Clinical and laboratory efficacy of repetitive triamcinolone injections in carpal tunnel syndrome
Mustafa Ceylan1, Fatma Simsek1, Ali Riza Sonkaya2
1Ataturk University Faculty of Medicine, Department of Neurology, Erzurum, Turkey
2Okmeydani Training and Research Hospital, Institute of Neurology, Istanbul, Turkey
Aim:Carpal tunnel syndrome (CTS) is the most common compressive neuropathy affecting the upper extremity. There are many surgical and non-surgical treatment options and it is not clear which approach is more effective. Corticosteroid injections are known to be effective on both CTS symptoms and electrophysiological parameters. Many different techniques are used for injection. It is recommended to use a maximum of 3 injections at intervals of 2-3 months. In our study, we aimed to examine the clinical and electrophysiological efficacy of triamcinolone injection performed in the cases with a rarely used technique.
Material and Methods: This is a retrospective study.Patients who were diagnosed with mild to moderate CTS between December 2012 and June 2018 treated with 40 mg triamcinolone injection were evaluated. Ages of patients were between 18 to 65 years. The changes in the electrophysiological parameters, clinical and examination findings, and visual analog scale (VAS) of 121 patients were examined before and after the injections.
Results: Clinical and examination findings were consistent with previous studies. The second injection was applied to 43.9% and the third injection to 16.4% of the cases. After the third injection, mild to moderate CTS was detected in 6.9% of the cases. The statistically significant changes were observed in the clinical, examination findings and VAS values of the cases before and after the injection. Besides, a significant statistical difference was determined in all parameters of the sensory conductions and in the distal latency of the motor conduction, before and after the injection.
Conclusion: It was determined that 40 mg of triamcinolone caused a significant change in VAS values, and the clinical and examination findings of CTS. There were no complications associated with injection. Consequently, 40 mg of triamcinolone, applied approximately 3 cm distal to the carpal tunnel, is as effective as the more frequently applied techniques.