Evaluation of Local Corticosteroids Injection in Treatment of Carpal Tunnel Syndrome

Abstract

Background: Carpal tunnel syndrome is the most common type of peripheral nerve entrapment; it affects females more than males; it may be idiopathic or secondary to other disorders especially diabetes mellitus. Carpal tunnel syndrome mostly affects manual workers and may be bilateral or unilateral and mainly affects the dominant hand. Carpal tunnel syndrome has characteristic symptoms and signs including paresthesia and pain along median nerve distribution, these symptoms are usually accompanied by positive provocative tests. Electrodiagnostic studies remain the cornerstone in the diagnosis of CTS. Carpal tunnel syndrome can be treated conservatively by activities of daily living instructions, splints, medical treatments as neurotropic drugs and NSAIDs and local steroid injection. Also, it can be treated by surgical decompression in severe cases. Aims: The aim of this study was to evaluate local steroid injection in the treatment of CTS. Twenty-one patients with mild and moderate CTS were included in this study. Patients and Methods: This was a prospective study included 21 patients with symptoms and signs of mild to moderate CTS attending the outpatient clinic of orthopedic Department, Tanta University Hospitals in the period between February 2019- January 2020. 1 ml Triamcinolone was used with 2 ml lidocaine. Patient’ hand was rested on towel roll flexed about 30 to 45 degrees and injection was done according to landmarks. Night splint was described for 3 days after injection. Results: In regards to clinical assessment; there was a significant clinical improvement after injection and follow-up period as compared to before injection. In regards to electrophysiological assessment; there was a significant improvement in NCS after injection. Conclusion: Local steroid injection is an effective treatment and recommended as a therapeutic tool in the management of idiopathic mild to moderate CTS.