A prospective study of the long-term efficacy of local methyl prednisolone acetate injection in the management of mild carpal tunnel syndrome

Agarwal, Vikas; Singh, Ranveer; Sachdev, Atul; Wiclaff,; Shekhar, Shashank; Goel, Deepak

doi:10.1093/rheumatology/keh571

Cited by 72 publications

(33 citation statements)

References 22 publications

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“…Surgical treatment is generally preferred in severe cases of CTS, whereas nonsurgical treatment is reserved for mild-to-moderate CTS. Several studies have shown that local corticosteroid application provides clinical improvement and could be a primary treatment option for CTS (20, 21). In our study, local corticosteroid injection therapy showed a moderate effect size at the 3-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Cross-Cultural Adaptation of the Korean Version of the Boston Carpal Tunnel Questionnaire: Its Clinical Evaluation in Patients with Carpal Tunnel Syndrome Following Local Corticosteroid Injection

et al. 2013

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The aim of this study was to assess and validate the Korean version of the Boston Carpal Tunnel Questionnaire (K-BCTQ) in patients with carpal tunnel syndrome (CTS). After translation and cultural adaptation of the BCTQ to a Korean version, the K-BCTQ was administered to 54 patients with CTS; it was administered again after 2 weeks to assess reliability. Additionally, we administered K-DASH and EQ-5D to assess construct-validity. In a prospective study of responsiveness to clinical change, 29 of 54 patients were treated by ultrasonography-guided local corticosteroid injection therapy. The internal consistency of the K-BCTQ was high (Cronbach's alpha: 0.915) and the intra-class correlation coefficients were 0.931 for the symptom severity scale (P<0.001) and 0.844 for the functional severity scale (P<0.001). The construct-validity between the symptom severity scale and the K-DASH, and between the functional severity scale and the K-DASH were significantly correlated (both P<0.001). Clinical improvement was noted in 29 patients with injection therapy. The effect size of symptom severity was 0.67, and that of functional severity was 0.58. In conclusion, the K-BCTQ shows good reliability, construct-validity, and acceptable responsiveness after local corticosteroid injection therapy (Clinical trial number, KCT0000050).

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Section: Discussionmentioning

confidence: 99%

Cross-Cultural Adaptation of the Korean Version of the Boston Carpal Tunnel Questionnaire: Its Clinical Evaluation in Patients with Carpal Tunnel Syndrome Following Local Corticosteroid Injection

et al. 2013

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“…There was a significant weight loss in the first 3 months in patients who were enrolled in our study, which is consistent with data in the literature. Furthermore, in various methods for CTS treatment, optimal improvements were found in the first 3 months, both clinically and electrophysiologically, and after that the effectiveness of treatment gradually decreased [23, 24]. Lack of improvement in NCS values of patients after losing weight suggests that the association between CTS and obesity may not be solely explained by excess body weight.…”

Section: Discussionmentioning

confidence: 99%

Obesity and Carpal Tunnel Syndrome: Is There a Causal Relationship?

Kurt

Kısacık²,

Kaplan

et al. 2008

Eur Neurol

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Objectives: Obesity is defined as a risk factor for carpal tunnel syndrome (CTS). In this study, the presence or absence of recovery in median nerve conduction velocities after weight loss in obese patients was assessed in order to determine whether excess weight or other factors influence the higher prevalence of CTS in obese patients. Methods: Patients with body mass indexes (BMIs) ≧30 were included in the study. CTS symptoms, age, gender, height, body weight, and concomitant diseases were evaluated. Nerve conduction studies (NCS) were obtained on one upper extremity. All patients were included in dietetic programs. Three months later, NCS were repeated and compared with the first NCS. Results: BMIs were statistically significantly lower on the second visits 3 months later (p = 0.0001). No statistically significant difference was observed in the second NCS of electromyographically diagnosed cases with CTS (p > 0.05). Conclusion: We expected a recovery in median nerve conduction velocities in patients with CTS after weight loss. In the literature, even in untreated cases with CTS, spontaneous improvements in second NCS have been reported. This finding suggests that factors other than excess body weight may be influential in the higher prevalence of CTS in obese patients. A more detailed, genetic-factor-targeted investigation may prove more beneficial to clarify this issue.

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“…9 Corticosteroid injection is one of the few nonsurgical treatments with proven short-term effectiveness in the treatment of carpal tunnel syndrome (CTS). 21 Agarwal et al 1 showed that local injection of 40 mg methylprednisolone acetate into the carpal tunnel in mild CTS significantly reduced the symptoms in 80% of patients for at least 16 months, and it normalized electrodiagnostic parameters in 50% of subjects by 12 months after the treatment. 18 Local corticosteroid injection can be as effective as decompression surgery in relieving the CTS symptoms up to 1 year after treatment.…”

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confidence: 99%

Corticosteroid iontophoresis to treat carpal tunnel syndrome: A double‐blind randomized controlled trial

et al. 2009

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Even though injection of corticosteroids into the carpal tunnel alleviates the symptoms of mild to moderately severe carpal tunnel syndrome (CTS), it has not gained universal popularity due to its invasiveness. This study was designed to investigate the effectiveness of dexamethasone iontophoresis as a noninvasive method of treating CTS. We carried out a double-blind randomized controlled trial comparing six sessions of iontophoresis with 0.4% dexamethasone sodium phosphate with distilled water in 17 patients. Outcome measures including nerve conduction studies, the Levine Self-Assessment Questionnaire, and the Semmes-Weinstein Monofilaments were done monthly for 6 months after intervention. Most of the outcome measures did not show any significant change following treatment. Although there was subjective improvement of symptom severity scores in the treatment group as quantified by the Levine Self-Assessment Questionnaire, similar improvement was also observed in the control group (P < 0.05). Although corticosteroid iontophoresis is feasible in clinical settings and is well-tolerated by patients, iontophoresis of 0.4% dexamethasone was not effective in the treatment of mild to moderate CTS. Muscle Nerve 39: 627-633, 2009.

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A prospective study of the long-term efficacy of local methyl prednisolone acetate injection in the management of mild carpal tunnel syndrome

Abstract: Local glucocorticoid injection results in long-term improvement in nerve conduction parameters, symptom severity and functional scores in patients with mild CTS.

Cited by 72 publications

References 22 publications

Cross-Cultural Adaptation of the Korean Version of the Boston Carpal Tunnel Questionnaire: Its Clinical Evaluation in Patients with Carpal Tunnel Syndrome Following Local Corticosteroid Injection

Cross-Cultural Adaptation of the Korean Version of the Boston Carpal Tunnel Questionnaire: Its Clinical Evaluation in Patients with Carpal Tunnel Syndrome Following Local Corticosteroid Injection

Obesity and Carpal Tunnel Syndrome: Is There a Causal Relationship?

Corticosteroid iontophoresis to treat carpal tunnel syndrome: A double‐blind randomized controlled trial

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