Comparison of ultrasound-guided pulsed radiofrequency versus steroid injection in the treatment of carpal tunnel syndrome.

Abstract

Carpal tunnel syndrome (CTS) is the most widespread form of nerve entrapment neuropathy results from increase compression pressure of the median nerve at the wrist under the transverse carpal ligament. To compare ultrasound (US)-guided median nerve steroid injection and pulsed radiofrequency (PRF) on pain intensity, functional status, and patient satisfaction in the treatment of CTS. A total of 90 hands of 59 patients who underwent steroid injection at the level of proximal carpal tunnel or PRF for CTS were retrospectively analyzed. Demographic and clinical characteristics of the patients were recorded. The pain severity was assessed using the Numerical Rating Scale (NRS), and the functional status and clinical outcomes were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) before the procedure and at Week 1, Month 1, and Month 3 after the procedure. Time to pain relief was evaluated at week 1. Patient satisfaction was evaluated at Month 3. There was no significant difference in the NRS and BCTQ scores between the two treatment methods (p > 0.05 for both). In addition, a significant decrease in the NRS and BCTQ scores were detected at all follow-ups compared to baseline in treatment groups (p < 0.001). The mean time to pain relief was significantly shorter in the PRF group (p < 0.001). Patient satisfaction was similar at Month 3 between the treatment methods (p > 0.05). Our study results suggest that both US-guided steroid injection to the median nerve and PRF are effective and safe methods in the short-term in the treatment of CTS.