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        DGReview


        Steroid Effect Temporary In Carpal Tunnel Syndrome

        A DGReview of :"Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome"
        Rheumatology International

        05/28/2002
        By Anne MacLennan


        Steroid injection for carpal tunnel syndrome is as good as surgical release of the median nerve at three months, but is not long-lasting, researchers in Turkey have found.

        This comparison of local steroid injection versus open carpal tunnel release was by Serpil Demirci and colleagues from Suleyman Demirel University School of Medicine, Isparta, and Hosdere Caddes, Ankara.

        Ninety patients with electrophysiologically proven idiopathic carpal tunnel syndrome participated in this study. Forty-four were treated surgically, 46 were treated with a two-dose steroid injection.

        A symptom and function status questionnaire (Boston Questionnaire) and sensory and motor nerves conduction studies was used to compare the groups. The electrophysiological studies and questionnaire were applied before and at the third and sixth month after treatment.

        Both groups showed significant improvement at the first follow-up at three months.

        However, between the third- and sixth-month evaluations, the surgically treated group showed significant and further improvement of symptoms and conduction values, whereas no significant changes were seen in those treated by steroid injection.

        By the end of follow-up, 5 percent of the hands in the open carpal tunnel release group and 13 percent of those in the local steroid injection group showed electrophysiological worsening. At the same time, there was symptomatic worsening in 5 percent of hands in the surgical group versus 22 percent of hands in steroid injection group.

        The authors conclude that while steroid injection provides an improvement comparable with that from surgical release at three months post-treatment, this improvement is not does not last long.
        Rheumatol Int (2002) 22: 33-37. "Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome"

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