The effect of steroid injection by Novel method in carpal tunnel syndrome on pain severity and electrophysiological findings

Abstract

ÖZETAmaç: Bu çalışmadaki amacımız Novel metodu ile yapı-lan lokal steroid enjeksiyon tedavisini hastanın sübjektif şikayetleri ile elektrofizyolojik çalışmalar üzerine olan etkilerinin 3 ay sonra incelenmesidir.Yöntemler: Hafif düzeyde karpal tünel sendromu olan, 5 erkek ve 54 kadın olmak üzere toplam 59 kişide ve 101 elden Novel tekniği ile steroid enjeksiyonu yapıldı. Ağrı şid-detini belirlemek için görsel analog skalası (Visual Analogue Scale) (VAS) uygulandı. VAS ile sinir ileti bulguları enjeksiyon öncesi ve 3 ay sonrası karşılaştırıldı.Bulgular: VAS'a göre sağ el (n:56) enjeksiyon öncesi ortalama ağrı şiddeti 7.79±1.4 3 ay sonrası 3.29±1.9. Sol el (n:45) enjeksiyon öncesi ortalama ağrı şiddeti 7.71±1.2 3 ay sonrası 3.16±2.0 idi. Enjeksiyon sonrası, her iki elde median motor sinir distal latansı istatistiksel olarak anlamlı bulundu (p<0.001). Enjeksiyon sonrası her iki elde median motor hızları istatistiksel olarak anlamsızdı. Enjeksiyon sonrası, her iki elde median duysal distal latansı, amplütüd ve hızı istatistiksel olarak anlamlı bulundu. Sonuçlar: Bizim çalışmamız gösterdi ki hafif şiddetteki karpal tünel sendromunda lokal kortikosteroid enjeksiyon tedavisi sübjektif yakınmalar ve elektrofizyolojik bulgular üzerine etkilidir. Non-dominant elde düzelme, diğer ele göre daha fazla olduğundan dolayı lokal enjeksiyon ile beraber eli nötral pozisyonda tutacak splintler kullanılmalı ve el istirahati yapılmalıdır.Anahtar kelimeler: Karpal tünel sendromu, Novel metod, steroid enjeksiyonu, ağrı şiddeti, sinir ileti çalışmaları ABSTRACT Objective: The aim of the present study is to investigate the effects of local steroid injection therapy with the Novel method on subjective patient complaints and electrophysiological investigations at the end of 3 months.Methods: 101 hands of 59 subjects (5 men and 54 women) with mild carpal tunnel syndrome received steroid injection with the Novel technique. Visual Analogue Scale (VAS) was used to determine the severity of pain. Nerve conduction findings obtained prior to and 3 months after the injection were compared using the VAS.Results: According to the VAS, mean pain severity for the right hand (n:56) was 7.79±1.4 before the injection, and 3.29±1.9 at 3 months. Mean pain severity for the left hand (n=45) was 7.71±1.2 before the injection, and 3.16±2.0 at 3 months. Median motor nerve distal latency was statistically significant for both hands after the injection (p<0.001). Median motor velocity was statistically non-significant in both hands after the injection. After the injection, median sensory distal latency, amplitude and velocity were statistically significant for both hands. Conclusion:The present study showed the efficacy of local steroid injection therapy on subjective complaints and electrophysiological findings in mild carpal tunnel syndrome. Because the improvement is greater in the non-dominant hand compared to the other, splints should be used to keep the hand in neutral position and hand rest should be employed in addition to the local injection.

Comparison Between Distal and Proximal Approaches for Local Corticosteroid Injection in Carpal Tunnel Syndrome Management: A Randomized Controlled Trial

“…22 Up to now, 5 other studies have compared this new distal approach (DA) with the wellknown conventional proximal technique using different methods and have found similar results in symptom relief and electrophysiological parameter improvement. [22][23][24][25][26] Therefore, the present study intended to compare the distal and proximal approaches (PAs) used for local corticosteroid injection in CTS symptom management. Despite the 2 approved proximal methods, ultrasound-, and landmarkguided injections, we aimed to focus on the relatively new alternative of DA as a less time-consuming, safe, practical, and effective method for CTS treatment.…”

A Sonographically Guided In-Plane Distal-to-Proximal Transligamentous Approach to Carpal Tunnel Injections

“…Nevertheless, using this approach, many patients experienced decreased pain severity and neural improvement. 25 Although median nerve damage may be less likely with this method than other blind methods, 6 the method is likely more dangerous without ultrasound guidance, because the location of the median nerve would be uncertain throughout the procedure. For this reason, it is likely that there is a higher risk of intraneural, intratendinous, or intravascular injection using a blind technique than with ultrasound guidance.…”

Evaluation of Vitamin D, Vitamin B12 and Folic Acid Levels in Patients with Carpal Tunnel Syndrome

“…2 Tanı klinik semptomlar, fizik muayene ve elektromiyografik (EMG) testler ile konulmaktadır. [4][5][6] EMG aynı zamanda hastalık şiddetini belirlemede de temel yöntemdir. D vitamini, hem endojen olarak sentezlenebilen hem de diyetle alınabilen steroid yapıda bir hormondur.…”