| Objective: In this study the clinical effectiveness of ultrasound-guided corticosteroid injection
“above” versus “below” the median nerve for treatment of patients with mild to moderate carpal
tunnel syndrome (CTS) was compared.
Design: This prospective randomized double-blind clinical trial included 44 patients with mild to
moderate CTS. The subjects were randomly assigned to two groups to receive ultrasoundguided
injection of 40 mg triamcinolone either “above” or “below” the involved median nerve.
Outcome measures were the Boston Carpal Tunnel Questionnaire, Visual Analogue Scale,
electrophysiological tests, and ultrasonographic measurement of the median nerve crosssectional
area at baseline, 6 weeks and 12 weeks after the injection
Results: All outcome measures improved significantly in both groups at 6 weeks after
intervention, and these improvements were persevered up to 12 weeks follow up (all P-value
<0.05). However, there was no significant difference in measured outcomes between the two
groups. No adverse side effects were observed.
Conclusions: Both above and under median nerve ultrasound-guided steroid injection techniques
were effective in reducing the symptoms, improving the function and electrodiagnostic and
sonographic findings of CTS. However the amount of improvement in the outcomes did not
differ between groups, implying that none of technique has the superiority over another. |