensidad y frecuencia de 15 Hz. Seis meses después de la intervención se documenta recuperación en los parámetros neurofisiológicos a nivel bilateral, pero clínica y funcionalmente solo hubo mejoría completa en la mano izquierda, registrando empeoramiento en la mano derecha; por tal razón se realizó liberación quirúrgica con buenos resultados. En la actualidad la paciente se encuentra asintomática en ambas manos. El tratamiento con ondas de choque radiales se constituye en una alternativa efectiva para el manejo conservador del síndrome de túnel del carpo leve a moderado. Los pacientes presentan buena tolerancia, garantizando la adherencia a la intervención.
Referencias bibliográficas
Pourmemari M-H, Heliövaara M, Viikari-Juntura E, Shiri R. Carpal tunnel release: Lifetime prevalence, annual incidence, and risk factors. Muscle Nerve. 2018;58(4):497–502. Disponible en: https://doi.org/10.1002/mus.26145
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273–1284. Disponible en: https://doi.org/10.1016/s1474-4422(16)30231-9
Ortiz F, Díaz JA, Delgado ON. Electrodiagnóstico del síndrome de túnel del carpo. En: Ortiz F, Rincón M, Mendoza JC., editores. Texto de Medicina Física y Rehabilitación. Bogotá (Colombia): Manual Moderno; 2017. p. 65–72. Disponible en: https://store.manualmoderno.com/catalog/product/view/id/1155/s/texto-de-medicina-fasica-y-rehabilitacia-n-9789588993034-9789588993041/
Ashworth NL. Carpal Tunnel Syndrome. Am Fam Physician. 2016;94(10):830–831. PMID: 27929273. Disponible en: https://www.aafp.org/afp/2016/1115/p830.html
Daniell WE, Fulton-Kehoe D, Franklin GM. Work-related carpal tunnel syndrome in Washing-ton State workers’ compensation: utilization of surgery and the duration of lost work. Am J Ind Med. 2009;52(12):931–942. Disponible en: https://doi.org/10.1002/ajim.20765
Jerosch-Herold C, Houghton J, Blake J, Shaikh A, Wilson EC, Shepstone L. Association of psychological distress, quality of life and costs with carpal tunnel syndrome severity: a cross-sectional analysis of the PALMS cohort. BMJ Open. 2017;7(11):e017732. Disponible en: http://dx.doi.org/10.1136/bmjopen-2017-017732
Stapleton MJ. Occupation and carpal tunnel syndrome. ANZ J Surg. 2006;76(6):494–496. Disponible en: https://doi.org/10.1111/j.1445-2197.2006.03770.x
Mosier BA, Hughes TB. Recurrent Car pal Tunnel Syndrome [Internet]. Hand Clinics. 2013;29(3):427–434. Disponible en: http://dx.doi.org/10.1016/j.hcl.2013.04.011
Franklin GM, Evanoff B. Treatment of Carpal Tunnel Syndrome: Surgery or More Conservative Management? [Internet]. Muscle Nerve. 2019;60:12-13 Disponible en: http://dx.doi.org/10.1002/mus.26502
Kim JC, Jung SH, Lee S-U, Lee SY. Effect of extracorporeal shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine. 2019;98(33):e16870. Disponible en: https://doi.org/10.1097/md.0000000000016870
Romeo P, d’Agostino MC, Lazzerini A, Sansone VC. Extracorporeal shock wave therapy in pillar pain after carpal tunnel release: a preliminary study. Ultrasound Med Biol. 2011;37(10):1603–1608. Disponible en: https://doi.org/10.1016/j.ultrasmedbio.2011.07.002
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. 2013;92(4):327– 34. Disponible en: https://doi.org/10.1097/phm.0b013e31826edc7b
Atthakomol P, Manosroi W, Phanphaisarn A, Phrompaet S, Iammatavee S, Tongprasert S. Comparison of single-dose radial extracorporeal shock wave and local corticosteroid injection for treatment of carpal tunnel syndrome including mid-term efficacy: a prospective randomized controlled trial. BMC Musculoskelet Disord. 2018;19(1):32. Disponible en: https://doi.org/10.1186/s12891-018-1948-3
The International Society for Medical Shockwave Treatment. Introduction and prerequisites and minimal standards of performing ESWT. ISMST [Internet]. 2017 Aug 8 [citado 2020 julio 13]. Disponible en: https://www.shockwavetherapy.org/about-eswt/indications/
Hausner T, Nógrádi A. The use of shock waves in peripheral nerve regeneration: new perspectives? Int Rev Neurobiol. 2013;109:85–98. Disponible en: https://doi.org/10.1016/b978-0-12-420045-6.00003-1
Rempel D, Evanoff B, Amadio PC, de Krom M, Franklin G, Franzblau A, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health. 1998;88(10):1447–1451. Disponible en: https://doi.org/10.2105/ajph.88.10.1447
Giannini F, Cioni R, Mondelli M, Padua R, Gregori B, D’Amico P, et al. A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment [Internet]. Clin Neurophysiol. 2002;113:71–77. Disponible en: http://dx.doi.org/10.1016/s1388-2457(01)00704-0
Rosales RS, Delgado EB, de la Lastra-Bosch ID. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: Cross-cultural adaptation process and reliability [Internet]. J Hand Surg. 2002;27(2):334–343. Disponible en: http://dx.doi.org/10.1053/jhsu.2002.30059
American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement [Internet]. Muscle Nerve. 2002;25:918–922. Disponible en: http://dx.doi.org/10.1002/mus.10185
Sucher BM. Grading severity of carpal tunnel syndrome in electrodiagnostic reports: why grading is recommended. Muscle Nerve. 2013;48(3):331–333. Disponible en: https://doi.org/10.1002/mus.23824
Paoloni M, Tavernese E, Cacchio A, D’orazi V, Ioppolo F, Fini M, et al. Extracorporeal shock wave therapy and ultrasound therapy improve pain and function in patients with carpal tunnel syndrome. A randomized controlled trial. Eur J Phys Rehabil Med. 2015;51(5):521–528. PMID: 25697763. Disponible en: https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2015N05A0521
Xie Y, Zhang C, Liang B, Wang J, Wang L, Wan T, et al. Effects of shock wave therapy in patients with carpal tunnel syndrome: a systematic review and meta-analysis. Disabil Rehabil. 2020;18;1–12. Disponible en: https://doi.org/10.1080/09638288.2020.1762769
Lohrer H, Nauck T, Dorn-Lange NV, Schöll J, Vester JC. Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures. Foot Ankle Int. 2010;31(1):1–9. Disponible en: https://doi.org/10.3113/fai.2010.0001
Ke M-J, Chen L-C, Chou Y-C, Li T-Y, Chu H-Y, Tsai C-K, et al. The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial. Sci Rep. 2016;6:38344. Disponible en: https://doi.org/10.1038/srep38344
Raissi GR, Ghazaei F, Forogh B, Madani SP, Daghaghzadeh A, Ahadi T. The Effectiveness of Radial Extracorporeal Shock Waves for Treatment of Carpal Tunnel Syndrome: A Randomized Clinical Trial. Ultrasound Med Biol. 2017;43(2):453–460. Disponible en: https://doi.org/10.1016/j.ultrasmedbio.2016.08.022
Demonceau J, Ruppar T, Kristanto P, Hughes DA, Fargher E, Kardas P, et al. Identification and assessment of adherence-enhancing interventions in studies assessing medication adherence through electronically compiled drug dosing histories: a systematic literature review and meta-analysis. Drugs. 2013;73(6):545–562. Disponible en: https://doi.org/10.1007/s40265-013-0041-3
Atroshi I, Flondell M, Hofer M, Ranstam J. Methylprednisolone injections for the carpal tunnel syndrome : a randomized, placebo-controlled trial. Ann Intern Med. 2013;159(5):309–317. Disponible en: https://doi.org/10.7326/0003-4819-159-5-201309030-00004
Cartwright MS, White DL, Demar S, Wiesler ER, Sarlikiotis T, Chloros GD, et al. Median ner ve changes following steroid injection for car pal tunnel syndrome. Muscle Ner ve. 2011;44(1):25–29. Disponible en:https://doi.org/10.1002/mus.22067
Carlson H, Colbert A, Frydl J, Arnall E, Elliot M, Carlson N. Current options for nonsurgical management of carpal tunnel syndrome. Int J Clin Rheumtol. 2010;51:129–142. Disponible en: https://doi.org/10.2217/ijr.09.63
Mariotto S, Cavalieri E, Amelio E, Ciampa AR, De Prati AC, Marlinghaus E, et al. Extracorporeal shock waves: from lithotripsy to anti-inf lammatory action by NO production. Nitric Oxide. 2005;12(2):89–96. Disponible en: https://doi.org/10.1016/j.niox.2004.12.005
Park G-Y, Kwon DR, Lee SC. Timing of extracorporeal shock wave therapy in rabbits with carpal tunnel syndrome. J Tissue Eng Regen Med. 2019;13(6):1071–1078. Disponible en: https://doi.org/10.1002/term.2862
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