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Prospective comparison of the six-item carpal tunnel symptoms scale and portable nerve conduction testing in measuring the outcomes of treatment of carpal tunnel syndrome with steroid injection

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HAND

Abstract

Background

We prospectively studied patients clinically diagnosed with carpal tunnel syndrome (CTS) and treated with the injection of corticosteroid into their carpal tunnel in order to compare changes in the six-item CTS symptoms scale and portable nerve conduction study (NCS) parameters as outcome tools. Our pilot study was the first to assess the utility of the six-item CTS symptom scale (CTS-6) with steroid injections as a patient-directed outcome measure for the treatment of CTS.

Methods

We enrolled patients who presented to our county hospital orthopedic surgery clinic from August 2012 through August 2013. The patients were clinically diagnosed with CTS. After completing the six-item CTS symptoms scale questionnaire, portable NCS was obtained. Each patient then received an injection of 1 ml of triamcinolone acetonide 40 mg/ml mixed with 1 ml of 1 % lidocaine into the carpal tunnel. Six weeks postinjection, each patient repeated a CTS-6 questionnaire and underwent a repeat portable NCS. The CTS-6 and NCS results were analyzed using the paired samples t test. A Pearson correlation was used to assess the correlation between the changes in the CTS-6 and the NCS measurements. Statistical significance was set at P < 0.05.

Results

Thirty-two wrists in 20 patients were evaluated. There was a statistically significant difference between the CTS-6 scores before and after injection. There were also statistically significant changes in the five of the NCS parameters. None of the correlations between the CTS-6 and the NCS parameters were statistically significant.

Conclusions

The six-item CTS symptoms scale and portable NCS are both useful measures for evaluating the results of steroid injections. The CTS-6 is an effective tool because of its ease of use, low cost, correspondence with changes in NCS, and ability to monitor the outcome of steroid treatment for carpal tunnel syndrome.

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Conflict of Interest

John R. Craw, Dane J. Church, and Richard L. Hutchison declare that they have no conflict of interest.

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). The study was approved by our institutional review board.

Statement of Informed Consent

A waiver of informed consent was obtained.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Missouri-Kansas City, Kansas City, MO, USA

    John R. Craw, Dane J. Church & Richard L. Hutchison

  2. Section of Hand Surgery, Division of Orthopaedic Surgery, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Richard L. Hutchison

Authors
  1. John R. Craw
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  2. Dane J. Church
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  3. Richard L. Hutchison
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Correspondence to Richard L. Hutchison.

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Craw, J.R., Church, D.J. & Hutchison, R.L. Prospective comparison of the six-item carpal tunnel symptoms scale and portable nerve conduction testing in measuring the outcomes of treatment of carpal tunnel syndrome with steroid injection. HAND 10, 49–53 (2015). https://doi.org/10.1007/s11552-014-9672-4

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  • DOI: https://doi.org/10.1007/s11552-014-9672-4

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