Carpal Tunnel Syndrome (CTS) Surgery or Injection?

Carpal Tunnel Syndrome (CTS) Surgery or Injection?

Reference:Andreu JL et al Local injection versus surgery in carpal tunnel syndrome: neurophysiologic outcomes of a randomized clinical trial. Clin Neurophysiol. 2014 Jul;125(7):1479-84.

Let’s assume a patient has failed to respond to any of your treatments, and they ask you, “Should I get an injection or get the surgical release?”

Based on this study, CTS surgical release and local corticosteroid injection were both equally effective in reducing pain and tingling. However, only surgery resulted in improvements of nerve conduction tests repeated one year later.

Clinical Relevance: If a patient primarily has symptoms of pain and paraesthesia then perhaps an injection is enough. However, if a patient has actual loss of hand strength and thenar eminence atrophy; then seriously consider the surgical release option.

Posted on: October 11, 2015

Categories: Wrist & Hand