Tkachenko S. S., Rodinskii O. H., Portniaha M. M.

THE EFFECT OF ULTRASONIC WAVE THERAPY ON THE PERIPHERAL NERVE IN THE TREATMENT OF CARPAL TUNNEL SYNDROME

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Tkachenko S. S., Rodinskii O. H., Portniaha M. M.

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LITERATURE REVIEWS

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Scientific article

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Due to the prevalence of tunnel syndromes in the structure of the entire pathology of the peripheral nervous system and the lack of unambiguous data on the effectiveness of shock wave therapy in their treatment, the topic of the effect of ultrasound waves on the nerve remains relevant. The aim is analysis of data over the past 5 years on physiological changes in the peripheral nerve under the influence of ultrasound waves and the effectiveness of the use of shock wave therapy in the treatment of carpal tunnel syndrome. The use of extracorporeal shock wave therapy (ESWT) in clinical practice is based on the biological effect of ultrasound, caused by mechanotransduction with the launch of sequential biochemical processes that promote tissue regeneration and healing. SWT modulates nerve conduction in nerve fibers both directly and through changes in microcirculation, that is manifested in an increase in the speed of nerve impulse conduction mainly in sensory nerve fibers. Low-intensity low-frequency ul trasound stimulates the production of neurotrophic factors, improves angiogenesis and remyelination. When using low-frequency ultrasound, suppression of evoked muscle potentials was observed along with histologically detected structural damage of the peripheral nerve. There are a number of studies that prove the positive effect of the use of ultrasound waves in the treatment of CTS. Focal application of ESWT demonstrates improvement in distal motor and sensory latency, and the use of radial SWT increases the bioelectric activity of mainly sensory fibers. Ultrasound therapy, in general, causes a positive effect, acting on several pathogenetic links at once, reducing the intensity of the pain syndrome and modulating the conductivity of peripheral nerves.

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1. Rekalov DG, Holovach IY, Daniuk IO, Ryndina NH. Tunelni syndromy verkhnikh kintsivok u praktyci revmatoloha: yak vybratysya z tune lyu? Ukr. Rheumatol. J. 2025;101(3):23-29. DOI: 10.32471/rheumatology.2707-6970. 19996. [in Ukrainian].
2. Rekalov DG, Holovach IY. Neiropatii pid tyskom: pohliad na tunelni syndromy. Ukrainian Med J. 2025;8(174):3-7. DOI: 10.32471/umj. 1680-3051.272147. [in Ukrainian].
3. Gebrye T, Jeans E, Yeowell G, Mbada C, Fatoye F. Global and regional prevalence of carpal tunnel syndrome: a meta-analysis based on a systematic review. Musculoskelet Care. 2024;22(4):e70024. DOI: 10.1002/msc.70024.
4. Volosovets AO. Suchasnyi pidkhid do korektsii nevrolohichnoho defitsytu vnaslidok karpalnoho tunelnoho syndromu. Zdorovya Ukrayiny. 2024;2:18-19. Dostupno: https://health-ua.com/neurology/zaxvoriuvannia-perifericnix-nerviv/77911-suchasnij-pdhd-dokorektc nevrologchnogo-deftcitu-vnasldok-karpalnogo-tuneln. [in Ukrainian].
5. Tezen Ö, Bilir EE, Arslan HB, Adıgüzel E, Yaşar E. Investigation of the effectiveness of extracorporeal shock wave therapy in patients diagnosed with plantar fasciitis: comparison of radial and focus applications. J Foot Ankle Surg. 2025;64(1):36-41. DOI: 10.1053/j. jfas.2024.08.012.
6. Elgendy MH, Khalil SE, ElMeligie MM, Elazab DR. Effectiveness of extracorporeal shockwave therapy in treatment of upper and lower limb tendinopathies: a systematic review and meta-analysis. Physiother Res Int. 2024;29(1):e2042. DOI: 10.1002/pri.2042.
7. Xiong Y, Wen T, Jin S, Lin L, Shao Q, Peng Y, et al. Efficacy and safety of extracorporeal shock wave therapy for upper limb tendon itis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2024;11:1394268. DOI: 10.3389/ fmed.2024.1394268.
8. Cao B, Tang X, Liu C, Xu G, Lei M, Wu F, et al. Unlocking new frontiers: the cellular and molecular impact of extracorporeal shock wave therapy (ESWT) on central nervous system (CNS) disorders and peripheral nerve injuries (PNI). Exp Neurol. 2025;384:115052. DOI: 10.1016/j.expneurol. 2024.115052.
9. Chen Y, Cai Q, Pan J, Zhang D, Wang J, Guan R, et al. Role and mechanism of micro-energy treatment in regenerative medicine. Transl Androl Urol. 2020;9(2):690-701. DOI: 10.21037/tau.2020.02.25.
10. Auersperg V, Trieb K. Extracorporeal shock wave therapy: an update. EFORT Open Rev. 2020;5(10):584-592. DOI: 10.1302/2058-5241.5. 190067.
11. Guo J, Hai H, Ma Y. Application of extracorporeal shock wave therapy in nervous system diseases: a review. Front Neurol. 2022;13:963849. DOI: 10.3389/fneur.2022.963849.
12. Likuvalno-diahnostychnyy tsentr Meddiahnostyka. Udarno-khvylova terapiya shcho za protsedura, zastosuvannya ta perevahy. Kyyiv: Likuvalno-diahnostychnyy tsentr Meddiahnostyka. Dostupno: . [in Ukrainian].
13. Opara J, Taradaj J, Walewicz K, Rosińczuk J, Dymarek R. The current state of knowledge on the clinical and methodological aspects of extracorporeal shock waves therapy in the management of post-stroke spasticity-overview of 20 years of experiences. J Clin Med. 2021;10(2):261. DOI: 10.3390/jcm10020261.
14. Central Ohio Spine and Joint. What is focused shockwave therapy? Benefits, conditions treated, and results. Central Ohio Spine and Joint; 2025. Available from: https://cospineandjoint.com/focused-shockwave-therapy-benefits-conditions-results/.
15. Xin Z, Lin G, Lei H, Lue TF, Guo Y. Clinical applications of low-intensity pulsed ultrasound and its potential role in urology. Transl Androl Urol. 2016;5(2):255-266. DOI: 10.21037/tau.2016.02.04.
16. Ryskalin L, Fulceri F, D’Agostino MC, Vetrano M, Vulpiani MC, Gesi M. Recent Advances in Shockwave Therapy for Musculoskeletal and Soft-Tissue Disorders. Life (Basel). 2025;15(12):1912. DOI: 10.3390/life 15121912.
17. Di X, Gao X, Peng L, Ai J, Jin X, Qi S, et al. Cellular mechanotransduction in health and diseases: from molecular mechanism to therapeu tic targets. Signal Transduct Target Ther. 2023;8(1):282. DOI: 10.1038/s41392-023-01501-9.
18. Guo J, Hai H, Ma Y. Application of extracorporeal shock wave therapy in nervous system diseases: A review. Front Neurol. 2022;13:963849. DOI: 10.3389/fneur.2022.963849.
19. Szwarc-Hofbauer D, Simböck E, Hromada C, Stoiber M, Tomasch J, Weitzer G, et al. Purinergic receptors play a key role in shock wave-in duced proliferation. Sci Rep. 2025;15(1):19138. DOI: 10.1038/s41598-025-02955-3.
20. Peng D, Tan Y, Reed-Maldonado AB, Lin G, Lue TF. Molecular mechanism of action of low-intensity extracorporeal shockwave therapy for regenerating penile and peripheral nerves. Turk J Urol. 2022;48(5):315-323. DOI: 10.5152/tud.2022.20419.
21. Modena DAO, Soares CD, Candido EC, Chaim FDM, Cazzo E, Chaim EA. Effect of extracorporeal shock waves on inflammation and angiogenesis of integumentary tissue in obese individuals: stimulating repair and regeneration. Lasers Med Sci. 2022;37(2):1289-1297. DOI: 10.1007/s10103-021-03387-x.
22. Pölzl L, Nägele F, Hirsch J, Graber M, Lobenwein D, Kirchmair E, et al. Defining a therapeutic range for regeneration of ischemic myocardium via shock waves. Sci Rep. 2021;11(1):409. DOI: 10.1038/s41598-020-79776-z.
23. Li Z, Ye K, Yin Y, Zhou J, Li D, Gan Y, et al. Low-intensity pulsed ultrasound ameliorates erectile dysfunction induced by bilateral cavernous nerve injury through enhancing Schwann cell-mediated cavernous nerve regeneration. Andrology. 2023;11(6):1188-1202. DOI: 10.1111/ andr.13406.
24. Peng DY, Reed-Maldonado AB, Lin GT, Xia SJ, Lue TF. Low-intensity pulsed ultrasound for regenerating peripheral nerves: potential for penile nerve. Asian J Androl. 2020;22(4):335-341. DOI: 10.4103/aja.aja_95_19.
25. Badawe HM, Mourad PD, Khraiche ML. Low-intensity ultrasound for controlled excitation and suppression in rat sciatic nerve. Sci Rep. 2025;15(1):34260. DOI: 10.1038/s41598-025-16407-5.
26. Rodríguez-Meana B, Santos-Nogueira E, Trujillo-Vázquez S, Jakob A, Udina E, Fournelle M, et al. Assessment of focused ultrasound stimulation to induce peripheral nerve activity and potential damage in vivo. Front Neurol. 2024;15:1346412. DOI: 10.3389/ fneur.2024.1346412.
27. Ghasemi A, Olyaei GR, Bagheri H, Hadian MR, Jalaei S, Otadi K, et al. A randomized clinical trial on the changing of median nerve cross sectional area and pain after extracorporeal shock wave and low-level laser therapy added to conventional physical therapy in patients with mild-to-moderate carpal tunnel syndrome. J Hand Ther. 2024;37(4):555-562. DOI: 10.1016/j.jht.2023.12.009.
28. Ceylan İ, Kürtüncüoğlu B, Tuncay F, Canli M, Alkan H, Tayfur A. Comparison of high- and low-dose radial extracorporeal shock wave therapy in carpal tunnel syndrome. Rev Assoc Med Bras (1992). 2025;71(3):e20241815. DOI: 10.1590/1806-9282.20241815.
29. Zong Y, Zhang H, Xu P, Chen M, Xie Q, Zhou P. Electrophysiological assessment of radial shock wave therapy for carpal tunnel syndrome. Front Neurosci. 2023;17:1251807. DOI: 10.3389/fnins.2023.1251807.
30. AbdelRazeq SS, Ashem HN, Elsebaie AM, Ali KM, Ibrahim MM. Efficacy of extracorporeal shock wave therapy on carpal tunnel syndrome post-mastectomy lymphoedema: a double-blind randomised, controlled study. Physiol Quart. 2025;33(3):95-103. DOI: 10.5114/pq/192351.

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 1, 180, 116-122 pages, index UDC 612.83:612.662.9:618.173-073.7/-076-085:615.2.1-092.9

DOI:

10.29254/2077-4214-2026-1-180-116-122