Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study.
OBJECTIVE
To study the efficacy of splinting and oral steroids in the management of carpal tunnel syndrome (CTS).


METHODS
Prospective, randomized, open-label, clinical and electrophysiological study with 3-month follow-up.


METHODS
Forty patients with CTS were randomly divided into splint group (N-20), wearing splint in neutral position for 4 weeks; and steroid group (N-20), who received oral prednisolone 20 mg/day for 2 weeks followed by 10 mg/day for 2 weeks. Clinical and electrophysiological evaluations were done at baseline and at 1-month and 3-month follow-up. Independent 't' test and paired 't' test were used for statistical analysis.


METHODS
Primary outcome measure was the symptom severity score and functional status score. Secondary outcome measures were median nerve sensory and motor distal latency and conduction velocity.


RESULTS
At the end of 3 months, statistically significant improvement was seen in symptom severity score and functional status score in both groups (P<0.001). Median nerve sensory distal latency and conduction velocity also improved significantly in both the groups at 3 months. Improvement in motor distal latency was significant (P=0.001) at 3 months in steroid group, while insignificant improvement (P=0.139) was observed in splint group. On comparing the clinical and electrophysiological improvement between the two groups, except for the functional status score, there was no significant difference at 3-month follow-up. Improvement in functional status score was significantly more in steroid group (P=0.03).


CONCLUSIONS
There was significant improvement in both groups, clinically as well as electrophysiologically, at 3 months. On comparing the efficacy of the two treatment methods, except for the functional status score, there was no significant difference between the two groups.
Mishra
Sanjay
S
Department of Neurology, PGIMER, Chandigarh, India.
Prabhakar
Sudesh
S
Lal
Vivek
V
Modi
Manish
M
Das
Chandi P
CP
Khurana
Dheeraj
D
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D004334:Drug Administration Schedule; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D013165:Splints; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D011239:Prednisolone