Clinical and electrophysiological follow-up after local steroid injection in the carpal tunnel syndrome

Background: Carpal tunnel syndrome (CTS) is a common health problem in Bangladesh especially among women. It causes significant morbidity and reduces work output in affected patients. There are few treatment options available like oral steroid, steroid injection, UST, surgical treatment etc. Considering the cost, time and consequence of surgery, short term nonsurgical management is desirable e.g. local steroid injection in the affected limb. Therefore a comparative analysis is necessary to understand the efficacy of local steroid injection.Objective: To evaluate the efficacy of local corticosteroid injection in the treatment of idiopathic carpal tunnel syndrome. Methods: 60 idiopathic CTS patients divided into two groups by randomization. One group received Inj. Triamcinolone 30 mg close to carpal tunnel and other group received oral steroids. Efficacies of treatmemt were compared in between groups.Result: The mean age of two groups were 37.5 ± 10.5 and 37.0 ± 10.24 years respectively (p = 0.272) and Majority of the patients in both treatment groups (76.7% in local steroid and 80% in oral steroid groups, p = 0.754) were female. Relief from tingling sensation and nocturnal awakening was higher in the steroid injection receivers (100% and 86.7% respectively) than that in the oral steroid receivers (6.9% and 3.4% respectively) during evaluation of outcome at the end of 3 month. End point treatment shows that none but SNAP at wrist in the local steroid group improved significantly better than that in the oral steroid group (16.2 ± 10.5 vs. 12.4 ± 6.3, p =0.039). No major side effects occurred in local steroid group except depigmentation in injected area 3 (10%) cases.Conclusion: It may be concluded that local steroid injection is an effective treatment of idiopathic carpal tunnel syndrome. But long-term efficacy of steroid injection remains uncertain.Bangladesh Journal of Neuroscience 2012; Vol. 28 (1): 10-15

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Median nerve injury from local steroid injection in carpal tunnel syndrome

Neurosurgery ◽

10.1097/00006123-199003000-00021 ◽

1990 ◽

pp. 512 ◽

Cited By ~ 4

Author(s):

M E Linskey ◽

R Segal

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Nerve Injury ◽

Carpal Tunnel ◽

Steroid Injection ◽

Tunnel Syndrome ◽

Local Steroid Injection ◽

Median Nerve Injury

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Comparison of surgical out come between virgin carpal tunnel syndrome and previous local steroid injected tunnel

Muthanna Medical Journal ◽

10.52113/1/7.2/20.33 ◽

2020 ◽

Vol 7 (2) ◽

pp. 33-40

Author(s):

Ali Shahad Safi ◽

Hussein A. Alseady ◽

Mohammed H. Younise

Keyword(s):

Carpal Tunnel ◽

Steroid Injection ◽

Night Pain ◽

Group A ◽

Tunnel Syndrome ◽

Local Steroid Injection ◽

Group B ◽

Grip Power ◽

Surgical Release

Carpal tunnel syndrome(CTS) is the most commonly occurring peripheral nerve compression neuropathy and its condition characterized by an abnormality of the median nerve function due to compression of the nerve within the carpal tunnel. Surgical release of the transverse carpal ligament is an effective treatment for patients with CTS. Non-steroidal anti-inflammatory drugs, diuretics, vitamin B6 injection, ultrasound therapy, laser therapy, acupuncture, magnetic therapy, bracing and local steroid injections have been used for closed treatment of CTS and effective results in the short-term treatment have been demonstrated clearly only for bracing and local steroid injections. Aim: was to identify the effect of local steroid injection on the outcome of surgical release of CTS. A prospective study that was conducted in the Orthopedic Department of at Basra General Hospital during the period from 1st of July 2005 till end of September 2006 on 40 patients, 20 of them with received local steroid injection (group A) and 20 without local steroid injection (group B virgin carpal tunnel) operations done to release the tunnel with monthly follow up by telephone call because of social and security problems at time of study. Pearson’s Chi–square test was used to assess statistical association between injection of local steroid and outcome of CTS surgery. A level of P – value less than 0.05 was considered significant. Postoperatively, in Group A, night pain and grip power were found to be improved in 17 (85%) and 11 (55%) of women, respectively, while 16 (80%) relieved from night pain, paresthesia and numbness. On the other hand, the postoperative follow up of women in group B showed that the improvement of night pain was occurred in 20 cases (90%), relieving of night pain, paresthesia and numbness in 17 (85%), and improvement of grip power was reported in 12 (60%). The analysis of association didn’t show statistical significant difference (P > 0.05) in surgical outcome between study groups. In conclusion; local steroid injection for CTS prior to surgery didn’t affect outcome of surgical release.

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