Clinical Experience of Local Steroid Injections through the Flexor Carpi Radialis for Treating Carpal Tunnel Syndrome / 대한마취과학회지

ABSTRACT

BACKGROUND: Local steroid injections for the treatment of carpal tunnel syndrome have become common, but median nerve injuries after the injections have rarely been reported. In our study, we checked the occurrence of a severe pain during local steroid injections through the flexor carpi radialis, and we evaluated the efficacy of injections for several short-term period. METHODS: A total of 24 patients with 32 affected hands were studied. The patients who presented with known medical causes or thenar muscle atrophy or a previous trauma history at the affected wrist were excluded from the study. The diagnosis was made both clinically and electrophysiologically, and then the injections were performed through the flexor carpi radialis with the hand in the supine position. Triamcinolone Acetonide (TA) 40 mg was injected first, and TA 20 mg was reinjected when the recovery rate on a 100 mm visual analog scale (VAS) score was below 50% 1 week after the injection. The patients were reevaluated with the VAS score before and 1, 3 and 6 months after the injections. RESULTS: In our study, no patients reported severe pain indicating there was median nerve injury during the injections. The mean VAS scores were 64.9, 9.5, 31.1 and 47.3 before and 1, 3 and 6 months after the injections respectively. As a result, the injections were deemed for the short-term period (P < 0.05). CONCLUSIONS: In our study, we concluded that local steroid injection through the flexor carpi radialis for treating carpal tunnel syndrome is a safe and effective method.