Evaluating the Effectiveness of Surgical Treatment and Local Steroid Injection in Patients with Carpal Tunnel Syndrome

Document Type : Original Article

Authors

1 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran

2 Department of Neurology, Zabol University of Medical Sciences, Zabol, Iran

3 Zabol University of Medical Sciences, Zabol, Iran

4 Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran

Abstract

Background: Carpal tunnel syndrome (CTS) is considered as the most common entrapment neuropathy. Median nerve release by surgery is a manual therapy intervention used for treating CTS.

Objectives: The aim of the present study was to compare the effectiveness of surgical decompression with respect to local steroid injection in the treatment of idiopathic.

Methods: In this study, 100 patients with mild and moderate carpal tunnel syndrome were assigned to two equal groups. In one group, patients received a single local injection of triamcinolone acetonide and in the other one, open carpal tunnel release was used. A number of variables including pain (based on Visual Analogue Scale), symptom severity and functional status (based on Bostone/ Levine symptom severity and functional status scale) were assessed at the baseline and after a 6-month follow-up. Analysis was carried by intention to treat.

Results : the severity of symptoms in the surgery and injection groups was 2.51 and 2.61 respectively. However, in the follow-up, the severity of symptoms in the surgery group (1.77) was significantly lower than the injection group (2.62) (p <0.001). Before the treatment, the mean limb function was 2.68 in the surgery group and 2.71 in the injection group. However, after the treatment, the mean performance score in the surgery group (1.74) was significantly lower than the injection group (2.58) (p<0.0001). Before the treatment, the amount of the mean pain was 5.82 in the surgery group and 5.86 in the group of injection. However, after the treatment, the mean pain score in the surgery group (0.63) was significantly lower than the injection group (1.72)(p = 0.0001).

Conclusion: The findings suggested that both local steroid injection and surgical decompression were effective in alleviating symptoms of primary CTS after a 6-month follow-up but surgery offered additional benefits. In terms of security, conservative approach to surgery was preferred.

Keywords

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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