Premium
Comparison of proximal and distal corticosteroid injections for carpal tunnel syndrome
Author(s) -
Nair Pradeep Pankajakshan,
Wadwekar Vaibhav,
Chakkalakkoombil Sunitha Vellathussery,
Narayan Sunil K.,
Marusani Revanth,
Murgai Aditya,
Thirunavukkarasu Sibi,
Krishnamoorthy Amritha,
Thazhath Harichandrakumar Kottyen
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26886
Subject(s) - medicine , wrist , sss* , carpal tunnel syndrome , corticosteroid , placebo , surgery , carpal tunnel , methylprednisolone , randomized controlled trial , alternative medicine , pathology
Evidence for the efficacy of distal corticosteroid injection compared with proximal injection in carpal tunnel syndrome (CTS) is inadequate. Methods We conducted a randomized, double‐blind noninferiority trial of 131 wrists with CTS. Forty milligrams of methylprednisolone was injected medial to the palmaris longus tendon 2 cm proximal to the wrist crease, or at the volar aspect, 2 to 3 cm distal to the wrist crease. Proximal & distal groups received a placebo. The primary outcome was difference in CTS Symptom Severity Scale (SSS) score at 1 month. Secondary outcome measures included the difference in SSS score at 3 months, Functional Status Scale (FSS) score at 1 and 3 months, and pain of injections. Results No significant differences were noted between groups in scores on the SSS and FSS. Pain was lower in the proximal group compared with the distal group. Discussion Corticosteroid injections for CTS distal to the wrist are not inferior to proximal injections, yet they are more painful.