34 patients (40 wrists) with carpal tunnel syndrome were randomized to receive either radial extracorporeal shock wave therapy (rESWT) or sham therapy as treatment. The purpose of this study was to determine if active rESWT was associated with significant improvement in pain and paresthesia, symptom severity, and function when compared to sham therapy at 1, 4, 8, and 12 weeks post-treatment. Results demonstrated that patients in the rESWT group had significantly improved pain and function scores at all follow-up when compared to the control group. Additionally, symptom severity scores at weeks 1, 4, and 8 were significantly improved for rESWT patients when compared to the control group.