Local steroid treatment in idiopathic carpal tunnel syndrome short- and long-term efficacy
A clinical and electrophysiological study evaluated the usefulness of local steroid therapy for carpal tunnel syndrome (CTS). To evaluate the efficacy of local steroid therapy 32 patients (53 nerves) were randomly assigned to one of two groups: one (27 nerves) received 15 mg methylprednisolone acetate injected locally and the other (26 nerves) received the same amount of saline solution. The injections were repeated after a week. Clinical and electrophysiological findings were evaluated, double blind, at regular intervals. A clear-cut efficacy of steroid treatment was found. Only 8% of nerves were not benefitted while a marked early improvement was observed in most of the nerves. In order to appraise the long-term effect of local steroid treatment on CTS, 53 patients (91 nerves) were studied and followed up by means of clinical and electrophysiological examinations performed every 2 months for 2 years. The benefit of steroid treatment was transient. About 50% of the nerves became worse within 6 months and 90% within 18 months. Only a small percentage (8%) of the nerves remained improved at the 2-years follow-up. The clinical features were not useful in foretelling the duration of the improvement, which appeared to be related to the antidromic SAP latency.
Key wordsCarpal tunnel syndrome Local steroid injection
Unable to display preview. Download preview PDF.
- 1.Crow RS (1960) Treatment of the carpal tunnel syndrome. BMJ 1:1611–1615Google Scholar
- 2.Foster JB (1960) Hydrocortisone and the carpal tunnel syndrome. Lancet 1:454–456Google Scholar
- 3.Gelberman RH, Aronson D, Weisman MH (1980) Carpal tunnel syndrome. Results of a prospective trial of steroid injection and splinting. J Bone Joint Surg [Am] 62:1181–1184Google Scholar
- 5.Green DP (1984) Diagnostic and therapeutic value of carpal tunnel injection. J Hand Surg [Am] 9:850Google Scholar
- 6.Kendall PH (1962) Carpal tunnel syndrome. BMJ 1:115Google Scholar
- 7.Kulick MI, Gordillo G, Javidi T, Kilgore ES, Newmeyer WL III (1986) Long-term analysis of patients having surgical treatment for carpal tunnel syndrome. J Hand Surg [Am] 11:59–65Google Scholar
- 8.Myles AB, Casemore VA, Coulthard M, et al (1973) Management of the carpal tunnel syndrome with local corticosteroid injections. Rheum Rehabil 12:205–208Google Scholar
- 9.Phalen GS (1966) The carpal tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg [Am] 48:211–228Google Scholar
- 11.Richmond DA (1958) Carpal tunnel syndrome. BMJ 1:773–774Google Scholar
- 13.Van Der Bracht AA (1958) Carpal tunnel syndrome. BMJ 1:1180–1181Google Scholar