Electrophysiological and clinical comparison of local steroid injection by means of proximal versus distal approach in patients with mild and moderate carpal tunnel syndrome
EL-Badawy, Mohja;
Abstract
Background
Local corticosteroid injection is one of the treatment modalities for carpal tunnel syndrome.
Symptomatic and electrophysiological improvement following local corticosteroid injection
has been documented.
Objectives
The aim of the present study was to compare the effects of proximal and distal approaches
of local steroid injection in patients with mild and moderate carpal tunnel syndrome on clinical
scores and electrophysiological parameters at the end of 1 month following injection.
Patients and methods
A total of 30 patients were included and randomly assigned into one of the two groups based on
the local steroid injection approach either by means of distal (group I) or by mean of proximal
approach (group II). Clinical and electrophysiological examinations were carried out before
and 1 month following the injection.
Results
There was a significant reduction in the pain and disability scores of the Boston Carpal Tunnel
Questionnaire between the baseline and follow-up in both groups. Median motor nerve distal
latency was statistically significantly reduced in both groups 1 month after the injection. Median
motor conduction velocity and amplitude (amp) showed a statistically nonsignificant difference
1 month following the injection. Median sensory distal latency, amp, and conduction velocity
showed statistically significant difference between the two groups. The average duration of
the procedure in group I was 9.29 ± 0.76 s compared with 47.91 ± 9.66 s in group II. The
average grade of pain expressed by the patients in group I was 1.97 ± 0.82 compared with
5.11 ± 0.67 in group II.
Conclusion
Local corticosteroid injection at the carpal tunnel using the distal approach is associated with
favorable clinical and electrophysiological results similar to those reported using the proximal
approach. The distal approach is much less time consuming and more comfortable compared
with the proximal approach.
Local corticosteroid injection is one of the treatment modalities for carpal tunnel syndrome.
Symptomatic and electrophysiological improvement following local corticosteroid injection
has been documented.
Objectives
The aim of the present study was to compare the effects of proximal and distal approaches
of local steroid injection in patients with mild and moderate carpal tunnel syndrome on clinical
scores and electrophysiological parameters at the end of 1 month following injection.
Patients and methods
A total of 30 patients were included and randomly assigned into one of the two groups based on
the local steroid injection approach either by means of distal (group I) or by mean of proximal
approach (group II). Clinical and electrophysiological examinations were carried out before
and 1 month following the injection.
Results
There was a significant reduction in the pain and disability scores of the Boston Carpal Tunnel
Questionnaire between the baseline and follow-up in both groups. Median motor nerve distal
latency was statistically significantly reduced in both groups 1 month after the injection. Median
motor conduction velocity and amplitude (amp) showed a statistically nonsignificant difference
1 month following the injection. Median sensory distal latency, amp, and conduction velocity
showed statistically significant difference between the two groups. The average duration of
the procedure in group I was 9.29 ± 0.76 s compared with 47.91 ± 9.66 s in group II. The
average grade of pain expressed by the patients in group I was 1.97 ± 0.82 compared with
5.11 ± 0.67 in group II.
Conclusion
Local corticosteroid injection at the carpal tunnel using the distal approach is associated with
favorable clinical and electrophysiological results similar to those reported using the proximal
approach. The distal approach is much less time consuming and more comfortable compared
with the proximal approach.
Other data
Title | Electrophysiological and clinical comparison of local steroid injection by means of proximal versus distal approach in patients with mild and moderate carpal tunnel syndrome | Authors | EL-Badawy, Mohja | Keywords | carpal tunnel syndrome, distal approach, local corticosteroid injection, proximal approach | Issue Date | 2015 | Journal | Egyptian Rheumatology & Rehabilitation |
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