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

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.

scholarly journals The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome

2011 ◽  
Vol 32 (5) ◽  
pp. 1285-1290 ◽  
Author(s):  
Orhan Deniz ◽  
Recep Aygül ◽  
Dilcan Kotan ◽  
Gökhan Özdemir ◽  
Faruk Ömer Odabaş ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Sympathetic Skin Response ◽  
Skin Response ◽  
Tunnel Syndrome ◽  
F Wave ◽  
Local Corticosteroid Injection

scholarly journals Efficacy of Local Corticosteroid in Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial

2013 ◽  
Vol 28 (1) ◽  
pp. 10-15
Author(s):  
Anis Ahmed ◽  
Md Rafiqul Islam ◽  
Hasan Zahidur Rahman ◽  
Md Moniruzzaman Bhuiyan ◽  
Sukumar Majumder ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Oral Steroid ◽  
Steroid Group ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Local Steroid Injection

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

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

Prevalence of decompression surgery in patients with carpal tunnel syndrome 8 years after initial treatment with a local corticosteroid injection

2016 ◽  
Vol 42 (3) ◽  
pp. 275-280 ◽  
Author(s):  
A. Hameso ◽  
J. D. P. Bland
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Decompression Surgery ◽  
Level Of Evidence ◽  
Clinically Important Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Repeated local corticosteroid injections have become a common mode of treatment for carpal tunnel syndrome, despite an existing recommendation that no more than three injections should be given. We studied the clinical outcomes in 254 patients who initially opted for a corticosteroid injection into their carpal canal during 2007. Follow-up records of treatment were obtained for 157 patients of whom 41% had proceeded to surgery by 2015. A mean of 1.9 injections had been given before surgery. In the unoperated group, a mean of two (range 0–12) further injections had been given. The final subjective severity and functional status scores measured using the Boston carpal tunnel questionnaire were significantly lower in the operated than in the unoperated group, but both groups improved significantly from baseline. The differences between the final scores are less than the estimated minimal clinically important difference for these measures. We conclude that repeated steroid injection may be a valid treatment option for some patients with carpal tunnel syndrome. Level of evidence: III

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