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Clinical Trial
. 1999 Oct 2;319(7214):884-6.
doi: 10.1136/bmj.319.7214.884.

Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial

J W Dammers  1 , M M Veering, M Vermeulen
Affiliations
Clinical Trial

Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial

J W Dammers et al. BMJ. .

Abstract

Objective: To assess the effect of a 40 mg methylprednisolone injection proximal to the carpal tunnel in patients with the carpal tunnel syndrome.

Design: Randomised double blind placebo controlled trial.

Setting: Outpatient neurology clinic in a district general hospital.

Participants: Patients with symptoms of the carpal tunnel syndrome for more than 3 months, confirmed by electrophysiological tests and aged over 18 years.

Intervention: Injection with 10 mg lignocaine (lidocaine) or 10 mg lignocaine and 40 mg methylprednisolone. Non-responders who had received lignocaine received 40 mg methylprednisolone and 10 mg lignocaine and were followed in an open study.

Main outcome measures: Participants were scored as having improved or not improved. Improved was defined as no symptoms or minor symptoms requiring no further treatment.

Results: At 1 month 6 (20%) of 30 patients in the control group had improved compared with 23 (77%) of 30 patients the intervention group (difference 57% (95% confidence interval 36% to 77%)). After 1 year, 2 of 6 improved patients in the control group did not need a second treatment, compared with 15 of 23 improved patients in the intervention group (difference 43% (23% to 63%). Of the 28 non-responders in the control group, 24 (86%) improved after methylprednisolone. Of these 24 patients, 12 needed surgical treatment within one year.

Conclusion: A single injection with steroids close to the carpal tunnel may result in long term improvement and should be considered before surgical decompression.

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Figures

Figure 1
Figure 1
Site for injecting corticosteroid to treat carpal tunnel syndrome
Figure 2
Figure 2
Participant flow
See this image and copyright information in PMC

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References

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