Question:My mother had two steroid injections for carpal tunnel syndrome in an attempt to avoid having surgery. How will we know if she still needs the operation?
Answer:Comparing symptoms before and after a treatment is one simple way to see the results. This could be a change in symptoms (better or worse) such as pain or numbness. Decreased weakness seen as improved strength may be a meaninful change.
Each person will have his or her own standard of improvement. For example, one patient may want and need to be able to lift a coffee pot and pour coffee without spilling. Another patient may say that getting a good night's sleep is what counts.
A meaningful change from the patient's point-of-view may not be the same as what society or the physician would say. Society might see the patient's ability to go back to work sooner as the important change. The physician may say there were no complications and that's what counts.
Researchers often use patient surveys of questions before and after treatment to calculate the minimal clinically important difference (MCID). The MCID is a measure of success and guides treatment. If the MCID shows a benefit from treatment, then it's possible no further treatment is needed. If not, then further treatment may be needed. The patient and doctor decide this together.Tuna ÃzyÃ¼rekoglu, MD, et al. The Minimally Clinically Important Difference of the Carpal Tunnel Syndrome Symptom Severity Scale. In The Journal of Hand Surgery. May-June 2006. Vol. 31A. No. 5. Pp. 733-738.
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