Our Experience in Carpal Tunnel Syndrome Therapeutic Effectiveness Evaluation (original) (raw)
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Efficacy of Local Corticosteroid in Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial
Bangladesh Journal of Neuroscience, 2013
Background: Carpal tunnel syndrome (CTS) is a common health problem in Bangladesh especially among women. It causes significant morbidity and reduces work output in affected patients. There are few treatment options available like oral steroid, steroid injection, UST, surgical treatment etc. Considering the cost, time and consequence of surgery, short term nonsurgical management is desirable e.g. local steroid injection in the affected limb. Therefore a comparative analysis is necessary to understand the efficacy of local steroid injection.Objective: To evaluate the efficacy of local corticosteroid injection in the treatment of idiopathic carpal tunnel syndrome. Methods: 60 idiopathic CTS patients divided into two groups by randomization. One group received Inj. Triamcinolone 30 mg close to carpal tunnel and other group received oral steroids. Efficacies of treatmemt were compared in between groups.Result: The mean age of two groups were 37.5 ± 10.5 and 37.0 ± 10.24 years respective...
Archives of Physical Medicine and Rehabilitation, 2020
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Corticosteroid injection for carpal tunnel syndrome: a 5-year survivorship analysis
Hand (New York, N.Y.), 2012
The purpose of our study was to determine the rate of carpal tunnel decompression (CTD) following local corticosteroid injection for carpal tunnel syndrome (CTS), as well as identifying predictors of requiring further intervention and eventual decompression. All patients diagnosed with CTS in our unit over a 6-year period were prospectively assessed. Patients were diagnosed using a combination of clinical presentation and nerve conduction studies. Patients were managed with open carpal tunnel decompression or corticosteroid injection. There were 1,564 consecutive patients diagnosed with CTS over the study period, of whom 824 (53%) underwent a corticosteroid injection as their primary treatment. We performed a survivorship analysis of these patients and used Kaplan-Meier survivorship methodology to determine the 5-year rate of re-intervention. Risk factors for re-intervention were also determined. The overall 5-year Kaplan-Meier rate of secondary CTD was 15% at 1 year and 33% at 5 ye...
Quality of life of carpal tunnel syndrome with non operative treatment: cohort study
International Journal of Research in Medical Sciences, 2020
Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy entrapment and it interferes with the quality of life. Treatment for CTS can be divided into operative and non-operative treatment. Our objective was to compare the quality of life and pain intensity in a patient with CTS after oral treatment and local corticosteroid injection (LCI).Methods: A prospective cohort study was conducted in 18-65 years patients with CTS. Primary outcome was to compare the quality of life post oral treatment (NSAIDs, oral steroids, gabapentin) and LCI using the Short Form-36 questionnaire. Secondary output was to compare pain intensity using Numeric Rating Scale (NRS). Mann-Whitney and independent t-test were used to assess the comparison between the treatment.Results: Sixty CTS patients were included in this study, with 32 patients (53.33%) assigned to LCI. After observation one month, statistical analysis showed that LCI improved the quality of life better than oral in phys...
Journal of back and musculoskeletal rehabilitation, 2016
The purpose of this study was to evaluate the neuropathic symptoms after local steroid injection in CTS. Since 2001, neuropathic pain scales have been used in the assessment and follow-up of neuropathic pain. DN4 and LANSS pain questionnaires have been applied to groups, mostly consisted of radiculopathy and polyneuropathy cases, before and after various treatments and the results have been compared with the electrophysiologic findings. However to our knowledge there is yet no such study focusing on neuropathic complaints and the relationship between neuropathic pain and electrophysiological findings before and after local corticosteroid injection. Forty-one patients aged 22-65 years and diagnosed with carpal tunnel syndrome by nerve conduction studies who were also found to have a neuropathic symptoms were included in the study. All patients received local steroid injection into the carpal tunnel while the questionnaires and nerve conduction studies were performed before and 2 mont...
Rheumatology (Oxford, England), 2005
Local glucocorticoid injections are used to treat carpal tunnel syndrome (CTS). However, this treatment is associated with frequent relapses. An important limitation of studies with higher relapse rates is that no attempt has been made to identify patients with mild or severe disease. We evaluated the efficacy of local glucocorticoid injection in patients with mild CTS. Mild CTS was defined as intermittent symptoms without absence of sensations, muscle atrophy or weakness of the thenar muscles. Forty-eight patients with idiopathic mild CTS were evaluated before and 3 and 12 months after a single local injection of 40 mg methyl prednisolone acetate. Outcome was assessed by overall satisfaction on a 100 mm visual analogue scale, the Boston self-administered questionnaire for symptom severity and functional scores and improvement in the electrophysiological parameters. At 3 months, 93.7% of the patients reported marked improvement in their symptoms, with significant improvement in the ...
Effectiveness of second corticosteroid injections for carpal tunnel syndrome
2013
Introduction: A single local corticosteroid injection is an effective treatment for carpal tunnel syndrome. No study has specifically examined the effectiveness of a second injection on relapse after primary injection. Methods: We identified a cohort of patients who had received an initial corticosteroid injection into 1 wrist and then, at a later date, a second injection into the same wrist. We compared the change in the Boston Symptom Severity Scale (SSS) and Functional Status Scale (FSS) between first and second injections. Results: In 229 patients who received 2 injections the mean improvement on the SSS was 1.2 (SD 5 0.8) for the first injection and 1.3 (SD 5 0.9) for the second, which was not statistically significant. Improvement in FSS for the first injection was 0.4 (SD 5 0.8) and 0.7 (SD 5 0.8) for the second, which was statistically significant (P < 0.001). Conclusion: Second corticosteroid injections appear to be at least as effective as the first.
Clinical management of carpal tunnel syndrome: A 12-year review of outcomes
American Journal of Industrial Medicine, 1999
Single group prospective, in which all patients were assigned to a single treatment group and followed longitudinally. 4. Multiple group retrospective, in which patients were assigned to different treatment conditions, and archival data were analysed to assess outcomes. 5. Single group retrospective, in which patients were assigned to one treatment condition and archival data were used. 6. Case study, which presented data on single patient outcomes. All prospective multiple group studies available were included in the review. Other study designs were included depending on availability of studies with higher levels of study design within the treatment category. Specific interventions included in the review Surgery (open and endoscopic release), pharmacological/vitamins/steroids (taken orally, injected into the carpal canal or transported via iontophoresis), physical therapy (range or motion exercises)/splinting, chiropractic/manipulation, biobehavioural therapies (individual and group cognitive behaviour therapy, muscle activity biofeedback, neuromuscular re-education and movement retraining), and occupational/work rehabilitation. Participants included in the review People with diagnosed carpal tunnel syndrome, or diagnoses such as 'hand pain', both work-related and non-workrelated. Outcomes assessed in the review Medical status (two-point discrimination, nerve conduction velocity, Semmes-Weinstein, Phalen's test, Tinel's test, thenar atrophy, interstitial pressure), symptoms (self report) (pain, tenderness, numbness, parasthesia, weakness, night symptoms, fine dexterity loss), function (grip, key pinch, pulp pinch, range of motion, activities of daily living), work status (median days out of work, workers' compensation status, working with pain), psychological well-being (anxiety, depression, coping strategies, sickness), patient satisfaction (treatment satisfaction rating). How were decisions on the relevance of primary studies made?