Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome

Sevim, Serhan; Doğu, Okan; Ankaralı, Handan; Kaleağası, Hakan; Aral, Mübin; Arslan, Enver; Milcan, Abtullah

doi:10.1007/s10072-004-0229-0

Cited by 76 publications

(48 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are many studies regarding splint application on neutral and extension. (0-20°) [5,9,[20][21][22][23][24]. It is reported that in splint application the optimal angle on which the median nerve is most comfortable can vary for each individual [16].…”

Section: Introductionmentioning

confidence: 99%

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

et al. 2010

View full text Add to dashboard Cite

To evaluate the clinical effectiveness of wrist splint usage arranged by determining the optimal position on which the median nerve is compressed the least through sonographic examination for patients with carpal tunnel syndrome (CTS). This study was a prospective, clinical trial with a 6-week follow-up. Twenty-four patients diagnosed clinically and electromyographically with CTS were included in the study. A total of 37 wrists were studied on. When the patients were grouped according to the optimal position, Group I comprising 16 (43.24%) wrists was at 15 degree flexion, Group II comprising 12 (32.43%) wrists was neutral, Group III comprising 6 (16.22%) wrists was at 15° extension and Group IV comprising 3 (8.11%) wrists was at 30° extension configurations. Groups I, II and III were included in clinical follow-up. Symptom severity score (SSS), functional status score (FSS), Grip strength and Pinch strength were used for the clinical follow-up and evaluation of the patients. When pre- and post-treatment were compared, a statistically significant recovery was detected in all three groups in respect to SSS (Group I P < 0.01, Group II P < 0.05, Group III P < 0.05). A statistically significant recovery was detected for FSS only in Group I (P < 0.05) and for Grip strength in Group II (P < 0.05). When the groups were compared among themselves, no statistically significant difference was detected for any of the parameters (P > 0.05). In this study, by sonographic examination of the patients included in the study with CTS, we saw that the optimal position on which the median nerve is compressed the least varies depending on the individual and we determined that this position was 15° flexion most frequently for our patients. We also observed that in clinical follow-up of wrist splint usage arranged on custom optimal position results in significant recovery.

show abstract

Section: Introductionmentioning

confidence: 99%

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The neutral position of the wrist, reduce the pressure on the median nerve in the carpal tunnel and splints are designed to hold the wrist in the neutral position [8,22]. The efficacy of wrist splinting has been variably demonstrated in several studies [7,[23][24][25]. In a randomized case-control trial by Premoselli et al, it is reported that splinting therapy improved symptoms and electrophysiological parameters in CTS patients [23].…”

Section: Discussionmentioning

confidence: 99%

“…Similar to our study, Kruger et al reported significant improvement in signs and symptoms of CTS and distal sensory latency in 67% of 105 patients with CTS and also reported that it is possible to get a positive result if the treatment starts within the first three months of the disease [7]. Also in a prospective, randomized, and blinded trial with 1-year follow-up, it is reported that splinting therapy improved symptoms, motor, and sensorial conduction velocities when the splints were worn almost every night [25]. Usually, the diagnosis of carpal tunnel syndrome is made primarily by clinical examination and the patient's history of symptoms, though it is necessary to confirm the diagnosis with the use of electrodiagnostic nerve testing.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of splint treatment or splint plus gabapentin treatment in idiopathic carpal tunnel syndrome

Mehmetoglu¹

2018

Ann Clin Anal Med

View full text Add to dashboard Cite

Aim: The aim of the present study was to evaluate the efficiency of gabapentin treatment combined with splint application in idiopathic carpal tunnel syndrome (CTS) and to determine clinically and electroneurophysiologically if the combined treatment is superior to splint application alone. Material and Method: A total of 30 patients with a clinical and electroneurophysiological diagnosis of CTS were recruited to the study and randomized into two groups to receive combined treatment consisting of 1800 mg/day gabapentin and splint application or to use splint alone. Clinical assessments were performed at baseline, at month 1 and month 6. Patients were assessed by Visual Analogue Scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), grip strength and electroneurophysiological studies; the treatment satisfaction was evaluated by a Lickert scale. Results: VAS-pain, -paresthesia scores were improved in both groups with no statistical difference between the groups. Grip strength and functional assessments were improved significantly only in the splint group. In electroneurophysiological studies, distal motor latency in the combined treatment group, sensory latency in splint group and sensory conduction velocity in both groups were improved significantly. Intergroup comparisons revealed significant improvement in combined treatment group only for sensory conduction velocity. Discussion: In conclusion, our study suggests that combination of splint and gabapentin is not superior to the splint alone in the treatment of CTS, except for median nerve sensory conduction velocity.

show abstract

“…On the other hand, in the other trial of 120 patients by Sevim et al comparing steroid injection and splinting, only splinting provided symptomatic relief while injections of steroids were ineffective at 1-year follow-up. 26 However, the conclusions of these two studies are limited either by the small sample size or the lack of a validated outcome measure.…”

Section: Discussionmentioning

confidence: 99%

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

Chung

Cheng

et al. 2017

Int J of Rheum Dis

View full text Add to dashboard Cite

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.

show abstract

Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome

Cited by 76 publications

References 10 publications

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

Determination of the position on which the median nerve compression is at the lowest in carpal tunnel syndrome and clinical effectiveness of custom splint application

Efficacy of splint treatment or splint plus gabapentin treatment in idiopathic carpal tunnel syndrome

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

Contact Info

Product

Resources

About