Carpal Tunnel Syndrome
Conditions
Keywords
Carpal Tunnel Syndrome, Corticosteroids, Platelet-Rich Plasma, Nerve Conduction Study, Boston Questionnaire, Visual Analogue Scale
Brief summary
This clinical trial aims to evaluate the effect of a single local platelet-rich plasma injection Versus local steroid injection in treating mild idiopathic carpal tunnel syndrome regarding pain relief and function improvement and electrophysiological studies of the median nerve as a baseline and during a follow-up period of 3 months. The main question\[s\] it aims to answer are: * Does platelet-rich plasma injection provide better pain relief for CTS symptoms than steroid injection? * Does platelet-rich plasma improve parameters of median nerve conduction study than local steroid? Participants will have: * A complete history and clinical examination, including sensory and motor examination and provocative tests for CTS. * Visual analog scale (VAS), Symptom severity scale (SSS), and functional severity scale (FSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) before local injection and three months after local injection by the same investigator. * Nerve conduction studies (NCS) for median and ulnar nerves were carried out before local injection and three months after local injection by the same investigator. Researchers will compare the efficacy of a single PRP local injection compared to a single corticosteroid local injection for treating mild idiopathic CTS using nerve conduction studies (NCS), Visual Analog Scale (VAS), and Boston Carpal Tunnel Questionnaire (BCTQ) as objective and subjective outcome measures.
Detailed description
Carpal tunnel syndrome (CTS) is the most known entrapment neuropathy. Diagnosis of CTS is clinical, which could be confirmed by nerve conduction study (NCS). Non-operative management is the first line of treatment, including splitting, antiinflammatory, and neurotonics. There is evidence of improvement in CTS after local corticosteroid injection, but complications are still recorded \[5\]. Platelet-rich plasma (PRP) is a novel, promising treatment providing growth factors for nerve regeneration and inflammation relief. This field needs further evaluation and analysis compared to traditional local steroid injection.
Interventions
Local corticosteroid injection;1 ml of triamcinolone acetonide 40 milligram/1.0 mL
Platelet-rich Plasma (From 2-step centrifugation of patient blood) Local injection.
Sponsors
Menoufia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Intervention model description
A prospective, interventional, comparative double-blinded study.
Eligibility
Sex/Gender
ALL
Age
30 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients with mild primary CTS complaining of paresthesia in the palmar aspect of lateral three and half fingers of the hand. They are selected clinically and confirmed according to Padua's Neurophysiologic Severity Scale (PNSS) for CTS
Exclusion criteria
* Patients were excluded if they had moderate-to-severe NCS findings, space-occupying lesions within the carpal tunnel, traumatic CTS, pregnancy, diabetes mellitus, rheumatoid arthritis, or previous CTS surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog scale | before and after three months from injection time | The pain severity was determined by the patients, on a scale of 0 (no pain) to 10 (agonizing pain) |
| Symptom severity scale of the Boston Carpal Tunnel Questionnaire | before and after three months from injection time | Pain severity evaluation |
| Functional severity scale of the Boston Carpal Tunnel Questionnaire | before and after three months from injection time | Hand function evaluation |
| Median nerve sensory peak latency | before and after three months from injection time | Sensory conduction evaluation of median nerve |
| Median nerve distal motor latency | before and after three months from injection time | Motor conduction evaluation of the median nerve. |
| Median nerve sensory amplitude | before and after three months from injection time | Sensory conduction evaluation of the median nerve |
| Median nerve motor amplitude | before and after three months from injection time | Motor conduction evaluation of the median nerve. |
| Median nerve sensory conduction velocity | before and after three months from injection time | Sensory conduction evaluation of the median nerve |
| Median nerve motor conduction velocity | before and after three months from injection time | Motor conduction evaluation of the median nerve. |
Countries
Egypt
Outcome results
None listed