Carpal Tunnel Soothed by Steroids

Steroid injections provided temporary relief from carpal tunnel symptoms

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Steroid injections are often used to treat symptoms of carpal tunnel syndrome. Evidence was lacking about how well steroid injections treated carpal tunnel past the first month. A recent study was conducted to shed light on this question.

Carpal tunnel syndrome is a condition that can cause pain, numbness and discomfort in the hand due to pressure on a nerve in the wrist.

The researchers found that patients who received injections of the steroid methylprednisolone had less pain at 10 weeks than patients who did not receive steroids. However, almost all the patients in the trial required surgery to treat their carpal tunnel within a year.

This study confirms that steroids may provide short-term relief for patients with carpal tunnel. 

"Ask your doctor about your treatment options for carpal tunnel."

From this study, Isam Atroshi, MD, PhD, of the Department of Orthopedics at Hässleholm Hospital in Sweden, and colleagues aimed to determine how well methylprednisolone injections treated carpal tunnel syndrome.

The study consisted of three groups of 37 patients each. One group received 80 milligrams of methylprednisolone, the other received 40 milligrams of methylprednisolone and the last group received a placebo (fake medication). They were followed up with on the 5th, 10th, 24th and 52nd week of the trial.

The patients were 18 to 70 years of age. None of the patients had steroid injections prior to the study.

The level of pain for patients at 10 weeks was measured by severity scores that ranged from 1 to 5.

The researchers found that patients who received an 80 milligram injection of methylprednisolone had a 0.64 point drop in the severity of their symptoms. The researchers also discovered that patients who received a 40 milligram injection of methylprednisolone had a 0.88 point drop in the severity of their symptoms.

The study also compared the rates of surgery for each group within a year. The 80 milligram steroid group had a surgery rate of 73 percent, the 40 milligram steroid group had a surgery rate of 81 percent and the placebo group had a rate of 92 percent within a year.

Approximately three out of four patients required surgery within a year.

Patients who received 80 milligrams of steroid injections were less likely to need surgery within a year in comparison to the placebo group. The difference between surgery rates for patients who received 40 milligrams of steroid injections versus the placebo group was insignificant.

It should be noted that this trial was limited to one research center. Furthermore, a device used to support the patients wrists, known as a splint, had failed on all the patients prior to the study.

“The probability of a long-term benefit is relatively small, which should be taken into consideration by doctors who currently use this treatment on most of their patients," said Dr. Atroshi.

"On the other hand, for doctors who rarely use it, our study shows that the treatment has a proven short-term benefit and therefore, in certain situations, could be an appropriate alternative to surgery," he said.

This study was published September 3 in the Annals of Internal Medicine and was funded by Region of Scania Research and Development Foundation and Hässleholm Hospital Organization. The authors declared no conflicts of interest.

Review Date: 
September 3, 2013
Last Updated:
September 5, 2013