Carpal Tunnel Syndrome - Steroid Injection for Carpal Tunnel Syndrome

What is the role of steroid injection in carpal tunnel syndrome?

Injection of corticosteroid into the carpal tunnel has been used as a treatment for some years. But what does the published evidence have to say about whether it works or not?

In my own experience, injection of steroid and / or local anaesthetic into the carpal tunnel area is effective in about half of the patients that I see. Some of them gain lasting relief of the carpal tunnel symptoms and others find that the symptoms of tingling in the median nerve skin area return a month or two after the injection.

Recent Studies on Steroid Injection for Carpal Tunnel Syndrome

Two small but quite good quality studies have been published recently. These are what is known as randomised controlled studies and the results of this kind of study are usually (but not always) reliable.

Both studies showed that injection with steroid into the carpal tunnel produced benefit with about a month of the injection. The benefit was sustained in many of the patients.

The studies compared carpal tunnel steroid injection with placebo injection. Placebo injection is when both the doctor and the patient think that an active drug is being injected but when - in truth - only an inert and inactive liquid is in the syringe.

The patients who were given the active drug typically reported an improvement in their symptoms of about 70% - compared with improvement of about 15% in the patients who were given a placebo.

The risks of steroid injection into the carpal tunnel are small but not zero. Some people find the injection to be very painful for two or three days afterwards. There is a small risk that the injected liquid may enter a blood vessel or may be injected into the median nerve itself. This last problem is rare but can potentially be very serious.

Dr Gordon Cameron's website contains more information about carpal tunnel syndrome and its treatment

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Back Pain Facts?

There are several causes of back pain: mechanical causes, eg lumbar disc disorders; degenerative conditions, eg degenerative disc disease; inflammatory conditions, eg ankylosing spondylitis; infective causes, eg osteomyelitis; neoplastic causes, eg primary benign or malignant tumours; metabolic bone disease, eg osteoporosis; referred pain, eg from duodenal ulcer; psychogenic pain - originating in the mind rather than the body.

Back pain is one of humanity's most frequent complaints and does not usually reflect any underlying disease. However, anyone with back pain that does not improve after a few days should first consult a Physician, as back pain can sometimes indicate significant and serious conditions which might not otherwise be diagnosed. Back pain is very rarely a sign of a serious medical problem. It is however important that the treatable medical causes are identified early on.

Back pain affects 50 to 80 percent of people in the U.S. at some point in their lives. In any given year, 10 percent of adults experience back pain or other symptoms, such as limited mobility or stiffness. Each year, Americans spend an estimated $24 billion on treatments for back pain - not including missed time from work nor the emotional costs of enduring pain and not being able to participate in daily activities. Imagine what it would be like to have problems working, golfing or enjoying playtime with children!

Back pain can be mildly uncomfortable, excruciating or anywhere in between. It can start slowly, sometimes a result of poor posture, or come on suddenly because of injury. If your question is not answered here, please contact one of our information specialists. Back pain can last for a few short days or can linger for weeks, months and even years. Arthritis is a common form of back pain. The earlier arthritis is diagnosed, the more steps can be taken to reduce disability in the future. Other factors that aggravate back pain include suffering from stress, not getting enough sleep, being overweight, having poor posture or not being physically fit.

Back pain should not be considered a normal part of aging; it is a chronic condition that calls for similar lifestyle changes as diseases like arthritis and diabetes do.