Friday, 22 Nov 2019

You are here

Steroid Injection Superior to Splinting in Carpal Tunnel Syndrome

Lancet has published a comparative effectiveness study examining the the value of night splints (conservative treatment) vs local injection for patients with carpal tunnel syndrome.

A randomised, open-label, pragmatic trial in adults with mild or moderate carpal tunnel syndrome (new; < 6 weeks' duration) involved 234 patients randomly assigned (1:1) to either a single injection of 20 mg methylprednisolone acetate (from 40 mg/mL) or a night-resting splint to be worn for 6 weeks. The primary outcome was the overall score of the Boston Carpal Tunnel Questionnaire (BCTQ) at 6 weeks.

At 6 weeks 91% completed the trial. The BCTQ score was significantly better at 6 weeks in the corticosteroid injection group (mean 2·02 [SD 0·81]) than the night splint group (2·29 [0·75]; adjusted mean difference −0·32; 95% CI −0·48 to −0·16; p=0·0001). No adverse events were reported.

This open label study suggests that a single corticosteroid injection is superior to conservative night splinting in the management of mild or moderate carpal tunnel syndrome.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Mallinckrodt Receives SEC Subpoena

Reuters reports that Mallinckrodt Plc has received a subpoena from the U.S. Securities and Exchange Commission for documents related to the drugmaker’s lawsuit against the U.S. Department of Health and Human Services (HHS).

ACR Responds to CY2020 Medicare Physician Fee Schedule Proposed Rule

Rheumatology leaders commend CMS for proposing E/M code changes and urge agency to make additional changes to final rule.d

Parenteral Out-Performs Oral Weekly Methotrexate

A systematic review in PLOS suggests that parenteral MTX therapy is more successful than oral MTX in achieving optimal disease activity control. 

ACR Survey Shows Half of Patients Cannot Afford Treatments

Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.

Medical Use of Cannabis in 2019

JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.