THE EFFICIENCY OF LOCAL CORTICOSTEROID WITH ORAL CORTICOSTEROID IN REDUCING CTS SYMPTOMS BY SYMPTOMS SEVERITY SCORE AND FUNCTIONAL STATUS SCORE

Dr. Anis Ahmed*, Dr. Sukumar Majumdar, Dr. Subash Kanti Dey and Dr. Md. Shahidullah

ABSTRACT

Background: Nowadays, injection with corticosteroids is one of the many recommended treatments and one of the most studied treatment modalities for Carpal tunnel syndrome (CTS).Objective: In this study our main goal is to evaluate the efficiency of local corticosteroid with oral corticosteroid in reducing CTS symptoms by symptoms severity score and functional status score. Method: This was a randomized controlled clinical trial carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU) starting from July 2020 to June 2021. A total of 80 patients attending the outpatient of Department of Neurology, BSMMU, designated as clinically suspected CTS and established by electrophysiological parameters and treated in two groups. One group, n=40 received Injection Triamcinolone 30 mg close to carpal tunnel once in a month and other group, n=40 received oral steroids for one month. Results: During the study, Majority of the patients in both treatment groups (65% in local steroid and 60% in oral steroid group) were female. In local steroid injection group, symptoms were greatly reduced than those who received oral steroid. Relief from nocturnal awakening was also appreciably higher in the steroid injection receivers (70%) than that in the oral steroid receivers (5%). Symptoms severity score and functional status score were also at much lower level in the former group than those in the latter group (p< 0.001 and p < 0.001 respectively). Relief of numbness was considerably higher in the steroid injection, 37.5% than that in the oral steroid, 22.5% though the difference was not statistically significant (p = 0.149). No major side effects occurred in local steroid group except 5% depigmentation in injected area. In oral steroid group 9% nausea, 7% epigastric pain, 8% bloating and 3% had insomnia cases. Conclusion: In conclusion we can say that, superiority of local steroid injection to oral steroid in the treatment of CTS.

Keywords: Carpal tunnel syndrome (CTS), local steroid injection, oral steroid.