A team of researchers recently set out to determine if surgery is the best course of action for carpal tunnel syndrome (CTS). The researchers concentrated on the results of 163 wrists belonging to 101 patients (n = 93 women, and n = 8 men) who were referred by their primary care physician to a CTS unit specifically established for the study. All the participants had reported CTS symptoms, mostly at night, for at least 3 months.
Of the total wrists, 80 were randomly assigned to receive the decompression of the median nerve, a standard surgical procedure. The remaining participants were given a local steroid injection. The participants in both groups were similar in agethe median was 50 for the surgery group and 53 for the injection groupas well as in the length and severity of the disease. The researchers examined all the wrists after 14 days following initial treatment. Of the injection group, 69 of the wrists required a second local injection.
Symptoms were assessed for both groups at 3, 6, and 12 months. The researchers used visual analog scale scores to check improvement. At 3 months, the researchers found that 94% of the wrists in the injection group reached significant improvement for the nocturnal symptoms, compared with 75% of the wrists in the surgery group. At 6 months, 85.5% of the wrists in the injection group reached a 20% or better response for nighttime symptoms, compared with 76.3% in the surgery group. At 12 months, 69.9% of the wrists in the injection group had a 20% or better response for the nocturnal symptoms, compared with 70% in the surgery group. (The findings were reported recently in Arthritis & Rheumatism.)