Ultrasound-Guided Injection vs Intramuscular Steroid for Carpal Tunnel Syndrome

Launched by KONYA BEYHEKIM TRAINING AND RESEARCH HOSPITAL · Dec 4, 2024

Keywords

ClinConnect Summary

This clinical trial is studying two different methods of delivering steroid treatment for carpal tunnel syndrome (CTS), a condition that causes numbness and pain in the hand due to pressure on a nerve in the wrist. The researchers want to compare the effectiveness of an ultrasound-guided local steroid injection, which uses sound waves to help guide the injection, with a traditional intramuscular steroid injection. They will look at things like pain levels, hand strength, and overall satisfaction with the treatment to see which method works better for people with mild to moderate CTS.

To participate in the study, you need to be at least 18 years old and have symptoms of CTS, such as tingling or pain, that have lasted longer than 12 weeks. You should also have certain clinical signs and mild to moderate CTS confirmed by tests. However, this study is not for everyone. For instance, if you have other issues with your wrist or hand, a history of trauma or surgery in that area, or certain health conditions, you may not be eligible. If you decide to join, you can expect to undergo assessments before and after the treatment to determine how well it worked for you.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥18 years
• • Presence of typical CTS symptoms (numbness, tingling, paresthesias, or pain that may be provoked by nighttime or activity-related posture
• • VAS score of ≥ 3/10
• • Symptom duration longer than 12 weeks
• • Positive Tinel's and/or Phalen's sign
• • Electrophysiologically mild or moderate CTS being diagnosed.
• • Volunteer to participate in study
• Exclusion Criteria:
• • Patients with shoulder, elbow, wrist, or finger problems (e.g., impingement syndrome, epicondylitis, history of fractures in the wrist, de Quervain's tenosynovitis, trigger finger, Complex Regional Pain Syndrome (CRPS), Dupuytren's contracture).
• • Patients with a history of trauma or surgery in the affected hand, or those with significant anatomical deformities.
• • Patients with systemic diseases such as rheumatological disorders, hypothyroidism, amyloidosis, diabetes, gout, or chronic kidney failure.
• • Patients with conditions that may mimic CTS, such as polyneuropathy, plexopathy, cervical radiculopathy, or thoracic outlet syndrome.
• • Patients with cognitive dysfunction or communication issues.
• • Patients with severe CTS, neurological deficits (e.g., thenar atrophy, muscle weakness in thumb abduction/opposition), or those requiring surgical intervention.
• • Patients who have received local steroid injections or physical therapy to the hand/wrist within the last 6 months.
• • Patients who are receiving or will receive another/additional treatment for CTS.
• • Pregnant or lactating women.
• • Patients with active malignancies or local/systemic infections.
• • Patients who are receiving any active treatment (e.g., NSAIDs, oral/intramuscular steroids, acupuncture, other pain medications).
• • Patients with upper extremity involvement due to first motor neuron damage (e.g., stroke-hemiplegia, tetraparesis, multiple sclerosis).
• • Patients with a bifid median nerve, persistent median artery, ganglion cyst, tenosynovitis, or tendinitis in the wrist.
• • Use of a wrist splint during the last 6 months.
• • Allergy to corticosteroids or local anesthetics, and blood diathesis