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Carpal Tunnel Syndrome (CTS) is the most common nerve entrapment syndrome worldwide. There are currently no studies examining the effectiveness of corticosteroid injections in patients with normal (negative) EMG studies. The purpose of this study is to gain a better understanding of the duration of symptom improvement post corticosteroid injection in patients with negative or mild EMG studies. The Boston Carpal Tunnel Questionnaire will be given to patients undergoing corticosteroid injections for the treatment of carpal tunnel syndrome to assess their response to the injection. Investigators will collect data retrospectively. The Boston Carpal Tunnel Questionnaire (BCTQ) is administered as per standard protocol to all patients with CTS who have a negative or mild EMG study. The BCTQ assesses the patient's self-reported symptom severity and functional status. Investigators will analyze this data with respect to demographics as well as numbness in the median n. distribution, nocturnal numbness, weakness/atrophy of the thenar musculature, Tinel's sign, Phalen's test, loss of 2-point discrimination, Quick-Dash score, and grip strength score.
The primary outcome will be the Boston Carpal Tunnel Questionnaire outcome score under the different EMG conditions.The secondary outcomes will be numbness in the median n. distribution, nocturnal numbness, weakness/atrophy of the thenar musculature, Tinel's sign, Phalen's test, loss of 2-point discrimination, QuickDash score, and grip strength score. Both outcomes will be examined in patients with negative or mild EMG readings. This information will allow orthopedic physicians to gain a better understanding of the duration of symptom improvement post-corticosteroid injection, allowing them to fine tune their treatment plans for CTS patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient with CTS/Mild EMG |
| ||
| Patient with CTS/Negative EMG |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Corticosteroid injections for CTS treatment | Other | Treatment of carpel tunnel syndrome with corticosteroid injections for EMG mild and EMG negative patients |
|
| Measure | Description | Time Frame |
|---|---|---|
| Boston Carpel Tunnel Questionnaire | Scaled 1-5, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with numbness in the median n. distribution | Positive test includes numbness in parts of palm, thumb, second and third finger, assessed by physician | Dec 23 2020-Dec 22 2021 |
| Number of patients with weakness/atrophy of the thenar musculature |
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Inclusion Criteria:
Exclusion Criteria:
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Patients clinically diagnosed with CTS, have a negative or mild EMG study, and receive a corticosteroid injection at Henry Ford Health System Orthopedics.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Elizabeth A Washnock-Schmid, B.S. | Contact | 8103474715 | gn3092@wayne.edu | |
| Aaron R Prater, M.S. | Contact | 2692752828 | aprater1@hfhs.org |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Henry Ford Health System | Recruiting | Detroit | Michigan | 48202 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27751557 | Background | Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016 Nov;15(12):1273-1284. doi: 10.1016/S1474-4422(16)30231-9. Epub 2016 Oct 11. | |
| 16886290 | Background | Graham B, Regehr G, Naglie G, Wright JG. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am. 2006 Jul-Aug;31(6):919-24. |
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| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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Positive test includes weakness in grip or holding objects as described by participant, assessed by physician |
| Dec 23 2020-Dec 22 2021 |
| Number of patients with positive Tinel's Sign | Positive sign includes 'pins and needles' in parts of palm, thumb, second and third finger upon percussion of median nerve, assessed by physician | Dec 23 2020-Dec 22 2021 |
| Number of patients with positive Phalen's Test | Positive test includes pain in parts of palm, thumb, second and third finger associated with compression of the median nerve, assessed by physician | Dec 23 2020-Dec 22 2021 |
| 2-point discrimination Test | Scaled 2-8mm, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 |
| QuickDash score | Scaled 1-100, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 |
| Grip Strength score | Scored in pounds(lbs), higher scores indicate better outcomes | Dec 23 2020-Dec 22 2021 |
| 21962473 | Background | Visser LH, Ngo Q, Groeneweg SJ, Brekelmans G. Long term effect of local corticosteroid injection for carpal tunnel syndrome: a relation with electrodiagnostic severity. Clin Neurophysiol. 2012 Apr;123(4):838-41. doi: 10.1016/j.clinph.2011.08.022. Epub 2011 Oct 1. |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |