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Steroid Injection for Carpal Tunnel Syndrome Forecasts Surgery Success

You may not find a crystal ball in your doctor's office, but sometimes the information doctors have gets close. This study offers one way to tell if a patient with carpal tunnel syndrome (CTS) could be helped by surgery. Getting relief from a steroid injection appears to be a good predictor of success for surgery.

CTS is a condition that is caused by pressure on (or damage to) the median nerve. This nerve travels down the arm and through a passageway formed of bones (the carpals) and ligaments in the wrist, called the carpal tunnel.

Taking the pressure off the median nerve by cutting the ligament over the tunnel is a well-known treatment. However, it doesn't work for everyone. Patients and doctors like to know that an operation will help. The results of this study may give some answers to that question.

Steroid injections often help in cases of CTS where swelling is part of the problem. Sometimes an injection is all a patient needs to get better. Other patients get better for a while after the shot, but then their symptoms come back. Patients who feel relief, according to this and other studies, are most likely to be helped by surgery.

This study showed that the success rate of surgery is best for patients who'd gotten relief of symptoms with a steroid injection. No other predictor of success is known.

The authors of this study advise doctors to try a steroid injection with any patient who has CTS. It's a simple treatment with few risks and low cost. The chances of success with surgery are less if symptoms are not relieved after an injection. In these cases, surgery may still be helpful for some patients and shouldn't be avoided altogether.

References: Stephen E. Edgell, PhD, et al. Predicting the Outcome of Carpal Tunnel Release. In The Journal of Hand Surgery. March 2003. Vol. 28A. No. 2. Pp. 255-261.

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