Effectiveness of splinting and splinting plus local steroid injection in severe carpal tunnel syndrome: A Randomized control clinical trial

Saeid Khosrawi, Masoud Emadi, Amir Ebrahim Mahmoodian, Saeid Khosrawi, Masoud Emadi, Amir Ebrahim Mahmoodian

Abstract

Background: The Study aimed to compare the effectiveness of two commonly used conservative treatments, splinting and local steroid injection in improving clinical and nerve conduction findings of the patients with severe carpal tunnel syndrome (CTS).

Materials and methods: In this randomized control clinical trial, the patients with severe CTS selected and randomized in two interventional groups. Group A was prescribed to use full time neutral wrist splint and group B was injected with 40 mg Depo-Medrol and prescribed to use the full time neutral wrist splint for 12 weeks. Clinical and nerve conduction findings of the patients was evaluated at baseline, 4 and 12 weeks after interventions.

Results: Twenty-two and 21 patients were allocated in group A and B, respectively. Mean of clinical symptoms and functional status scores, nerve conduction variables and patients' satisfaction score were not significant between group at baseline and 4 and 12 weeks after intervention. Within the group comparison, there was significant improvement in the patients' satisfaction, clinical and nerve conduction items between the baseline level and 4 weeks after intervention and between the baseline and 12 weeks after intervention (P < 0.01). The difference was significant for functional status score between 4 and 12 weeks after intervention in group B (P = 0.02).

Conclusion: considering some findings regarding the superior effect of splinting plus local steroid injection on functional status scale and median nerve distal motor latency, it seems that using combination therapy could be more effective for long-term period specially in the field of functional improvement of CTS.

Keywords: Carpal tunnel syndrome; splint; steroid.

Figures

Figure 1
Figure 1
Consort diagram of the study
Figure 2
Figure 2
Mean of studied clinical variables, symptom severity scale and functional status scale, at baseline and 4 and 12 weeks after interventions in group A (splint) and group B (splint + steroid) (P < 0.001 due to the significant differences between baseline and 4 weeks after intervention and baseline and 12 weeks after intervention) (not significant between 4 and 12 weeks after intervention). FSS: Functional status scale, SSS: Symptom severity scale

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