• Ho So, ChungVincent C HVCHThe Chinese University of Hong Kong, Tung Wah Group of Hospitals, Hong Kong, China., Joseph C K Cheng, and Ronald M L Yip.
• Kwong Wah Hospital, Tung Wah Group of Hospitals, Hong Kong, China.
• Int J Rheum Dis. 2018 Jan 1; 21 (1): 102-107.

AimWe conducted a prospective randomized parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with carpal tunnel syndrome (CTS).MethodsThe well-validated and disease-specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included patient satisfaction, the change of an objective finger dexterity test and the side effects.ResultsTwenty-five patients in the local steroid group and 25 patients in the wrist splinting group completed the study procedures. At 4 weeks after treatment, there was significant improvement of the BTCQ scores in both the steroid group and splinting group. There was improvement of the finger dexterity test only in the steroid group but not in the splinting group. However, there was no statistically significant difference in the changes of BTCQ scores between the two groups after treatment. Patient satisfaction score was higher in the steroid group. Patients in the steroid group took fewer painkillers after treatment. Four patients developed side effects after splinting and three after local steroid injection, which was not statistically significant.ConclusionAlthough local steroid injection and nocturnal wrist splinting were equally effective in the treatment of patients with CTS, only the former improved objective hand function. Local steroid injection also resulted in better patient satisfaction and less painkiller use without causing more side effects.© 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

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