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Ultrasound-Guided vs. Blind Steroid Injections in Carpal Tunnel Syndrome: A Single-Blind Randomized Prospective Study

Üstün, Nilgün MD; Tok, Fatih MD; Yagz, Abdullah Erman MDı; Kizil, Nurhan MD; Korkmaz, Inan MD; Karazincir, Sinem MD; Okuyucu, Esra MD; Turhanoglu, Ayse Dicle MD

American Journal of Physical Medicine & Rehabilitation: November 2013 - Volume 92 - Issue 11 - p 999–1004
doi: 10.1097/PHM.0b013e31829b4d72
Original Research Articles

Objective The aim of this study was to compare the efficacy and the safety of ultrasound (US)–guided vs. blind steroid injections in patients with carpal tunnel syndrome (CTS).

Design This prospective randomized single-blind clinical trial included 46 patients with CTS (46 affected median nerves). The subjects were randomized—to either the US-guided or the blind injection group—before they received 40 mg of methylprednisolone. They were evaluated using the Boston Carpal Tunnel Questionnaire symptom/function at baseline and at 6 wks and 12 wks after injection, and the side effects were noted.

Results The symptom severity and functional status scores improved significantly in both groups at 6 wks after treatment, and these improvements persisted at 12 wks after treatment (all P < 0.05). The improvement in symptom severity scores in the US-guided group at 12 wks was higher than in the palpation-guided group (P < 0.05). Average time to symptom relief was shorter in the US-guided group (P < 0.05). There was no significant difference between the two groups in terms of side effects (P > 0.05).

Conclusions Although both US-guided and blind steroid injections were effective in reducing the symptoms of CTS and improving the function, an earlier onset/better improvement of symptom relief suggests that US-guided steroid injection may be more effective than are blind injections in CTS.

From the Department of Physical Medicine and Rehabilitation (NU, AEY, NK, ADT), Department of Radiology (IK, SK), and Department of Neurology (EO), Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey; and Physical Medicine and Rehabilitation Clinic, İskenderun Military Hospital, Hatay, Turkey (FT).

All correspondence and requests for reprints should be addressed to Nilgün Üstün, MD, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mustafa Kemal University, Tayfur Sokmen Campus, 31000, Serinyol, Hatay, Turkey.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins