25 patients with carpal tunnel syndrome were randomized to treatment with either a single session of radial extracorporeal shockwave therapy or a single corticosteroid injection. Primary outcome was the Boston Carpal Tunnel Questionnaire, including both the Symptoms and Functional scores. Patients were assessed at 1, 4, 12, and 24 weeks after treatment. Within-group reductions from baseline in BCTQ scores were significant from 4 weeks to 24 weeks in the rESWT group, in contrast to only 1 week to 4 weeks in the corticosteroid injection group. The reduction in scores from 12 weeks to 24 weeks were significantly greater in the rESWT compared to the corticosteroid injection for each of the BCTQ total score, Symptoms subscore, and Functional subscore.