Do corticosteroid injections improve carpal tunnel syndrome symptoms?
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Q: Do corticosteroid injections improve carpal tunnel syndrome symptoms? Evidence-based answer: Yes. injected corticosteroids reduce symptoms of carpal tunnel syndrome (CTS) more effectively than placebo or systemic steroids, but no better than anti-inflammatory medication and splinting, from one to 12 weeks after therapy (strength of recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs] and consistent RCT). A 40-mg injection of methylprednisolone reduces symptoms as effectively as an 80-mg injection for as long as 10 weeks, but the 80-mg dose reduces progression to surgery at one year (SOR: B, RCT). Long-term effects of injections decrease by 12 months (SOR: B, RCT). After corticosteroid injections, 14% of patients proceed to surgery at one year, and 33% proceed to surgery at 5 years (SOR: B, cohort trial).