Randomized double ‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients
ObjectivePerineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double ‐blinded, head‐to‐head comparative trial to compare these two approaches for patients having mild‐to‐moderate CTS.MethodsFifty ‐four participants with mild‐to‐moderate CTS were randomly divided into dextrose and steroid groups. The patients were administered 1 session of perineural injection with 5ml D5W (dextrose group) or 3ml triamcinolone acetonide mixed with 2ml normal saline (steroid group), under ultrasound guid ance. A visual analog scale was assigned to assess the primary outcome. The secondary outcomes were assessed using the Boston Carpal Tunnel Syndrome Questionnaire, cross‐sectional area of the median nerve, and electrophysiological studies. The assessment was performed prior to injection and 1, 3, 4, and 6 months postinjection.ResultsAll patients (27 wrists per group) completed the study. Compared with the steroid group, the dextrose group exhibited a significant reduction in pain and disability through the 4th to the 6th month (p
ConclusionThe effect of acupuncture plus night splinting may show significant reduction on pain but failed to show significant differences compared with night splinting in patients with CTS. Further studies with larger sample size may confirm the findings.
ConclusionThe effect of acupuncture on pain combine night splinting has a better effect on pain in the treatment of CTS than that of the only splinting.
DiscussionThis is the first placebo-controlled randomized trial with electronic monitoring of actual splint use and will provide evidence regarding the efficacy of wrist splinting in patients with CTS.Trial registrationISRCTN Registry,ISRCTN81836603. Registered on May 5, 2018.
This study aimed to determine the environmental conditions for the occurrence of carpal tunnel syndrome (CTS) in a non-industrial area, and patient-reported outcomes after surgical release. MATERIAL AND METHODS: This observational study utilized convenience sampling to screen 100 consecutive patients for carpal tunnel syndrome at the Orthopedic Clinic, using two questionnaires. Data were collected from the Disability of Arm Shoulder and Hand (DASH) questionnaire, and the PROMIS® (Patient-Reported Outcomes Measurement Information System) Upper Extremity and PROMIS® SF 3a questionnaire (Pain Intensity). The rela...
Abstract The Academy of Orthopaedic Physical Therapy and the Academy of Hand and Upper Extremity Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline focuses on hand pain and sensory deficits in carpal tunnel syndrome. J Orthop Sports Phys Ther 2019;49(5):CPG1-CPG85. doi:10.2519/jospt.2019.0301. PMID: 31039690 [PubMed - in process]
ConclusionUse of the ReHand tablet application for early rehabilitation after carpal tunnel release is more effective in the recovery of functional ability than a conventional home exercise program. It remains unclear whether there are any benefits in grip strength, pain or dexterity.Trial registrationACTRN12618001887268.
CONCLUSIONS: Pain intensity and grip strength were dysfunctions affecting the upper extremity disability in women with bilateral idiopathic CTS. Rehabilitation approaches for CTS should be considered based on the adaptive activities of the neural networks. PMID: 30856127 [PubMed - as supplied by publisher]
Sickness absence mesmerizes many researchers, given the numerous publications on risk factors for sickness absence. A large variety of risk factors have been identified, including work-related risk factors such as physical work demands and psychosocial work factors (1,2), unhealthy behaviors such as lack pf physical activity and smoking (3,4), and chronic health problems (5). A logical next step seems to be the development of a prediction model, whereby an individual ’s profile on risk factors is converted into a probability on future sickness absence. In the past few years, several prediction models have been develo...
Abstract Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness that lead to functional disability. In this article, the authors review common entrapment neuropathies of the upper extremities, including median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and radial neuropathy. The authors discuss the pathophysiology of nerve compression and typical etiologies, as well as strategies for differentiating between common mimics such as cervical radiculopathy and for selecting between various treatment modalities. PMID: 30704687 [PubMed - in process]
Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness that lead to functional disability. In this article, the authors review common entrapment neuropathies of the upper extremities, including median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and radial neuropathy. The authors discuss the pathophysiology of nerve compression and typical etiologies, as well as strategies for differentiating between common mimics such as cervical radiculopathy and for selecting between various treatment modalities.