Patients with carpal tunnel syndrome treated with corticosteroid injection experienced superior clinical effectiveness at 6 weeks compared to patients treated with night-resting splints, according to results published in The Lancet.
Researchers randomly assigned 234 patients with mild or moderate carpal tunnel syndrome to receive either a single injection of 20 mg methylprednisolone acetate (n=116) or a night-resting splint to be worn for 6 weeks (n=118). Overall score for the Boston Carpal Tunnel Questionnaire at 6 weeks was considered the primary outcome measure.
Results showed patients who received corticosteroid injection had significantly greater improvement in overall Boston Carpal Tunnel Questionnaire score at 6 weeks compared with the night splint group. Researchers also found patients in the injection group experienced better adjusted effect estimates for the Boston Carpal Tunnel Questionnaire symptom severity subscale and functional status subscale and had less frequent hand-wrist pain intensity and insomnia due to hand or wrist problems. Although patients in the night splint group had further improvements and patients in the corticosteroid group sustained improvements in overall Boston Carpal Tunnel Questionnaire score, according to results, the outcomes did not differ between treatment groups. Researchers noted no serious or unexpected adverse events reported by either group.
“In summary, a single corticosteroid injection shows superior clinical effectiveness at 6 weeks and is cost-effective over 6 months compared with night resting splints, which should make it the treatment of choice for rapid and sustained symptom response in mild or moderate carpal tunnel syndrome presenting in primary care,” the authors wrote. “These findings inform evidence-based treatment choices for [general practitioners] GPs and clinicians in community musculoskeletal services.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.