Effectiveness of splinting and splinting plus local steroid injection in severe carpal tunnel syndrome: A Randomized control clinical trial

Abstract

Background:The Study aimed to compare the effectiveness of two commonly used conservative treatments, splinting and local steroid injection in improving clinical and nerve conduction findings of the patients with severe carpal tunnel syndrome (CTS).Materials and Methods:In this randomized control clinical trial, the patients with severe CTS selected and randomized in two interventional groups. Group A was prescribed to use full time neutral wrist splint and group B was injected with 40 mg Depo-Medrol and prescribed to use the full time neutral wrist splint for 12 weeks. Clinical and nerve conduction findings of the patients was evaluated at baseline, 4 and 12 weeks after interventions.Results:Twenty-two and 21 patients were allocated in group A and B, respectively. Mean of clinical symptoms and functional status scores, nerve conduction variables and patients’ satisfaction score were not significant between group at baseline and 4 and 12 weeks after intervention. Within the group comparison, there was significant improvement in the patients’ satisfaction, clinical and nerve conduction items between the baseline level and 4 weeks after intervention and between the baseline and 12 weeks after intervention (P < 0.01). The difference was significant for functional status score between 4 and 12 weeks after intervention in group B (P = 0.02).Conclusion:considering some findings regarding the superior effect of splinting plus local steroid injection on functional status scale and median nerve distal motor latency, it seems that using combination therapy could be more effective for long-term period specially in the field of functional improvement of CTS.

A Comparative Study of Effectiveness of Splinting and Splinting Plus Local Corticosteroid Injection in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial

“…Also, the mean difference of FSS from baseline to the 12th week after treatment was significantly higher in Group B. Our study results were similar to the reported results of Khosrawi et al [16].…”

Revisiting the Urge to Operate: One-year Neurophysiological Follow-up in Severe CTS

“…The symptoms and functional status improved significantly, though the symptoms got better greatly. The data of other researches were mostly in favor of our results [3,5,7,13,14,16,17]. Our study showed that patients who used splint had meaningful enhancement in both the symptoms and functional scores, while the others who had no treatment only showed enhancement in their symptoms.…”

“…Another study by Khosravi et al compared the effectiveness of steroid injection versus steroid injection plus splinting in severe CTS. Their results showed significant improvement of functional scale, patient satisfaction, and nerve conduction parameters after 4 weeks in both groups [14].…”

Efficiency of therapeutic underwater ultrasound therapy in mild-to-moderate carpal tunnel syndrome: A randomized sham-controlled study

“…[ 35 , 36 ] In many randomized controlled studies, a splint is used as a control group treatment. [ 37 , 38 ] In this study, which we conducted to evaluate the effectiveness of active underwater pulsed US therapy more clearly, we administered splints to all groups, and an improvement was observed in VAS, clinical assessment parameters, HGS, and PQAS in all groups. However, as other treatment types were also administered to two groups in addition to splinting, we could not attribute the success only to the splint alone.…”