Effectiveness of Ultrasound‐Guided Compared to Blind Steroid Injections in the Treatment of Carpal Tunnel Syndrome

Abstract

Background The aim of this study was to compare the effectiveness of ultrasound-guided injections to blind injections in the treatment of carpal tunnel syndrome (CTS) in a large community-based cohort. Methods This study evaluated residents of Olmsted County, MN, USA, treated with a corticosteroid injection for CTS between 2001 and 2010. The proportion of patients receiving retreatment and the duration of retreatment-free survival between blind and ultrasound-guided injections were compared. Propensity score matching was used to control for confounding by indication. Results In the matched dataset consisting of 234 (out of 600) hands treated with a blind injection and 87 (out of 89) ultrasound-guided injection cases, ultrasound guidance was associated with a reduced hazard of retreatment (hazard ratio, 0.59; 95% confidence interval [CI], 0.37 - 0.93). In addition, ultrasound guidance was associated with 55% reduced odds of retreatment within one year compared to blind injections (adjusted odds ratio, 0.45; 95% CI, 0.24 - 0.83). Conclusion This study indicates that ultrasound-guided injections are more effective in comparison to blind injections in the treatment of CTS.

Effectiveness of ultrasound-guided vs direct approach corticosteroid injections for carpal tunnel syndrome: A double-blind randomized controlled trial

“…Although Makhlouf et al (30) also compared the outcomes of these 2 injection techniques at 6-month follow-up, the results lacked objective findings (only procedural pain, pain scores, and responder rates were reported). In a recent community-based cohort study, Evers et al (31) found that ultrasound-guided injection was associated with a reduced hazard of retreatment, but the research was also short of objective outcomes.…”

Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

“…In another study, which was a large community-based cohort over a longer period of follow-up, US-guided injections were found more effective in comparison to blind injections in the treatment of CTS (20). In a study of 44 patients with CTS receiving corticosteroid injections using either one of two different US-guided approaches or blind injection, the investigators reported that US-guided carpal tunnel injections were Data are given as mean ± SD.…”

Ultrasound-guided peripheral nerve interventions for common pain disorders

“…[ 16 17 ] Ultrasound-guided injection is more effective than surface marking-guided injections. [ 18 19 ] Splints are used initially for treatment, but its utility is questionable. [ 20 ] Steroid injection in the carpal tunnel, performed when splints fail, causes clinical and electrophysiological improvement lasting as long as 10 weeks; and surgical release is used for persistently symptomatic cases.…”