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Evidence summaries

Local Corticosteroid Injection for Carpal Tunnel Syndrome

Local corticosteroid injection for carpal tunnel syndrome provides greater clinical improvement in symptoms one month after injection compared to placebo or systemic steroids. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 12 studies with a total of 671 subjects. Two high quality randomized controlled trials (n=141) demonstrated clinical improvement of carpal tunnel syndrome at one month or less following local corticosteroid compared to placebo injection (RR 2.58, 95% CI 1.72 to 3.87). One trial compared local corticosteroid injection to oral steroid and at three months after treatment there was a significant improvement in the injection group (mean difference -7.00; 95% CI -11.58 to -2.42). In one trial the rate of improvement after one month was greater after local than systemic corticosteroid injection (RR 3.17, 95% CI 1.02 to 9.87). In one trial symptoms did not improve significantly for the injection group at eight weeks after injection compared to treatment with anti-inflammatory medication and splinting (mean difference 0.10, 95% CI -0.33 to 0.53). Two injections versus one injection of local corticosteroid did not provide further clinical improvement, mean difference -3.80 (95% CI -9.27 to 1.67).

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    References

    • Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev 2007 Apr 18;(2):CD001554. [PubMed]

Primary/Secondary Keywords