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Local steroid injections better than placebo for carpal tunnel syndrome, literature review confirms
Researchers found that a second corticosteroid injection provided no further clinical improvement over the first injection.
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A single local corticosteroid injection can provide patients who have carpal tunnel syndrome with at least 1 month of clinical improvement in symptoms, according to a systematic literature review. However, "Significant symptom relief beyond 1 month has not been demonstrated," the study authors noted.
Shawn Marshall, MD, a specialist in physical medicine and rehabilitation at the University of Ottawa, Ontario, and colleagues evaluated the efficacy of local corticosteroid injections vs. either placebo injections or other nonsurgical interventions for treating carpal tunnel syndrome patients. The study included 12 randomized or quasi-randomized studies involving 671 total participants identified through a search of several medical literature databases, including the Cochrane Neuromuscular Disease Group Trials register, Medline and EMBASE.
The researchers published their findings in the Cochrane Database of Systematic Reviews.
Of the 12 studies reviewed, two high-quality randomized, controlled trials involving 141 participants showed that local corticosteroid injections provided a clinical improvement at 1 month or less compared to placebo injections. One study found that patients treated with a local corticosteroid injection had a significantly greater improvement at 12 weeks follow-up compared to patients treated with oral corticosteroids, and another study found a greater rate of improvement at 1 month from local vs. systemic corticosteroid injections, the authors reported.
However, one study found no significant difference between patients treated with a local injection and those treated with anti-inflammatory medications and splinting at 8 weeks follow-up. In addition, a second corticosteroid injection provided no further clinical improvement over the first injection, the authors noted.
The review did not look at the effectiveness of surgery compared to injections or the benefit of injections for treating less-than-severe carpal tunnel syndrome, according to a press release announcing the study findings.
For more information:
- Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007;2; Art.No.:CD001554.