PMID- 33814051
OWN - NLM
STAT- MEDLINE
DCOM- 20210806
LR  - 20210806
IS  - 1531-6564 (Electronic)
IS  - 0363-5023 (Linking)
VI  - 46
IP  - 4
DP  - 2021 Apr
TI  - Nonsurgical Treatment for Symptomatic Carpal Tunnel Syndrome: A Randomized 
      Clinical Trial Comparing Local Corticosteroid Injection Versus Night Orthosis.
PG  - 295-300.e1
LID - S0363-5023(20)30707-3 [pii]
LID - 10.1016/j.jhsa.2020.11.014 [doi]
AB  - PURPOSE: For carpal tunnel syndrome (CTS), local corticosteroid injection 
      (corticosteroid), and/or wrist immobilization with night orthosis (orthosis) are 
      commonly prescribed and are supported by strong evidence. The aim of this study 
      was to compare orthosis versus corticosteroid for patients with CTS. METHODS: A 
      CTS diagnosis was made clinically and supported by electrodiagnostic study. 
      Patients were randomly allocated to either orthosis or corticosteroid. Clinical 
      assessments were performed before the intervention, within the first week of the 
      intervention, and 1, 3, and 6 months after the intervention. Primary outcomes 
      were improvement in nocturnal paresthesia and Boston-Levine questionnaire (BLQ) 
      score. Secondary outcomes were pain assessed by visual analog scale and 
      complications. RESULTS: Of 100 patients enrolled in the study, 95 completed the 
      planned follow-up (45 in the orthosis arm and 50 in the corticosteroid arm). 
      Corticosteroid injections were superior to orthosis in remission of nocturnal 
      paresthesia (remission rates at 1 month, 84.6% versus 43.83%; 3 months, 71.1% 
      versus 40.4%; and 6 months, 80.3% versus 28.8%). The BLQ scores (functional and 
      symptom subscales) were also more favorable for corticosteroid at 1, 3, and 6 
      months (minimal clinically important differences for Function > 0.5 and Symptom > 
      0.16). Pain scores were lower and favored the corticosteroid group. There were no 
      complications in either group. CONCLUSIONS: Both options are effective in the 
      short term. Corticosteroid is superior to orthosis for improving CTS-related 
      nocturnal paresthesia, BLQ scores, and pain. TYPE OF STUDY/LEVEL OF EVIDENCE: 
      Therapeutic I.
CI  - Copyright (c) 2021 American Society for Surgery of the Hand. Published by Elsevier 
      Inc. All rights reserved.
FAU - de Moraes, Vinicius Ynoe
AU  - de Moraes VY
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil; Departamento de Ortopedia e Traumatologia, Universidade Federal de Sao 
      Paulo, Sao Paulo/SP, Brazil. Electronic address: vymoraes@gmail.com.
FAU - Queiroz, Jesus Jr
AU  - Queiroz J Jr
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil.
FAU - Raduan-Neto, Jorge
AU  - Raduan-Neto J
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil; Departamento de Ortopedia e Traumatologia, Universidade Federal de Sao 
      Paulo, Sao Paulo/SP, Brazil.
FAU - Fernandes, Marcela
AU  - Fernandes M
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil; Departamento de Ortopedia e Traumatologia, Universidade Federal de Sao 
      Paulo, Sao Paulo/SP, Brazil.
FAU - Okamura, Aldo
AU  - Okamura A
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil.
FAU - Belloti, Joao Carlos
AU  - Belloti JC
AD  - Hand Surgery Division, Hospital Alvorada Moema-United Health, Sao Paulo/SP, 
      Brazil; Departamento de Ortopedia e Traumatologia, Universidade Federal de Sao 
      Paulo, Sao Paulo/SP, Brazil.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Hand Surg Am
JT  - The Journal of hand surgery
JID - 7609631
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Boston
MH  - *Carpal Tunnel Syndrome/drug therapy
MH  - Humans
MH  - Orthotic Devices
MH  - Treatment Outcome
MH  - Wrist Joint
OTO - NOTNLM
OT  - Carpal tunnel syndrome
OT  - conservative treatment
OT  - randomized controlled trial
EDAT- 2021/04/06 06:00
MHDA- 2021/08/07 06:00
CRDT- 2021/04/05 05:31
PHST- 2019/07/13 00:00 [received]
PHST- 2020/09/04 00:00 [revised]
PHST- 2020/11/03 00:00 [accepted]
PHST- 2021/04/05 05:31 [entrez]
PHST- 2021/04/06 06:00 [pubmed]
PHST- 2021/08/07 06:00 [medline]
AID - S0363-5023(20)30707-3 [pii]
AID - 10.1016/j.jhsa.2020.11.014 [doi]
PST - ppublish
SO  - J Hand Surg Am. 2021 Apr;46(4):295-300.e1. doi: 10.1016/j.jhsa.2020.11.014.