The comparison between effectiveness of ultrasound guided corticosteroid injection above versus below the median nerve in mild to moderate carpal tunnel syndrome: A randomized controlled trial
In this study the clinical effectiveness of ultrasound-guided corticosteroid injection “above” versus “below” the median nerve for treatment of patients with mild to moderate carpal tunnel syndrome (CTS) was compared.Design
This prospective randomized double-blind clinical trial included 44 patients with mild to moderate CTS. The subjects were randomly assigned to two groups to receive ultrasound-guided injection of 40 mg triamcinolone either “above” or “below” the involved median nerve. Outcome measures were the Boston Carpal Tunnel Questionnaire, Visual Analogue Scale, electrophysiological tests, and ultrasonographic measurement of the median nerve cross-sectional area at baseline, 6 weeks and 12 weeks after the injectionResults
All outcome measures improved significantly in both groups at 6 weeks after intervention, and these improvements were persevered up to 12 weeks follow up (all P-value <0.05). However, there was no significant difference in measured outcomes between the two groups. No adverse side effects were observed.Conclusions
Both above and under median nerve ultrasound-guided steroid injection techniques were effective in reducing the symptoms, improving the function and electrodiagnostic and sonographic findings of CTS. However the amount of improvement in the outcomes did not differ between groups, implying that none of technique has the superiority over another.