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.
Highlights
Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist
This study aimed to demonstrate the outcomes pertaining to the management of CTS after performing a local injection using a mixture of corticosteroid and local anesthetics at a three-month follow-up
Based on the statistical significance and clinical effectiveness, the results of this study suggest that local injection of a corticosteroid in the treatment of CTS is effective and safe in the reduction of pain intensity and symptom severity, contributing to increasing functioning of the hand
Summary
Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. 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. 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. Objetivo: O objetivo do presente estudo foi avaliar os resultados clínicos e eletrofisiológicos de curto prazo da injeção de corticosteroide local (ICL) em pacientes com STC sintomática. A Escala Numérica de Avaliação (NRS), a Escala de Gravidade de Sintomas de Boston (BSS) e a Escala de Status Funcional (FSS) foram administradas antes e após a injeção. Conclusão: A ICL para STC fornece uma melhoria a curto prazo em resultados neurofisiológicos e clínicos, tais como intensidade da dor, gravidade dos sintomas e capacidade funcional
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