Extracorporeal shock wave therapy in pillar pain after carpal tunnel release : a preliminary study

“Pillar Pain” is a relatively frequent complication after surgical release of the median nerve at the wrist. The aetiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar Pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms 2 or even 3 years after surgery. The aim of this study was to investigate the efficacy of low energy flux density focussed Extracorporeal Shock Waves (ESWT) in the treatment of Pillar Pain. We treated 40 consecutive patients with ESWT who had suffered Pillar Pain for at least 6 months after Carpal Tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this condition. Our results show that in all of the treated patients there was a marked improvement: the mean Visual Analogue Scale (VAS) score reduced from 6.18 (±1.02) to 0.44 (±0.63) 120 days after treatment, and redness and swelling of the surgical scar had also reduced significantly.