Comparison of the Efficacy of Oral and Local Steroids in the Management of Carpal Tunnel Syndrome

Objective: This research was conducted to compare the efficacy of oral steroids with local steroid injection in the carpal tunnel as regards relieving the symptoms and improvement in neurophysiological parameters. Materials and Methods: This study was performed at the Neurology Department, Punjab Institute of Neurosciences, Lahore. 72 patients were part of the study and divided into 2 groups; Group A (oral steroids) and B (steroid injection). Patients in Group A received a local injection of 1.5cc Normal Saline and oral prednisolone (20 mg once daily for two weeks, followed by 10 mg once daily for the next two weeks), whereas those in Group B received a local injection of 15 mg triamcinolone and an oral placebo for four weeks. The outcome was assessed using the Global Symptom Score. Results: The average age of the patients involved in the study was 47 years. There were 33(46%) males and 39(54%) females. The mean Global Symptom Score for group A was 28.9 at baseline (0 week) and 23.5 at 4 weeks. In group B, it was found to be 27.1 at 0 week and 16.05 at 4 weeks. Independent T-test for comparing groups A and B showed a non-significant p-value at 0 week and significant at 4 weeks (p-value of 0.04). Conclusion: The study concluded that local injection of steroids (triamcinolone) is more efficacious in improving carpal tunnel syndrome symptoms as compared to patients receiving oral steroids.