Short-term outcomes of local steroid injection in carpal tunnel syndrome: Triamcinolone (20 and 40 mg) versus Methyl prednisolone (20 and 40 mg)

BackhroundsLocal steroid injection is one of the most common methods to treat carpal tunnel syndrome(CTS). However, the most efficient substance and the appropriate dosage are not clearlyknown. In current clinical trial, the outcomes of treating CTS with local injection oftriamcinolone 20 and 40 mg and methyl prednisolone 20 and 40 mg were compared.MethodsThere were 73 patients with mild or moderate CTS assigned to 4 groups randomly:triamcinolone 20 mg (T20- group; 18 patients), triamcinolone 40 mg (T40- group; 20patients), methyl prednisolone 20 mg (M20- group; 17 patients) and methyl prednisolone40 mg (M40- group; 18 patients). Before and 3 months after injection the followingmeasurements were performed: SNAP Amp and latency, CMAP Amp and latency, NCV,intensity of pain using visual analogue scale (VAS), pain free grip (PFG) and Boston CTSquestionnaire including symptom severity scale (SSS) and functional severity scale (FSS).ResultsBefore the treatment, all of the variables were the same in four groups. SNAP latency,CMAP Amp and latency, NCV, pain, PFG, SSS and FSS improved after treatment in all of thegroups (P<0.05). SNAP Amp did not changed significantly after treatment in M20- group.SNAP Amp was significantly higher in M40- group compared to M20- group (P=0.024).Furthermore, FSS was significantly lower in T40- group compared to T20- group (p=0.009).There was no significant difference between four groups in other variables after treatment.ConclusionsIn short-term follow up, local steroid injection was associated with improvement infunctional status, grip strength, symptoms and electrodiagnostic studies (SNAP Amp and latency, CMAP Amp and latency, NCV). However, the authors suggest injection of methylprednisolone and triamcinolone 40 mg due to significantly better outcomes in somevariables compared to prednisolone and triamcinolone 20 mg.