Scientists developed a non-surgical treatment model for carpal tunnel syndrome

The treatment does not require anesthesia or hospitalization.
Mert Erdemir
Stock image of tendon and nerve in the hand.
Stock image of tendon and nerve in the hand.

Ozgu Arslan/iStock 

A novel non-surgical treatment method could mark an end to the sufferings of carpal tunnel syndrome patients, according to a study that will be presented today at the annual meeting of the Radiological Society of North America (RSNA).

Carpal tunnel syndrome is a nerve entrapment neuropathy that is caused by pressure on the median nerve and tendons inside the carpal tunnel. Its symptoms, which may include tingling, numbness, or weakness in the fingers or hand, can affect one's daily life negatively due to a loss of proprioception.

Current treatments for the syndrome include bracing, splinting, nerve gliding exercises, or steroid injections. But if nonsurgical treatment does not relieve symptoms, a surgical procedure can be necessary. The most commonly used surgical method involves making an incision into the wrist and cutting the carpal ligament to release pressure on the median nerve.

The new study is significant for offering a non-surgical and corticosteroid-free option for treating nerve entrapments. It entails injecting a liquid -generally saline - into a nerve to cut it loose from the surrounding tissue, and utilizes ultrasound guidance to identify nerves accurately.

“Previously, the studies that have been done on ultrasound-guided hydrodissection for carpal tunnel syndrome have used corticosteroids either alone or as a part of the injection, making it difficult to assess whether hydrodissection alone was beneficial or if it was due to the effect of the steroids,” said study lead author Anindita Bose, M.B.B.S., M.D., senior resident at the University College of Medical Sciences and Guru Teg Bahadur Hospital in Delhi, India.

A short and cost-effective procedure

During the clinical trial, which included 63 patients with carpal tunnel syndrome, researchers employed the Boston Carpal Tunnel Questionnaire (BCTQ), the Visual Analog of Pain (VAS), and cross-sectional area ultrasounds of the median nerve to evaluate the symptoms and pain of the patient both before and after the procedure.

Dividing the 63 patients into three groups, the research team gave group one ultrasound-guided hydrodissection with just a saline injection while group two received ultrasound-guided hydrodissection with a mixture of saline and corticosteroid as an injection. Group three, on the other hand, was given just an ultrasound-guided corticosteroid injection with no hydrodissection.

The research team conducted follow-ups at four weeks, 12 weeks, and six months and observed a reduction in pain in all three groups. The first two groups that received ultrasound-guided hydrodissection further improved, while the other group that only got a corticosteroid injection appeared to show a return of symptoms and an increase in BCTQ and VAS scores.

The procedure requires only ten to 15 minutes and is also cost-effective for not requiring any high-end equipment, according to Dr. Bose.

“It came as a pleasant surprise when this simple procedure of ultrasound-guided hydrodissection provided patients with long-term relief,” said co-author Anupama Tandon, M.B.B.S, M.D., professor at the University College of Medical Sciences and Guru Teg Bahadur Hospital.

“The patients were highly satisfied, as the cost was low, no anesthesia or hospitalization was needed, and they could go back in an hour’s time and resume their routine work.”

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