Comparison of corticosteroid injection dosages in mild to moderate idiopathic carpal tunnel syndrome: A randomized controlled trial

Abstract Objectives To evaluate whether the therapeutic effect of ultrasound-guided injections with 10 mg or 40 mg triamcinolone acetonide (TA) was dose-dependent in patients with idiopathic mild to moderate carpal tunnel syndrome (CTS). Design Prospective, double-blinded, randomized controlled study with 12 weeks of follow-up. Setting Rehabilitation outpatient clinic of a single medical center. Participants Patients with CTS (N=56). Intervention Participants were randomly assigned to two treatment groups for injection: (A) 40 mg TA + 2% lidocaine hydrochloride or (B) 10 mg TA + 2% lidocaine hydrochloride. Main outcome measures Participants were evaluated using Visual Analogue Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ, including Symptom Severity Scale (SSS) and Functional Status Scale (FSS)) at baseline, 6 and 12 weeks after injection). Nerve conduction studies (NCS), including parameters of distal motor latency, amplitude of compound motor action potential, amplitude of sensory nerve action potential and sensory nerve conduction velocity of median nerve, and the patient's subjective impression of improvement were recorded before injection and 6 and 12 weeks after injection. Results No significant differences were observed in baseline demographic characteristics and clinical evaluations. The parameters in group A and B at the baseline, 6, and 12 weeks were: (1) SSS: 2.17±0.14, 1.19±0.04, and 1.34±0.09 and 1.87±0.11, 1.21±0.07, and 1.26±0.04; (2) FSS: 1.63±0.07, 1.27±0.06, and 1.33±0.08 and 1.50±0.10, 1.18±0.05, and 1.26±0.05; VAS: 6.4±0.3, 2.2±0.3, and 3.0±0.1 and 6.7±0.3, 2.0±0.3, and 3.1±0.3, respectively, and significantly decreased after 6 and 12 weeks in both treatment groups (p Conclusion In patients with idiopathic mild to moderate CTS, ultrasound-guided injection with 10 and 40 mg TA yield similar improvements in BCTQ, VAS, and NCS at the 12-week follow-up.