1. Elbaz, A., Gagnon, S., Beaumont, P., Morcos, R., “Carpal tunnel syndrome: A double blind study on the effect of steroid injection.” Presented at ASSH meeting in Cincinnati, OH, 1994.
Shows the lack of long-term relief, futility of this treatment.
2. Gelberman, R.H., Aronson, D., Weisman, M.H., “Carpal tunnel syndrome.” J Bone and Joint Surg, 1980; 62A: 7:1181-1184.
Showed the high rate of short term relief with most patients ultimately requiring CTR.
3. Goodwill, C.J., “The carpal tunnel syndrome: A long term follow up showing relationship of latency measurements to response of treatment.”
This is a very limited value study and for the most part really only shows the lack of benefit from splinting and cortisone in the long term for the treatment of carpal tunnel syndrome. They reviewed 114 patients, of which 9 were men and 105 were women followed up 1-4 years after initial exam. They noted no relationship between the likelihood of response to treatment and the results of the NCS. They felt the results of non-operative treatment on patients with CTS were similar to those previously reported citing Crow, 1960, Foster 1960, and Kendall 1962 with long term relief of corticosteroid injection occurring in only 11% of cases and only those with a motor latency of 7 msec or less. They found that night splints gave similar long-term results to local steroid, i.e. very poor, with permanent relief achieved only in those with 7 msec or less with distal motor latency with 74% obtaining some temporary benefit only. They concluded that a DML of 8 msec or greater almost certainly indicated that non-operative would fail. With a motor latency of 7 msec or less, 10% of the patients could achieve permanent relief with local steroid therapy or splints. 85% of those initial responses will relapse in 1-4 years.
4. Green, D.P. “Diagnostic and therapeutic value of carpal tunnel injection.” JHS, 1984; 9A: 850-854.
This study suggested a potential prognostic value regarding the results from patients given corticosteroid injection, though it did not show that the bulk of the patients had resolution of their problems. Those that got temporary relief were felt to be better candidates for surgery. There was no control group and the concept is scientifically untenable. It is of historical interest only and definitely not suggested reading.
5. Ozdogan, H., Yazici, H., “The efficacy of local steroid injections in idiopathic carpal tunnel syndrome: A double-blind study.” Brit J of Rheum, 1984; 23:272-275.
No long-term benefit of cortisone.
6. Schuchmann, J.A., Melvin, J.L., Duran, R.J., Coleman, C.R., “Evaluation of local steroid injection for carpal tunnel syndrome.” Arch Phys Med & Rehabil, June, 1971; 253-255.
No long-term benefit.
7. Weiss, A.C., Sachar, K., and Gendreau, M. “Conservative management of carpal tunnel syndrome: A reexamination of steroid injection and splinting.” JHS, 1994; 19A: 410-415.
No long-term benefit. Short term relief limited to young women are the least likely to benefit.
8. Wood, M.R. “Hydrocortisone injections for carpal tunnel syndrome.” JHS, 1980; 12:1: 62.