Effect of Out of Plane and In Plane Injection Techniques in Patients With Carpal Tunnel Syndrome

Istanbul University - Cerrahpasa (IUC)

Status

Completed

Conditions

Carpal Tunnel Syndrome

Pain

Carpal Tunnel

Treatments

Other: Technique of injection method

Study type

Interventional

Funder types

Other

Identifiers

NCT05343351

25.03.2022/109

Details and patient eligibility

About

The aim of this study, using two different injection techniques,

To evaluate the patients in terms of the pain they feel during the application of carpal tunnel syndrome (CTS) injection,
Evaluation in terms of undesirable effects developing after injection,
To evaluate the degree of pain/drowsiness, symptom severity and functionality, and median nerve diameter at the end of the first month after the injection, and to evaluate the relationship of these parameters with the pain felt by the patients during the injection.

Full description

Among the evaluated patients, the patients who met the inclusion and exclusion criteria and accepted the carpal tunnel syndrome injection will be randomized into 2 groups using the random numbers table.

One group will be injected using the out-of-plane technique under ultrasound, and the other group will be injected using the in-plane technique. Patients will be evaluated before the treatment, at the 1st hour after the injection and at the end of the 4th week after the injection.

Randomization and injection of the patients will be done by Dr Gül Tuğba Bulut, while the evaluation of the patients and the sonographic evaluation of the median nerve will be done by Dr Alper Mengi.

Age, gender, education level, body mass index, duration of symptoms, dominant hand, injection hand, and carpal tunnel syndrome severity detected in EMG of the patients included in the study will be recorded.

The patients will be questioned about the pain they feel during the injection at the end of the 1st hour after the injection, while the degree of pain/numbness in the wrist and finger, symptom severity and functionality, and median nerve diameter are evaluated at the end of the 4th week before and after the injection.

Patients will be questioned about undesirable effects at the end of the 4th week after the injection.

Enrollment

50 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥18
Numbness and tingling in the median nerve innervation area with or without pain
Worsening of symptoms at night
Positive Tinel and/or Phalen sign
Symptom duration longer than 12 weeks
Electrophysiologically mild or moderate CTS being diagnosed.

Exclusion criteria

Presence of conditions such as cervical radiculopathy, polyneuropathy, brachial plexopathy, thoracic outlet syndrome that may mimic CTS
Presence of multiple entrapment neuropathy
Weakness in hand thumb abduction or opposition
Thenar atrophy
Presence of wrist corticosteroid and/or local anesthetic injection
Regular use of medical treatment such as oral corticosteroids or NSAIDs
Having entered a physical therapy program due to CTS in the last 6 months before the injection
A history of trauma or arthritis attack at the wrist level
Previous surgery due to CTS
Thyroid diseases, diabetes, chronic kidney failure
Having bifid median nerve, persistent median artery, ganglion cyst, tenosynovitis or tendinitis on wrist USG
Rheumatological disease (rheumatoid arthritis, ankylosing spondylitis, systemic lupus) erythematosus, vasculitis, systemic sclerosis, dermatomyositis)
Presence of malignancy
Pregnant or breastfeeding mothers
Infection or skin lesion at the injection site
Use of wrist splints in the last 4 weeks
Allergy to corticosteroids or local anesthetics