Abstract
Objectives
To evaluate whether the therapeutic effect of ultrasound-guided injections with 10
mg or 40 mg triamcinolone acetonide (TA) was dose-dependent in patients with idiopathic
mild to moderate carpal tunnel syndrome (CTS).
Design
Prospective, double-blind, randomized controlled study with 12 weeks of follow-up.
Setting
Rehabilitation outpatient clinic of a single medical center.
Participants
Patients with CTS (N=56).
Intervention
Participants were randomly assigned to 2 treatment groups for injection: (A) 40 mg
TA+2% lidocaine hydrochloride or (B) 10 mg TA+2% lidocaine hydrochloride.
Main Outcome Measures
Participants were evaluated using visual analog scale (VAS) and Boston Carpal Tunnel
Questionnaire (BCTQ, including Symptom Severity Scale [SSS] and Functional Status
Scale [FSS]) at baseline and 6 and 12 weeks after injection). Nerve conduction studies,
including parameters of distal motor latency, amplitude of compound motor action potential,
amplitude of sensory nerve action potential and sensory nerve conduction velocity
of median nerve, and the patient’s subjective impression of improvement, were recorded
before injection and 6 and 12 weeks after injection.
Results
No significant differences were observed in baseline demographic characteristics and
clinical evaluations. The parameters in group A and B at baseline, 6 weeks, and 12
weeks were (1) SSS: 2.17±0.14, 1.19±0.04, and 1.34±0.09 and 1.87±0.11, 1.21±0.07,
and 1.26±0.04; (2) FSS: 1.63±0.07, 1.27±0.06, and 1.33±0.08 and 1.50±0.10, 1.18±0.05,
and 1.26±0.05; (3) VAS: 6.4±0.3, 2.2±0.3, and 3.0±0.1 and 6.7±0.3, 2.0±0.3, and 3.1±0.3,
respectively, and significantly decreased after 6 and 12 weeks in both treatment groups
(P<.05). All parameters of nerve conduction studies improved in both groups after 12
weeks (P<.05). VAS, BCTQ, and nerve conduction studies did not show significant intergroup
differences after 6 and 12 weeks.
Conclusion
In patients with idiopathic mild to moderate CTS, ultrasound-guided injection with
10 and 40 mg TA yield similar improvements in BCTQ, VAS, and nerve conduction studies
at the 12-week follow-up.
Keywords
List of abbreviations:
ANOVA (analysis of variance), BCTQ (Boston Carpal Tunnel Questionnaire), CMAP (compound muscle action potential), CTS (carpal tunnel syndrome), DML (distal motor latency), FSS (Functional Status Scale), MCID (minimum clinically important difference), SNAP (sensory nerve action potential), SNCV (sensory nerve conduction velocity), SSS (Symptom Severity Scale), TA (triamcinolone acetonide), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 16, 2020
Footnotes
Supported by Taipei Veterans General Hospital (grant no. V108B-017), Taipei, Taiwan.
Clinical Trial Registration No.: NCT03072290.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
