Saturday 01 September 2007, 12:00AM
PEARLS 21, September 2007, written by Brian R
McAvoy
(First published New Zealand Doctor, 24 October 2007)
Clinical question
How effective are local corticosteroid injections for
carpal tunnel syndrome (CTS)?
Bottom line
Local corticosteroid injections for CTS provide greater
clinical improvement in symptoms one month after injection compared
to placebo (NNT* 2). They also provide significantly greater
clinical improvement compared to oral corticosteroids up to three
months after treatment. Two injections do not provide significant
further clinical improvement of symptoms. (*NNT = number needed to
treat to benefit one individual.)
Caveat
Significant symptom relief beyond one month has not been
demonstrated.
Context
CTS is a common problem with a prevalence of 3.8 per cent in the
general population. Up to one third of patients can have
spontaneous improvement in their symptoms without any formal
medical treatment.
Cochrane Systematic Review
Marshall S, Tardif G, Ashworth N. Local corticosteroid injection
for carpal tunnel syndrome. Cochrane Database of Systematic Reviews
2007, Issue 2. Article No. CD001554. DOI:
10.1002/14651858.CD001554.pub2. Note: This review contains 12
trials with 671 participants.