The comparison of the efficacy of extracorporeal shockwave therapy and high-intensity laser therapy in the treatment of de Quervain tenosynovitis.

Abstract

Objectives: This study aims to investigate and compare the treatment efficacy of extracorporeal shockwave therapy (ESWT) and high-intensity laser therapy (HILT) regarding pain management and functionality in patients with de Quervain tenosynovitis (DQT).

Patients and methods: Between May 2022 and November 2022, a total of 60 patients with DQT (16 males, 34 females; mean age: 43.3±7.7 years; range, 18 to 65 years) were included in this study. The patients were randomly divided into two groups as follows: Group A (ESWT, n=29) and Group B (HILT, n=31). The patients were asked to refrain from all types of exercise 24 h before the experiment. The pain level of the patients at the time of presentation was evaluated via Visual Analog Scale (VAS), and the function outcome was evaluated with Quick Disabilities of Arm, Shoulder and Hand (QDASH) before and after the treatment. Muscle strength was evaluated with a Jamar hand dynamometer, and an algometer was used to measure pressure pain threshold (PPT). The Global Assessment Scale (GAS) was used to measure the treatment success.

Results: The intragroup comparisons revealed significant improvements in all parameters after the treatment in both groups (p<0.05). The VAS-rest score, the VAS-movement score, the QDASH score, pain-free grip strength (PFGS), and PPT showed a significant difference before treatment at three weeks and three months (p<0.01). The difference between the PPT values of the groups at three weeks was significant (p<0.01). The third-week PPT value of Group B was higher than the PPT value of Group A. The difference between GAS 1 and GAS 2 of both groups was statistically significant at three weeks and three months (p<0.05).

Conclusion: Both ESWT and HILT treatments are safe and effective in DQT treatment. The ESWT is a recent, non-invasive therapeutic modality which is effective, convenient, and safe in DQT. On the other hand, HILT is a non-invasive, reliable method which has a greater effect on DQT.