Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review

Huisstede, Bionka M. A.; Randsdorp, Manon S.; Brink, Janneke van den; Franke, T.; Koes, Bart W.; Hoogvliet, Peter

doi:10.1016/j.apmr.2018.03.003

Cited by 44 publications

(25 citation statements)

References 42 publications

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“…Another method of reducing the pressure of the carpal tunnel is to stop the inflammation using anti-inflammatory agents (Eftekharsadat et al, 2011). A recent systematic review study reported that according to experimental evidence, oral steroids, and corticosteroid injections help patients with CTS in the short term, however, they are not effective in long term (Huisstede et al, 2018). Given systemic complications of oral steroids and potential side effects of diuretics on cardiovascular system, some studies reported using other drug combinations for treatment of CTS (Eftekharsadat et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

et al. 2018

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Carpal tunnel syndrome (CTS) is one of the reasons for labor abandonment due to inability and pain. The aim of this study was to evaluate the effectiveness of gabapentin and exercise training in the treatment of CTS and compare their effects. This single-blind clinical trial was conducted on patients referred to the Imam Hossein hospital’s electrodiagnostic (EDX) unit. The patients randomly assigned into four groups: using nocturnal splint as an approved treatment in the control group; taking 300-mg gabapentin per night and using nocturnal splint; nerve and tendon gliding exercises and using nocturnal splint; and taking 300-mg gabapentin per night, performing same exercise as group 3 and using nocturnal splint. At baseline, four indicators were assessed in all patients, including the Boston carpal tunnel questionnaire, visual analogue scale (VAS), pinch and grip strength of the affected hand. One month after the beginning of intervention, participants were reassessed and compared for each of the four indicators. Using nocturnal splint along with exercise and gabapentin significantly improved VAS, pinch and grip strength in moderate CTS compared to control group that only used nocturnal splint. However in mild CTS, grip strength was not significantly higher compared to control group (P=0.048). Results of this study showed that use of splint alone in mild CTS is an appropriate and sufficient treatment; however, in moderate CTS, receiving gabapentin along with exercise and splinting showed better treatment results compared to splinting alone.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

et al. 2018

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“…The intervention group received rehabilitation treatment, which started one week after the operation. The techniques included nerve gliding, splinting, massage, tendon gliding, and strengthening of the muscles innervated by median nerve based on the severity and duration of the symptom according to the multidisciplinary guideline [9,10]. The control group was instructed to have progressive home exercise based on their endurance and power (pinch and grip).…”

Section: Study Interventionmentioning

confidence: 99%

Effect of Rehabilitation Interventions on Sensation, Function, and Pain of the Patients With Carpal Tunnel Release

et al. 2019

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Carpal Tunnel Syndrome (CTS) is now the most common type of nerve compression neuropathies constituting about (90%) of the neuropathic disorders. To attain the optimal recovery following the operation, a rehabilitation intervention is urgent. This study aims at investigating the efficacy of short and long term rehabilitation interventions following Carpal Tunnel Release (CTR) on motor functions, sensory, and pain. Methods: Thirty patients were randomly assigned to two groups after CTR. The intervention group received rehabilitation exercises within a week after the operation, and the control group received a progressive home exercise program. The patients were assessed in terms of pain, sensation, function (measured by Boston Questionnaire), pinch, and grip (measured by dynamometer) in three periods of time, before operation, 6 weeks, and 12 weeks after operation by Visual Analogue Scale (VAS), Semmes Weinstein Test of Monofilaments, Boston questionnaire test, and dynamometer. Results: No significant differences in function were seen between the two groups (P=0.28). The average score of pain decreased. In spite of the increase in sensory score in the intervention group, no significant difference was found (P=0.19). A considerable difference was found in pain, grip, and pinch between the two groups during the first 6 weeks after the operation. Discussion: The rehabilitation interventions, even in short term, affect the pain and power (pinch and grip). Also, they facilitate returning to work. In the long term, however, there were no considerable diversities. In other words, improvements gained in two groups are the same in the long-term.

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“…A common steroid injection technique was used; different techniques exist but have no strong evidence for different outcomes. 6 However, injections were given not only by doctors but also by physiotherapists or occupational therapists, which is relevant to the conclusion that steroid injection is more cost-effective. Access to splints is easier whereas steroid injections are often prescribed and given by a doctor; costs would increase depending on the extent to which patients are referred for injections.…”

Section: Time For a New Obesity Narrativementioning

confidence: 99%

“…4,5 Efficacy of night splinting has not been assessed in placebo-controlled trials, and efficacy of local steroid injection is supported by strong evidence of efficacy 8 weeks after injection. 6 However, the long-term benefit is still being debated.…”

mentioning

confidence: 99%

Steroid injection or wrist splint for first-time carpal tunnel syndrome?

Atroshi

2018

The Lancet

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Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review

Cited by 44 publications

References 42 publications

The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

Effect of Rehabilitation Interventions on Sensation, Function, and Pain of the Patients With Carpal Tunnel Release

Steroid injection or wrist splint for first-time carpal tunnel syndrome?

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