Review: Steroids, US, electromagnetic field therapy, and nocturnal splinting have moderate, short-term effectiveness for the carpal tunnel syndrome

Background: The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy). Methods: Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan. Results: From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months. Conclusions: Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.

Download Full-text

Pulsed magnetic field therapy in refractory carpal tunnel syndrome: Electrodiagnostic parameters – pilot study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-2005-183-404 ◽

2005 ◽

Vol 18 (3-4) ◽

pp. 79-83 ◽

Cited By ~ 5

Author(s):

Michael I. Weintraub ◽

Steven P. Cole

Keyword(s):

Magnetic Field ◽

Pilot Study ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Pulsed Magnetic Field ◽

Magnetic Field Therapy ◽

Tunnel Syndrome ◽

Field Therapy

Download Full-text

Effectiveness of combined ultrasound and exercise therapy in the treatment of carpal tunnel syndrome - randomized, placebo-controlled investigation

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180214050l ◽

2018 ◽

Vol 146 (9-10) ◽

pp. 561-566

Author(s):

Milica Lazovic ◽

Mirjana Kocic ◽

Marija Hrkovic ◽

Dejan Nikolic ◽

Ivana Petronic ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Pain Intensity ◽

Carpal Tunnel ◽

Sensory Nerve ◽

Ultrasound Treatment ◽

Control Group ◽

Short Term ◽

Sensory Nerve Action ◽

Tunnel Syndrome ◽

And Control

Introduction/Objective. The aim of the paper was to evaluate the short-term effectiveness of ultrasound treatment procedure on defined clinical parameters and changes of electrodiagnostic parameters at the median nerve in carpal tunnel syndrome patients. Methods. Thirty-five patients (50 hands) were randomly divided into two groups: the experimental group (EG) (20 patients (29 hands)) and the control group (CG) (15 patients (21 hands)). Twenty sessions of ultrasound treatment were performed over a period of seven weeks and control examination was performed during the eighth week from the initial session. Clinical assessment parameters (pain intensity, superficial sensibility, and Tinel sign), and electrodiagnostic parameters (motor distal latency ? mDL), median sensory nerve conduction velocity (SNCV), and median sensory nerve action potential (SNAP) were assessed both at baseline (T1) and at control (T2). Results. There is significant improvement of pain intensity (T1 ? 10.4/58.6/31; T2 ? 65.5/27.6/6.9; p < 0.001) and superficial sensibility (T1 ? 3.4/69/27.6; T2 ? 44.8/34.5/20.7; p < 0.001) in the EG after the treatment. In the EG, there is significant reduction in frequency of positive Tinel?s sign (T1 ? 100/0; T2 ? 62.1/37.9; p < 0.001), and mDL significantly decreased after the treatment (T1 ? 4.7 ? 1.3; T2 ? 4.5 ? 1.2; p = 0.007), while SNAP (T1 ? 20.2 ? 15.4; T2 ? 24.4 ? 16.5; p < 0.001) and SNCV (T1 ? 36.5 ? 9.8; T2 ? 42.6 ? 9.7; p < 0.001) significantly increased. Conclusion. Ultrasound treatment along with exercises have positive short-term effects and benefits on improvement of clinical and electrodiagnostic findings in individuals with carpal tunnel syndrome.

Download Full-text

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

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190106 ◽

2019 ◽

Vol 77 (9) ◽

pp. 638-645 ◽

Cited By ~ 1

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.

Download Full-text