Efficacy of Perineural Dextrose Versus Corticosteroid Injection for Carpal Tunnel Syndrome: A Randomized, Double-Blind Clinical Trial
Abstract
Introduction/aims: Ultrasound (US)-guided perineural injection therapy (PIT) with corticosteroids (CS) or 5% dextrose in water (D5W) is commonly used to relieve symptoms in carpal tunnel syndrome (CTS). However, comparative data beyond short-term follow-up are limited. This study aimed to compare the efficacy of US-guided PIT using D5W and CS over a 12-month follow-up period.
Methods: Patients with bilateral mild to moderate CTS participated in a randomized, double-blind, within-subject trial. Each patient's right hand was randomly assigned to receive D5W or CS, while the contralateral hand received the alternate treatment. Primary outcomes included the Boston Carpal Tunnel Questionnaire symptom severity (BCTQs) and functional status (BCTQf) scales and the Visual Analogue Scale (VAS). A single US-guided PIT was performed using 6 mL of injectate: 5% dextrose or triamcinolone acetonide diluted with saline. Clinical assessment, nerve conduction studies, and ultrasonography were performed at baseline and at 1, 3, 6, and 12 months.
Results: Fifty-seven patients (114 hands) were included in the analysis. Both D5W and CS produced similar improvements, with the greatest symptom relief observed within the first 3 months. Clinically meaningful improvement in BCTQs was observed in approximately 50% of hands in both groups at 1 and 3 months, and in 29% (D5W) and 25% (CS) at 12 months.
Discussion: US-guided PIT with D5W and CS provides comparable clinical benefit over 12 months in mild…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
Read the paper
Related studies
- Preliminary Toxicity Analysis of 3DCRT versus IMRT on the High Dose Arm of the RTOG 0126 Prostate Cancer Trial
- Adaptive Radiotherapy for Head and Neck Cancer: Initial Clinical Outcomes from a Prospective Trial
- American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology
- Motion Management Strategies and Technical Issues Associated with Stereotactic Body Radiotherapy of Thoracic and Upper Abdominal Tumors: A Review from NRG Oncology
- High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial
- Highly efficient training, refinement, and validation of a knowledge-based plan quality control system for radiotherapy clinical trials
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.