Grasping for Solutions to Avoid Carpal Tunnel SurgeryTempted by job or hobby, the hands of carpal tunnel syndrome sufferers don't know when to quit. Repetitive wrist motions can often lead the ruinous way from pain and tingling to lasting problems.
Short of surgery, treatments traditionally have included resting the wrist, wearing a splint, taking anti-inflammatory medications, and receiving steroid injections into the wrist. Steroid injections are thought to reduce swelling in the carpal tunnel and ease pressure on the affected nerve.
Studies have been done to see how effective steroid injections can be and whether they can prevent the need for carpal tunnel surgery. For the most part, past research has shown that some people get relief for a while, but steroids aren't a "cure." In this study, about half the people who got relief after an injection ended up having symptoms again within 18 months.
To test whether steroid injections could help, the researchers enrolled 30 people whose tests were positive for carpal tunnel syndrome. Five people had problems in both wrists, so the study actually included injection treatments for 35 wrists.
After getting an injection, patients were instructed to wear a special wrist splint at all times for two weeks. They were also told to put the splint on again if the symptoms returned after two weeks.
Four checkups were scheduled over the next 18 months. The researchers tallied the results during each follow-up visit by asking patients how their wrists felt. Only a third of the wrists were reportedly doing better after three months. And at the end of the study period, only 11 percent were still feeling relief.
After measuring these poor long-term results, the researchers concluded that steroid injections shouldn't be viewed as a routine treatment choice in the conservative treatment of carpal tunnel syndrome.
Mark H. Gonzalez, MD, and Joseph Bylak, MD. Steroid Injection and Splinting in the Treatment of Carpal Tunnel Syndrome. In Orthopedics. May 2001. Vol. 24. No. 5. Pp. 479-481.
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