Comparative Study of Ultrasound-Guided Corticosteroid Injection with Acupotomy Release Versus Injection Alone in Carpal Tunnel Syndrome: A Randomized Controlled Trial

BACKGROUND Carpal tunnel syndrome (CTS) arises mainly from median nerve compression and inflammation. This study evaluated the efficacy of ultrasound-guided corticosteroid injection combined with acupotomy release of the transverse carpal ligament vs corticosteroid injection alone in treating CTS. MATERIAL AND METHODS In this randomized controlled trial, 68 patients with CTS were enrolled from January 2023 to June 2024 and randomly assigned to receive corticosteroid injection with acupotomy (group A) or corticosteroid injection alone (group B). Symptom severity and function were evaluated using the Boston Carpal Tunnel Questionnaire-Symptom Severity Score (BCTQ-S) and Functional Status Scale (BCTQ-F) at 2 weeks, 1 month, and 3 months after treatment. Ultrasound was used to assess the median nerve's cross-sectional area (CSA) and flattening ratio before and 3 months after treatment. Complications were monitored. RESULTS Both groups exhibited significant improvements in symptoms and function at all follow-up points (P<0.05). At 2 weeks after treatment, no significant differences were observed between the groups in BCTQ-S or BCTQ-F scores. At 1 month, group A had significantly better BCTQ-S (P=0.017) and BCTQ-F (P=0.039) scores than did group B; this superiority remained at 3 months (P<0.01). Ultrasound assessments at 3 months revealed significantly greater improvements in CSA (P=0.009) and flattening ratio (P=0.038) in group A than in group B. No complications were reported in either group. CONCLUSIONS Ultrasound-guided corticosteroid injection combined with acupotomy release yielded superior symptom relief and functional recovery than injection alone.