Carpal Tunnel Syndrome
Conditions
Keywords
carpal tunnel syndrome, betamethasone, % 5 dextrose
Brief summary
The aim of the study is to compare the effectiveness of ultrasound-guided betamethasone and 5% dextrose injection, which is routinely applied in clinical practice, in patients with mild and moderate carpal tunnel syndrome (CTS).
Detailed description
It is planned as an observational, single-center clinical study.A total of 28 patients diagnosed with mild-moderate carpal tunnel syndrome who meet the inclusion criteria will be included in the study.Patients who had been experiencing trigger finger symptoms for at least three month and who presented to the Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, affiliated with the Health Sciences University Faculty of Medicine. Patients will be divided into two groups. One group will receive 5% dextrose, the other group will receive 1 session of local injection by mixing Celeston chronodose \[1ml/3 mg betamethasone acetate+3,947 mg betamethasone disodium phosphate (equivalent to 3 mg betamethasone)\] and 1 ml 2% prilocaine. Evaluations will be made before injection, at weeks 4 and 12.
Interventions
PROCEDURE%5 dextrose injection
hydrodissection with %5 dextrose
PROCEDUREbetamethasone injection
perineural betamethasone injection
Sponsors
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Paresthesia and pain symptoms in the region corresponding to the distribution of the median nerve * Detection of mild or moderate CTS by electromyography * One or both of the Phalen test and/or Tinel sign are positive on physical examination * Symptoms have persisted for at least 3 months
Exclusion criteria
* Those diagnosed with polyneuropathy, plexopathy, radiculopathy, thoracic outlet syndrome * Having had surgery or any injection for carpal tunnel syndrome within the last year * History of wrist fracture * Those with rheumatoid arthritis, uncontrolled diabetes, gout, chronic renal failure, malignancy, active systemic infection * Those with cognitive impairment * Coagulopathy or bleeding tendency * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric rating scale - 10 | three months | The Numeric Rating Scale (NRS) is a simple and widely used tool for assessing pain intensity. Patients are asked to rate their pain on a scale from 0 to 10, where: 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-9 = Severe pain 10 = Worst pain imaginable The patient selects the number that best represents their pain at last one week |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| boston carpal tunnel syndrome questionnaire | three months | The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) is a disease-specific, patient-reported outcome measure used to assess symptom severity and functional status.1. Symptom Severity Scale (SSS) Contains 11 items Evaluates pain, numbness, tingling, weakness, nocturnal symptoms, and symptom frequency Each item is scored on a 5-point Likert scale (1 = no symptoms, 5 = very severe symptoms) 2\. Functional Status Scale (FSS) Contains 8 items Assesses difficulty in performing daily activities such as writing, buttoning clothes, holding a book, gripping a telephone, opening jars, and carrying grocery bags Each item is scored from 1 (no difficulty) to 5 (cannot perform the activity) |
| median nerve cross sectional area | three months | Median nerve cross-sectional area (CSA) refers to the measured area of the median nerve in a transverse (axial) plane, most commonly assessed using high-resolution ultrasonography.CSA measurements were performed using ultrasound at the scaphoid - pisiform bone level in the wrist, with results recorded in mm². To minimize measurement error, each measurement was performed three times, and the average of the three measurements was used for analysis. |
| tinnel test positivity | three months | Tinel test positivity refers to the reproduction of distal paresthesia in the distribution of a nerve following percussion over the nerve at a suspected site of compression. Definition of Positivity The test is considered positive when tapping elicits: Tingling "Pins and needles" sensation (paresthesia) Electric shock-like sensation radiating into the median nerve distribution (thumb, index finger, middle finger, and radial half of the ring finger). |
| phalen test positivity | three months | The Phalen test is performed by asking the patient to fully flex both wrists and maintain this position for approximately 60 seconds. This maneuver increases pressure within the carpal tunnel. Definition of Positivity The test is considered positive when the patient experiences: Numbness Tingling (paresthesia) Burning sensation Pain in the distribution of the median nerve (thumb, index finger, middle finger, and radial half of the ring finger) during the maneuver. |
| DuruÖz hand index | three months | The Duruöz Hand Index (DHI) is a patient-reported outcome measure developed to assess functional disability of the hand.Structure The questionnaire consists of 18 items. It assesses hand-related functional activities such as: Turning a key Buttoning clothes Opening jars Carrying objects Using kitchen utensils Scoring Each item is scored on a 6-point Likert scale: 0 = Without difficulty 1. = With slight difficulty 2. = With moderate difficulty 3. = With great difficulty 4. = Nearly impossible 5. = Impossible The total score ranges from 0 to 90. Higher scores indicate greater functional impairment. |
Countries
Turkey (Türkiye)
Outcome results
None listed