Distal vs. Proximal Approaches to Local Steroid Injection for Carpal Tunnel Syndrome .
Comparison of Distal and Proximal Local Steroid Injection for Carpal Tunnel Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials
Pain Ther. 2022 Dec;11(4):1389-1402.Five studies involving 339 patients with carpal tunnel syndrome were included in this systematic review and meta-analysis comparing distal and proximal approaches to corticosteroid injection. Pooled outcomes of interest included the Boston Carpal Tunnel Questionnaire (BCTQ), pain on a Visual Analog Scale (VAS), electrophysiological outcomes, pain on injection, duration of injection, and adverse events. Results revealed no differences in pooled BCTQ function or symptom scores between the two approaches. No difference in pain intensity or the risk of adverse events was observed either. However, a distal approach was found to take significantly less time to perform and resulted in a better sensory nerve action potential amplitude vs. a proximal approach.
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