Corticosteroid Carpal Tunnel Treatment Less Effective Than Surgery

Surgery may be a better long-term treatment option than local injections of corticosteroids when treating naïve carpal tunnel syndrome (CTS), claims a new study.

Researchers at the Gandhi Health Center (IMSALUD 4th Area, Madrid, Spain) assessed the long-term outcomes of both surgery and corticosteroid injections in an observational extension of patients who were originally enrolled in an open, randomized, clinical trial comparing injection to surgery. After the clinical trial, participants received the usual medical treatment for CTS, according to their doctors' opinions. Researchers noted whether participants needed any follow-up treatment. Therapeutic failure was defined as the need of any new therapeutic intervention on the affected wrist.

After an average follow-up of 5.9 years, 41.8% of participants who received corticosteroid injections needed additional treatment, while only 11.6% of participants who underwent surgery needed additional treatment. The researchers concluded that in long-term follow-up, decompression surgery is more effective than local injection with corticosteroids in naive CTS. The study was presented at the American College of Rheumatology annual scientific meeting, held during November 2007 in Boston (MA, USA).

"Local corticosteroid injections and decompression surgery are both equally effective in the treatment of naive carpal tunnel syndrome in the 1 year follow-up,” said lead author Domingo Ly-Pen, M.D., Ph.D. "Although almost half of the patients initially injected do not need any more treatment in the long-term, a little more than half will. Therefore, surgery appears to be more effective than injections in the long-term.”

Carpal tunnel syndrome is a common nerve disorder caused by compression of the median nerve as it passes through the carpal tunnel, located at the wrist on the palm side of the hand. When the median nerve is compressed, nerve impulses are slowed or blocked, resulting in symptoms ranging from mild occasional numbness to hand weakness, loss of feeling, and even loss of hand function.


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