Corticosteroid Injection vs. Nonsteroidal Antiinflammatory Drug and Splinting in Carpal Tunnel Syndrome

Çeliker, Reyhan; Arslan, Serkan; İnanıcı, Fatma

doi:10.1097/00002060-200203000-00005

Cited by 79 publications

(54 citation statements)

References 13 publications

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“…Celiker et al 13 in a prospective study compared oral anti-inflammatory plus splinting (neutral wrist, nocturnal use) to corticosteroid injection with methylprednisone acetate. Patients who had thenar muscle atrophy were not included in the study; so, perhaps, the assumption can be made that the study population of 33 hands in 23 subjects had mild or moderate CTS.…”

Section: Cortisone Injectionmentioning

confidence: 99%

Conservative Interventions for Carpal Tunnel Syndrome

Michlovitz¹

2004

J Orthop Sports Phys Ther

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The assessment and conservative interventions in patients with carpal tunnel syndrome (CTS) are described in this paper. Information about surgical procedures and postoperative care has also been included. It is difficult to make definitive conclusions about the literature regarding success of treatment for CTS due to variations in outcome measures, severity of CTS, and inconsistencies in duration, dosage, and follow-up time for interventions. Based on what is known to date, this author recommends that patients with mild or moderate CTS be provided with a conservative program of splinting the wrist in neutral for nocturnal wear. In addition, intermittent exercise (nerve-gliding exercises) and activity modification, including avoidance of protracted periods of sustained gripping activities and awkward wrist positions, can be useful. This conservative program may be complemented by pain-relieving modalities during times of activity and supplemental participation in other exercise such as yoga. If symptoms are not relieved to the satisfaction of the patient, or they recur, then it is incumbent upon the therapist to refer the patient to a hand surgeon for injection or possible surgical decompression.

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Section: Cortisone Injectionmentioning

confidence: 99%

Conservative Interventions for Carpal Tunnel Syndrome

Michlovitz¹

2004

J Orthop Sports Phys Ther

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“…Celiker et al conducted an unblinded randomized clinical trial with an 8-week follow-up of 33 hands in 23 patients, comparing the efficacy of steroid injection against splinting combined with the use of a non-steroidal anti-inflammatory drug. 25 It showed that both treatment regimes resulted in significant improvement but there was no difference between the two interventions. These findings resonate with those from ours.…”

Section: Discussionmentioning

confidence: 98%

Local steroid injection versus wrist splinting for carpal tunnel syndrome: A randomized clinical trial

Chung

Cheng

et al. 2017

Int J of Rheum Dis

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Aim: We conducted a prospective randomized parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with carpal tunnel syndrome (CTS). Methods:The well-validated and disease-specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included patient satisfaction, the change of an objective finger dexterity test and the side effects.Results: Twenty-five patients in the local steroid group and 25 patients in the wrist splinting group completed the study procedures. At 4 weeks after treatment, there was significant improvement of the BTCQ scores in both the steroid group and splinting group. There was improvement of the finger dexterity test only in the steroid group but not in the splinting group. However, there was no statistically significant difference in the changes of BTCQ scores between the two groups after treatment. Patient satisfaction score was higher in the steroid group. Patients in the steroid group took fewer painkillers after treatment. Four patients developed side effects after splinting and three after local steroid injection, which was not statistically significant. Conclusion:Although local steroid injection and nocturnal wrist splinting were equally effective in the treatment of patients with CTS, only the former improved objective hand function. Local steroid injection also resulted in better patient satisfaction and less painkiller use without causing more side effects.

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“…Carpal tunnel syndrome is the most commonly treated compression neuropathy and continues to be controversial in both diagnosis and treatment (17)(18)(19). The prevalence of carpal tunnel syndrome has been reported to be as high as 2.7% in the general population (20).…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of clinical testing for carpal tunnel syndrome

Wiesman¹

2003

J Plast Surg

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OBJECTIVE: The present study evaluated the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of carpal tunnel syndrome (CTS). METHODS: There were 29 carpal tunnel syndrome (CTS) subjects (mean age 48 years) and 30 control subjects (mean age 45 years). The six clinical tests included Tinel's sign, wrist flexion with fingers extended, wrist flexion with fingers flexed, wrist extension, combined wrist extension/median nerve pressure and combined wrist flexion/median nerve pressure. RESULTS:The highest sensitivity and highest negative predictive value was found with wrist flexion with pressure (96%) and wrist extension with pressure (94%) at 60 s. The highest specificity was found with wrist flexion with fingers flexed for 30 s (95%). The highest positive predictive values were found with the wrist flexion with fingers flexed test for 30 s (91%) and the wrist extension test for 30 s (90%). CONCLUSION:No one test possesses all the qualities necessary to be the ideal clinical test for the detection of carpal tunnel syndrome. Key Words: Carpal tunnel syndrome; EvaluationLa sensibilité et la spécificité des épreuves cliniques pour le syndrome du canal carpien OBJECTIF : La présente étude a évalué la sensibilité, la spécificité et les valeurs prédictives de six épreuves cliniques dans le diagnostic du syndrome du canal carpien. MÉTHODOLOGIE : Il y avait 29 sujets atteints du syndrome du canal carpien (SCC) (âge moyen de 48 ans) et 30 sujets témoins (âge moyen de 45 ans). Les six épreuves cliniques incluaient le signe de Tinel, la flexion du poignet les doigts dépliés, la flexion du poignet les doigts fléchis, l'extension du poignet, l'extension du poignet combinée à la pression du nerf médian et la flexion du poignet combinée à la pression du nerf médian. RÉSULTATS : La sensibilité la plus élevée et la valeur prédictive la plus négative ont été découvertes au moyen de la flexion du poignet avec pression (96 %) et de l'extension du poignet avec pression (94 %) pendant 60 s. La spécificité la plus élevée a été établie avec la flexion du poignet les doigts fléchis pendant 30 s (95 %) et avec l'épreuve d'extension du poignet pendant 30 s (90 %). CONCLUSION : Aucune épreuve ne possède toutes les qualités néces-saires pour constituer l'épreuve clinique idéale permettant de déceler le syndrome du canal carpien. C arpal tunnel syndrome (CTS) is a compressive neuropathy of the median nerve that is associated with numbness and tingling in the median nerve distribution of the hand. The diagnosis of CTS is made clinically by history and physical examination and confirmed with electrodiagnostic studies. The most useful clinical tests are those tests that have a high sensitivity (proportion of true positive tests to all diseased subjects) and specificity (proportion of true negative tests to all healthy subjects). Traditionally, Tinel's sign and Phalen's tests have been used to clinically diagnose CTS. The reported sensitivity and specificity of these clinical tests vary from 30% to 100% (1). Other ...

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Corticosteroid Injection vs. Nonsteroidal Antiinflammatory Drug and Splinting in Carpal Tunnel Syndrome

Abstract: Both splinting combined with the use of a nonsteroidal antiinflammatory drug and steroid injection into the carpal tunnel resulted in significant improvement in carpal tunnel syndrome.

Cited by 79 publications

References 13 publications

Conservative Interventions for Carpal Tunnel Syndrome

Conservative Interventions for Carpal Tunnel Syndrome

Local steroid injection versus wrist splinting for carpal tunnel syndrome: A randomized clinical trial

Sensitivity and specificity of clinical testing for carpal tunnel syndrome

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