scholarly journals Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

2019 ◽  
Vol 77 (9) ◽  
pp. 638-645 ◽  
Author(s):  
Devrimsel Harika Ertem ◽  
Tuba Cerrahoglu Sirin ◽  
Ilhan Yilmaz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Clinical Outcomes ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Short Term ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Local Corticosteroid Injection

ABSTRACT Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. Objective: The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Methods: Electrophysiological parameters were evaluated before and three months after LCI. Moreover, the Numeric Rating Scale (NRS), the Boston Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were administered before and after the injection. A mixture of 1 mL (40 mg) of methylprednisolone and 1 mL of 0.5% bupivacaine were injected blindly on the volar side of the forearm between the tendons of the radial carpal flexor muscle and long palmar muscle. Results: A total of 25 patients (45 hands) were enrolled in the study. Twenty women and five men with a mean age of 49.28 ± 11.37 years were included. A statistically significant difference was noted for improvement of sensory conduction velocities, sensory peak latency, and motor distal latency (p = 0.001) after LCI. A significant difference was recorded between pre- and post-injection for NRS, SSS and FSS scores (p = 0.000). Conclusion: Local corticosteroid injection for CTS provides a short-term improvement in neurophysiological and clinical outcomes such as pain intensity, symptom severity and functional ability.

Does prior local corticosteroid injection prejudice the outcome of subsequent carpal tunnel decompression?

2015 ◽  
Vol 41 (2) ◽  
pp. 130-136 ◽  
Author(s):  
J. D. P. Bland ◽  
N. L. Ashworth
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Ordinal Scale ◽  
Level Of Evidence ◽  
Carpal Tunnel Surgery ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Local Steroid Injection ◽  
Local Corticosteroid Injection

It has been suggested that treatment of carpal tunnel syndrome by local corticosteroid injection may prejudice the outcome of subsequent surgery. We identified patients who had proceeded directly to carpal tunnel surgery and patients who had initially been treated with one or more injections and then subsequently underwent carpal tunnel surgery on the same hand. Outcomes of surgery were evaluated using pre- and post-operative Boston carpal tunnel syndrome scales and an ordinal scale for overall satisfaction. Multivariate models were created to study the effect of pre-operation injection on the surgical outcome while controlling for demographic and clinical variables. A total of 942 patients were included; 85% of the direct group and 84% of the prior-injection group reported themselves either completely cured or much improved after surgery. Post-operative symptom severity and functional status scores showed no significant difference between the direct-to-surgery and prior-injection groups. Prior local steroid injection does not prejudice the outcome of surgery. Level of Evidence: IV

Ultrasound-guided local corticosteroid injection for carpal tunnel syndrome: A meta-analysis of randomized controlled trials

2021 ◽  
pp. 026921552110147
Author(s):  
Hongchen Wang ◽  
Yuting Zhu ◽  
Hongyu Wei ◽  
Chunke Dong
Keyword(s):  
Adverse Events ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Sensory Nerve ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Tunnel Syndrome ◽  
Local Corticosteroid Injection

Objective: This meta-analysis aimed to compare the efficacy and safety of ultrasound-guided (US-guided) versus landmark-guided (LM-guided) local corticosteroid injection for carpal tunnel syndrome (CTS). Methods: Database including Pubmed, Embase, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs). The outcomes mainly included Boston Carpal Tunnel Questionnaire (BCTQ): Symptom Severity Scale (BCTQs), Functional Status Scale (BCTQf); and electrophysiological indexes: distal motor latency (DML), sensory distal latency (SDL), compound muscle action potential (CAMP), sensory nerve action potential amplitude (SNAP), and sensory nerve conduction velocity (SNCV). Adverse events were also recorded. Results: Overall, nine RCTs were finally screened out with 469 patients (596 injected hands). Pooled analysis showed that US-guided injection was more effective in BCTQs (SMD, −0.69; 95% CI, −1.08 to −0.31; P = 0.0005), BCTQf (SMD, −0.23; 95% CI, −0.39 to −0.07; P = 0.005), CAMP (MD, 0.64; 95% CI, 0.35−0.94; P < 0.0001) improvement, and a lower rate of adverse events (RR, 0.34; 95% CI, 0.22−0.52; P < 0.00001). Subgroup analysis revealed that the US-guided injection had significantly better CMAP than the LM-guided for the in-plane approach (MD, 0.69; 95% CI, 0.36−1.01; P < 0.0001) but not for the out-plane approach (MD, 0.39; 95% CI, −0.39 to 1.17; P = 0.33). Conclusions: US-guided injection was superior to LM-guided injection in symptom severity, functional status, electrodiagnostic, and adverse events improvement for CTS. To some extent, the in-plane approach yields better results compared with the out-plane process under US guidance.

Local corticosteroid injection for carpal tunnel syndrome

2020 ◽  
Author(s):  
Nigel L Ashworth ◽  
Jeremy D P Bland ◽  
Kristine M Chapman ◽  
Gaetan Tardif ◽  
Loai Albarqouni ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Tunnel Syndrome ◽  
Local Corticosteroid Injection

Cochrane corner: local corticosteroid injection for carpal tunnel syndrome

2013 ◽  
Vol 38 (8) ◽  
pp. 911-914 ◽  
Author(s):  
H. Stark ◽  
R. Amirfeyz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Confidence Intervals ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Surgical Interventions ◽  
Relative Risks ◽  
Tunnel Syndrome ◽  
Local Corticosteroid Injection

Background: Carpal tunnel syndrome is a clinical syndrome manifested by signs and symptoms of irritation of the median nerve at the carpal tunnel in the wrist. Local corticosteroid injection for carpal tunnel syndrome has been studied but its effectiveness is unknown. Objectives: To evaluate the effectiveness of local corticosteroid injection for carpal tunnel syndrome versus placebo injection or other non-surgical interventions. Search methods: We searched the Cochrane Neuromuscular Disease Group Trials register (searched May 2006), MEDLINE (searched January 1966 to May 2006), EMBASE (searched January 1980 to May 2006) and CINAHL (searched January 1982 to May 2006). Selection criteria: Randomized or quasi-randomized studies. Data collection and analysis: Three authors independently selected the trials and rated their overall quality. Relative risks and 95% confidence intervals were calculated for each trial and summary relative risks and 95% confidence intervals were also calculated.

Evaluation of Iontophoresis and Local Corticosteroid Injection in the Treatment of Carpal Tunnel Syndrome

2005 ◽  
Vol 84 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Figen G??ko??lu ◽  
G??lin Fndko??lu ◽  
Z Rezan Yorganco??lu ◽  
M??yesser Okumu?? ◽  
Esma Ceceli ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Tunnel Syndrome ◽  
Local Corticosteroid Injection
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