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

Chen, Po‐Cheng; Wang, Lin-Yi; Pong, Ya-Ping; Hsin, Yi-Jung; Liaw, Mei-Yun; Chiang, Chia-Wei

doi:10.2340/16501977-2308

Cited by 26 publications

(38 citation statements)

References 31 publications

(56 reference statements)

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“…Although LCIs are considered in most patients with mild-to-moderate CTS 14 , our findings showed that patients who refuse surgical intervention may benefit from the injection. A number of randomized controlled trials have documented the treatment efficacy of LCI in patients with mild and moderate CTS 7,10,15 . We found that improvement of mean pain severity, symptoms and functional status scores did not differ between mild, moderate and severe CTS patient groups.…”

Section: Discussionmentioning

confidence: 99%

“…After 12 weeks, they found that there was no significant difference in symptom severity scores between the out-plane ultrasound-guided injection and direct injection groups 19 . In a double blind randomized controlled trial, Chen et al assessed the effectiveness of ultrasound-guided versus direct-approach injections for CTS 15 . They reported that they did not observe any difference in the clinical evaluation of the outcomes of the two groups, similar to the findings of Lee et al Ulnar approaches between the palmaris longus and flexor carpi radialis tendons, or just medial to the palmaris longus tendon, have commonly been performed as a successful blind injection technique for CTS treatment [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

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Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Ertem

Şirin

Yılmaz

2019

Arq. Neuro-Psiquiatr.

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Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. Objective: The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Methods: Electrophysiological parameters were evaluated before and three months after LCI. Moreover, the Numeric Rating Scale (NRS), the Boston Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were administered before and after the injection. A mixture of 1 mL (40 mg) of methylprednisolone and 1 mL of 0.5% bupivacaine were injected blindly on the volar side of the forearm between the tendons of the radial carpal flexor muscle and long palmar muscle. Results: A total of 25 patients (45 hands) were enrolled in the study. Twenty women and five men with a mean age of 49.28 ± 11.37 years were included. A statistically significant difference was noted for improvement of sensory conduction velocities, sensory peak latency, and motor distal latency (p = 0.001) after LCI. A significant difference was recorded between pre- and post-injection for NRS, SSS and FSS scores (p = 0.000). Conclusion: Local corticosteroid injection for CTS provides a short-term improvement in neurophysiological and clinical outcomes such as pain intensity, symptom severity and functional ability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Ertem

Şirin

Yılmaz

2019

Arq. Neuro-Psiquiatr.

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“…Although corticosteroid injections are a mainstay of conservative CTS treatment, they have been found to be inferior to surgery in the long term . Multiple recent studies, including a meta‐analysis, have demonstrated that injections performed with US guidance can be more efficacious than those without . In‐plane transverse median nerve injections can be performed from either a radial (lateral) or an ulnar (medial) approach .…”

Section: Approach To Ultrasound‐guided Treatment Of Individual Entrapmentioning

confidence: 99%

“…37 Multiple recent studies, including a meta-analysis, have demonstrated that injections performed with US guidance can be more efficacious than those without. [38][39][40][41][42] In-plane transverse median nerve injections can be performed from either a radial (lateral) or an ulnar (medial) approach. 43 The advantage of the ulnar approach is that it avoids most tendons and the palmar cutaneous nerve, whereas the radial approach has the advantage of avoiding the ulnar artery.…”

Section: Fibular (Peroneal) Nerve At the Fibular Neck Neuropathymentioning

confidence: 99%

Ultrasound‐guided treatment of peripheral entrapment mononeuropathies

Norbury

Nazarian

2019

Muscle and Nerve

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The advent of high‐resolution neuromuscular ultrasound (US) has provided a useful tool for conservative treatment of peripheral entrapment mononeuropathies. US‐guided interventions require careful coordination of transducer and needle movement along with a detailed understanding of sonoanatomy. Preprocedural planning and positioning can be helpful in performing these interventions. Corticosteroid injections, aspiration of ganglia, hydrodissection, and minimally invasive procedures can be useful nonsurgical treatments for mononeuropathies refractory to conservative care. Technical aspects as well as the current understanding of the indications and efficacy of these procedures for common entrapment mononeuropathies are reviewed in this study. Muscle Nerve, 2019

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“…9 There are different methods to treat CTS, including medication, 10 splint, exercises, 11 surgery, 12 low-level laser therapy (LLLT), [13][14][15] Bioptron, 16 and ultrasound. 17 Among various therapies, the LLLT and ultrasound methods may have potential effects on inducing biophysical effects within tissues. 18,19 The experiments on nerve regeneration and neurotransmission, which are affected by LLLT 20,21 and ultrasound 22,23 stimulatory effect, suggest that these treatments may facilitate the recovery process in the compressed nerve.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Low-Level Laser Therapy compared to Ultrasound in Patients With Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

Rayegani

Moradi-Joo²,

Raeissadat

et al. 2019

J Lasers Med Sci

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Introduction: Carpal tunnel syndrome (CTS) is the most common type of peripheral entrapment neuropathy that occurs in the wrist area in a space called the carpal tunnel. Low-level laser therapy (LLLT) and ultrasound are among the most common methods of physical modalities for treating CTS; the effectiveness of these 2 methods and the superiority of one over the other are not agreed among experts. Methods: In the present systematic review and meta-analysis study, the most important databases including PubMed, Cochrane Library, Scopus, Centre for Reviews and Dissemination, Science Direct, Trip medical database and Google Scholar were searched using appropriate keywords and specific strategies without time limitation to collect data. The collected data was analyzed using the meta-analytic method and the random-effects model. The heterogeneity among studies was examined using I2 . The data were analyzed using Review Manager Software. Results: From among 108 related studies, 49 cases were entered for the first stage. After the final examination, 6 studies were selected for meta-analysis. The total number of patients in these 6 studies was 403; 204 subjects were in the LLLT group and 199 subjects were in the ultrasound group. The results of the meta-analyses showed that there was no significant difference between these 2 therapeutic methods in terms of pain relief, symptom severity scale (SSS), functional status scale (FSS), motor latency, sensory latency, hand grip strength, and motor amplitude. Conclusion: Based on the meta-analyses, there was no significant difference between the 2 LLLT and ultrasound methods; in other words, they had similar effectiveness in improving the condition of patients with CTS. However, the authors believe that arriving at conclusions in this area requires high-quality and large size studies.

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

Cited by 26 publications

References 31 publications

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Ultrasound‐guided treatment of peripheral entrapment mononeuropathies

Effectiveness of Low-Level Laser Therapy compared to Ultrasound in Patients With Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

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