Local vs systemic corticosteroids in the treatment of carpal tunnel syndrome

Abstract

The authors compared the effectiveness of low-dose, short-term oral prednisolone vs local methylprednisolone injection in a prospective, double-blinded, parallel treatment study of carpal tunnel syndrome (CTS). A single injection of 15 mg methylprednisolone resulted in significant improvement in global symptom scores over a 12-week period. This study demonstrated the superiority of local steroid injection to oral steroid in the treatment of CTS.

The long-term follow-up of treatment with corticosteroid injections in patients with carpal tunnel syndrome. When are multiple injections indicated?

“…This percentage is identical to the results of Dammers and colleagues (1999), who reported improvement in 77% 1 month after treatment. Although some investigators have reported slightly lower percentages of success, there is no doubt about the beneficial shortterm effect of corticosteroid injections (Armstrong et al, 2004;Bickel, 2010;Bland, 2007;Girlanda et al, 1993;Hagebeuk and de Weerd, 2004;Herskovitz et al, 1995;Marshall et al, 2009;Peters-Veluthamaningal et al, 2010;Wong et al, 2001). Similar to our results, in the study by Dammers et al (1999) a good outcome decreased from 77% after 1 month to 39% after 1 year of follow-up.…”

Evaluation of the Effect of Local Corticosteroid Injection and Anti-inflammatory Medication in Carpal Tunnel Syndrome

“…They found that injections produced better results in the study group. 7 O'Gradaigh et al compared low-and high-dose and short-and long-acting corticosteroids in the treatment of CTS and found that low-dose corticosteroid is as effective as higher doses and potentially less toxic in short-and long-term followup. 8 We used six mg of betamethasone for injections and believe this dose is effective, but in our study we did not compare different doses in the different groups.…”

Conservative therapeutic management of carpal tunnel syndrome

“…In seven studies of adequate methodology 6,7,8,9,10,11,12,13 , Piazzini et al 11 concluded that corticosteroid injection in the carpal tunnel can be considered as an effective treatment. However, no significant clinical benefit was found for corticosteroid injections compared with other treatments, including splint immobilization 14,15 .…”