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Corticosteroid injections or a night splint?

Corticosteroid injections or a night splint?

If carpal tunnel syndrome is caused by rheumatoid arthritis or inflammatory arthritis, treating the arthritis can reduce carpal tunnel syndrome symptoms.

Often, there is no single cause for carpal tunnel syndrome. There may be a combination of risk factors that contribute to the development of this condition. Photo: shutterstock.

According to an article published in the journal Rheumatology, patients with mild to moderate carpal tunnel syndrome may benefit more from initial treatment with a night splint that is worn for six weeks than from receiving a local corticosteroid injection.

The analysis included 234 patients, of whom 116 received a corticosteroid injection and 118 were treated with a night splint. Outcomes were assessed at 12 and 24 months using the Boston Carpal Tunnel Questionnaire (BCTQ), the Numerical Rating Scale for Hand/Wrist Pain Severity (NRS), the number of patients referred and exposed to surgical treatment for carpal tunnel syndrome, and the use of Health Care. The researchers also performed a cost-benefit analysis.

The results showed that the response rate at 24 months was 73% in the corticosteroid injection group and 71% in the night splint group. At 24 months, a greater proportion of the corticosteroid-treated group was referred for surgery (28%) than the night cast (20%) group. Similarly, among patients who underwent surgical treatment, there were more patients in the group that received corticosteroid injections than in the group assigned to the night splint (22% vs. 16%). There were no significant differences between groups in BCTQ or NRS pain score at 12 or 24 months.

Additionally, corticosteroid injections were more expensive and resulted in fewer quality-adjusted life years than a 24-month night cast.

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carpal tunnel

Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by the bones and ligaments in the palm of the hand. When the median nerve is compressed, symptoms can include numbness, tingling, and weakness in the hand and arm.

Wrist anatomy, health problems and repetitive hand movements can contribute to carpal tunnel syndrome.

Appropriate treatment often relieves tingling and numbness and restores wrist and hand function.


Symptoms of carpal tunnel syndrome usually begin gradually and include:

Tingling or numbness. You may feel tingling and numbness in your fingers or hand. The fingers affected are usually the thumb, index finger, middle, or ring finger, but not the little finger. You may feel a sensation similar to an electric shock in these fingers.

The sensation can travel from the wrist to the arm. These symptoms often occur while holding the steering wheel, phone, or newspaper, or they can wake you up while you’re sleeping.

Many people shake their hands to try to relieve symptoms. The feeling of numbness may become constant.

soft point Your hand may feel weak and things fall. This may be due to numbness in the hand or weakness of the thumb muscles, which also control the median nerve.

When should you see a doctor

See your health care provider if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.