Comparison of pulsed radiofrequency and steroid injection in the treatment of carpal tunnel syndrome guided by USG imaging

Aims: The research evaluated the effectiveness between ultrasonography-guided pulsed radiofrequency treatment and steroid injection therapy for carpal tunnel syndrome. Methods: The research included 60 patients who received carpal tunnel syndrome diagnoses. The patients received their treatment based on two distinct approaches which formed separate groups: 30 patients who underwent ultrasonography-guided injection of 40 mg methylprednisolone acetate and 30 patients who underwent ultrasonography-guided application of pulsed radiofrequency targeting the median nerve at 42°C for 120 seconds. Visual Analog Scale (VAS) score, Boston Carpal Tunnel Scale and physical examination findings were evaluated before treatment, at 1, 3 and 6 months. All patients underwent EMG before the procedure and at 6 months. Results: At baseline, no significant variations were observed across groups regarding demographic characteristics as well as clinical parameters. At the third month, the VAS score decreased to 2.9±1.5 in the RF group while it was still 3.8±2.1 in the steroid group (p=0.048). Functional scores of the Boston scale were 1.6±0.7 in the pulsed radiofrequency group and 2.0±0.8 in the steroid group (p=0.037). In the electrophysiologic evaluation at the sixth month, motor distal latency was 3.9±0.7 ms in the RF group versus 4.3±0.8 ms in the steroid group (p=0.041). The rate of more than 50% improvement in VAS score was 80% in the RF group compared to 60% in the steroid group. Conclusion: Pulsed radiofrequency therapy delivers superior long-term results than steroid injection does. As a minimally invasive method, it should be evaluated before surgery.