Corticosteroid Injection in Carpal Tunnel Syndrome

Comparison of Different Dose of Steroid Injection in Carpal Tunnel Syndrome

To compare the effectiveness of different dose of ultrasound guided steroid injection in patient with carpal tunnel syndrome, by using clinical and electrophysiological parameters in evlauation

This is a prospective, single-blinded randomized controlled study to determine the efficacy of low dose corticosteroid in patient with CTS. Patient with CTS were randomly assigned to group receiving ultrasound guided steroid injection with different dosage of triamcinolone acetonide (Shincort) mixed, 1ml 10mg (10mg/ml) or 1ml 40mg (40mg/ml) with 1 ml of 2% lidocaine hydrochloride. The follow up at 6 and 12 weeks includes Boston Carpal Tunnel Questionnaire, nerve conductive study and VAS pain score.

Inclusion Criteria:

• Clinical diagnosis of CTS
• The diagnosis of CTS was confirmed by electrophysiological tests.

Exclusion Criteria:

• presence of thenar atrophy
• existence of disorders such as hypothyroidism, diabetes mellitus, chronic renal failure, or rheumatoid arthritis; any accompanying orthopedic or neurologic disorders that could mimic CTS such as cervical radiculopathy, polyneuropathy, proximal median nerve entrapment, or thoracic outlet syndrome
• prior steroid injection into the affected carpal tunnel within 6 months or ever received carpal tunnel surgery
• history of distal radius fracture
• pregnancy or lactation
• regular use of systemic NSAIDs ,corticosteroids or diuretics
• known allergy to corticosteroids and local anesthetics.
• impaired cognitive function