I had a steroid injection into my wrist for carpal tunnel syndrome. It really helped, but I'm starting to notice a return of my numbness and tingling. This is a real problem because I make clothing alterations for a living. If I can't feel the tips of my fingers, I poke myself repeatedly. Should I go for another injection?
Scientists are trying to get a handle on how helpful steroid injections are for symptoms of carpal tunnel syndrome. So far, there's no evidence that the drug actually changes the nerve function. But it does give the temporary relief you have experienced.
It does not appear that more is better. In other words, increasing the dose (amount of steroid used or number of injections given) doesn't reduce the pain, numbness, or tingling any faster or better than a single dose. Likewise, injecting a specific area (above or below the wrist crease) doesn't provide different results.
The biggest predictor of results with steroid injection is the outcome of electrodiagnostic tests. Electrical impulses through the nerve are evaluated. Slow or absent messages from the nerve to the muscles are an indication of damage to the median nerve.
Electrodiagnostic tests showing that the median nerve is damaged are an indicator that surgery is advised. A steroid injection may provide symptom relief, but it's only temporary. Patients with altered sensation and slow nerve impulses have the poorest response to injection. And they are more likely to have a relapse with return of symptoms.
For now, it looks like a single steroid injection is safe and offers fast relief from symptoms. Results are short-term and the symptoms may come back if there is damage to the nerve.
On the other hand, patients who have normal electrodiagnostic tests are actually more likely to benefit from a steroid injection. Steroid injection is one option for patients who want to avoid having surgery for as long as possible or for those who need immediate symptom relief.
If you have not had any nerve conduction tests done, it may be a good idea to pursue this. With the information from the tests, your surgeon will be able to advise you about further conservative (nonoperative) care versus having carpal tunnel surgery.
If the electrodiagnostic tests show nerve impairment, chances are that conservative care with steroid injection won't help. But if the test results are normal, then a second (up to three) steroid injections can be given. And keep in mind that steroid injections are only one way to treat carpal tunnel syndrome. Other nonsurgical treatment such as nonsteroidal antiinflammatory drugs (NSAIDs) and physical therapy can also help.
Martin I. Boyer, MD. Corticosteroid Injection for Carpal Tunnel Syndrome. In The Journal of Hand Surgery. October 2008. Vol. 33-A. No. 8. Pp. 1414-1416.
*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.