A Cochrane review «Local corticosteroid injection for carpal tunnel syndrome»1 «Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev 2007 Apr 18;(2):CD001554. »1 included 12 studies with a total of 671 subjects. Two high quality randomized controlled trials (n=141) demonstrated clinical improvement of carpal tunnel syndrome at one month or less following local corticosteroid compared to placebo injection (RR 2.58, 95% CI 1.72 to 3.87). One trial compared local corticosteroid injection to oral steroid and at three months after treatment there was a significant improvement in the injection group (mean difference –7.00; 95% CI –11.58 to –2.42). In one trial the rate of improvement after one month was greater after local than systemic corticosteroid injection (RR 3.17, 95% CI 1.02 to 9.87). In one trial symptoms did not improve significantly for the injection group at eight weeks after injection compared to treatment with anti-inflammatory medication and splinting (mean difference 0.10, 95% CI –0.33 to 0.53). Two injections versus one injection of local corticosteroid did not provide further clinical improvement, mean difference –3.80 (95% CI –9.27 to 1.67).
The following decision support rules contain links to this evidence summary: