BACKGROUND: Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral nerve entrapment and a leading cause of occupational impairment. Non-surgical and surgical treatment options are the two basic types of treatment. Steroid injection does not improve symptoms like surgery according to the previous researches. Nevertheless, additional research is required to further evaluate the comparative studies. OBJECTIVES: To compare the clinical and functional results of open carpal tunnel release (CTR) surgery VS local steroid injection (LSI) for carpal tunnel syndrome. METHODS: This is prospective randomized, single blind, controlled study. Forty patients who were clinically and electrophysiologically conrmed to have idiopathic CTS were enrolled in the study after informed consent. Patients were randomized and assigned into 2 groups of 20 patients each. Group-1 was managed by and Group-2 was managed by open carpal tunnel release single injection of steroid. Patients were followed every 4 weeks up to 24 week. They were assessed clinically and functionally based on Boston Carpal Tunnel Assessment Questionnaire (BCTQN). CONCLUSION: In our study we used Boston Carpal Tunnel Assessment Questionnaire (BCTQN), due to its ease of administration and responsiveness to clinical change, which can be considered as a valuable tool to evaluate functional outcome. Our ndings suggest that both local steroid injection and surgical decompression are effective treatments in alleviating symptoms in primary CTS at 24 weeks follow-up. Surgery group had statistically signicant improvement in comparison with steroid injection in terms of objective functional score in the 24 weeks followup, although clinical relevance of those differences remains to be dened. Hence we conclude, The steroid injection is a feasible non-expensive and effective therapy in most of the cases of CTS on the other hand surgical release is a day care, safe and effective treatment even in mild to moderate CTS. But cost effectiveness, cost benet analysis and surgery related morbidity should be evaluated in further clinical trials with larger sample size and longer follow up period.
BACKGROUND: Plantar fasciitis is one of the most common conditions of heel pain among adults. Most common affected age group being 40-60 years and it is a leading cause of occupational impairment. Non-invasive and invasive modalities are the two basic types of treatment. Invasive treatment modalilities like local injections, surgical treatment are advised for patients non-responding to non-invasive conservative treatment modalities. Local Steroid Injection (LSI) is the most common invasive treatment used whereas Dry Needling (DN) is proposed as a new modality of treatment recently. OBJECTIVES: The aim of this study is to evaluate the effectiveness of Dry Needling versus Local Steroid Injection for Plantar Fasciitis using short form of Foot Function Index Revised (FFI-R). METHODS:This is prospective randomized, single blind, controlled study. Fifty patients who were clinically and radiologically (USG) conrmed to have idiopathic plantar fasciitis were enrolled in the study after informed consent. Patients were randomized and assigned into 2 groups of 25 patients each. Group I was managed by Local Steroid Injection (LSI) and Group II was managed by Dry Needling (DN). Patients were followed every 4 weeks up to 12 weeks. They were assessed clinically and functionally based on short form of FFI-R CONCLUSION: Short form of Foot Function Index Revised (FFI-R) is a quick, reliable and patient friendly outcome measurement tool for plantar fasciitis. Both Local Corticosteroid Injection and Dry Needling are effective treatment in refractory cases of Plantar Fasciitis in adjunct to non-invasive conservative treatment modalities. Dry Needling is a safe and reliable procedure for treating refractory cases of Plantar Fasciitis. Even though corticosteroid injection is the most effective treatment for short term symptomatic relief (at 4 weeks), it is found that outcomes of Dry Needling are comparable with the efcacy of corticosteroid injection in the medium term follow-up (12 weeks). Dry Needling has greater physiological compatibility than corticosteroid injection in terms of ability to induce possible healing process in plantar fasciitis and devoid of any long term complication associated with corticosteroid injection.
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