Abstract
Objective
To present an evidence-based overview of the effectiveness of oral pain medication
and corticosteroid injections to treat carpal tunnel syndrome (CTS).
Data Sources
The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database
were searched for relevant systematic reviews and randomized controlled trials (RCTs).
Study Selection
Two reviewers independently applied the inclusion criteria to select potential studies.
Data Extraction
Two reviewers independently extracted the data on pain (visual analog scale), function
or recovery, and assessed the methodologic quality.
Data Synthesis
A best-evidence synthesis was performed to summarize the results of the included studies.
Four reviews and 9 RCTs were included. For oral pain medication, strong and moderate
evidence was found for the effectiveness of oral steroids versus placebo in the short
term. Moderate evidence was found in favor of oral steroids versus splinting in the
short term. No evidence was found for the effectiveness of oral steroids in the long
term. For corticosteroid injections, strong evidence was found in favor of a corticosteroid
injection versus a placebo injection and moderate evidence was found in favor of corticosteroid
injection versus oral steroids in the short term. Also, in the short term, moderate
evidence was found in favor of a local versus a systematic corticosteroid injection.
Higher doses of corticosteroid injections seem to be more effective in the midterm;
however, the benefits of corticosteroid injections were not maintained in the long
term.
Conclusions
The reviewed evidence supports that oral steroids and corticosteroid injections benefit
patient with CTS particularly in the short term. Although a higher dose of steroid
injections seems to be more effective in the midterm, the benefits of oral pain medication
and corticosteroid injections were not maintained in the long term.
Keywords
List of abbreviations:
CI (confidence interval), CTS (carpal tunnel syndrome), FSS (Fatigue Severity Scale), GSS (Global Symptom Scale), OR (odds ratio), PEDro (Physiotherapy Evidence Database), RCT (randomized controlled trial), SSS (Symptom Severity Scale), WMD (weighted mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 05, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
