Dr. Ron’s Research Review – August 1, 2018

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This week’s research review focuses on progesterone versus corticosteroid local injections in mild and moderate carpal tunnel syndrome.

A study compared the short-term effects of progesterone and corticosteroid local injections in the treatment of female patients with carpal tunnel syndrome. (Bahrami et al., 2015)
A randomized clinical trial was used for this study, 60 hands with mild and moderate Carpal Tunnel Syndrome categorized in two groups were used for this study. Patients were treated with a single local injection of triamcinolone acetonide (a synthetic corticosteroid) in one group and single local injection of 17-alpha hydroxy progesterone in the other group. Variables such as pain (based on Visual Analogue Scale), symptom severity and functional status (based on Bostone/Levine symptom severity and functional status scale) and nerve conduction study were evaluated before and 10 weeks after the treatments.
Ten weeks after treatment, pain severity and median nerve sensory and motor latencies decreased while patients' functional status increased meaningfully in both groups. However, there were no meaningful differences between two groups regarding mentioned variables. Pain severity was milder and duration of post-injection pain was shorter in the corticosteroid group. The rates of patient satisfaction were also meaningfully higher in the corticosteroid group.
Both treatments were effective in the short-term management of mild and moderate disease, clinically and electrophysiologically. There were no significant differences in therapeutic effects between two groups.

Dr. Ron

 


 

Articles

Comparison between the effects of progesterone versus corticosteroid local injections in mild and moderate carpal tunnel syndrome: a randomized clinical trial.
            (Bahrami et al., 2015) Download
BACKGROUND:  The objective of this study was to compare the short-term effects of progesterone and corticosteroid local injections in the treatment of female patients with carpal tunnel syndrome. METHODS:  A randomized clinical trial was used for this study, 60 hands with mild and moderate Carpal Tunnel Syndrome categorized in two groups were used for this study. Patients were treated with a single local injection of triamcinolone acetonide in one group and single local injection of 17-alpha hydroxy progesterone in the other group. Variables such as pain (based on Visual Analogue Scale), symptom severity and functional status (based on Bostone/Levine symptom severity and functional status scale) and nerve conduction study were evaluated before and 10 weeks after the treatments. RESULTS:  Ten weeks after treatment, pain severity and median nerve sensory and motor latencies decreased while patients' functional status increased meaningfully in both groups. However, there were no meaningful differences between two groups regarding mentioned variables. Pain severity was milder and duration of post-injection pain was shorter in the corticosteroid group. The rates of patient satisfaction were also meaningfully higher in the corticosteroid group. CONCLUSIONS:  Both treatments were effective in the short-term management of mild and moderate disease, clinically and electrophysiologically. There were no significant differences in therapeutic effects between two groups. TRIAL REGISTRATION:  Current controlled trials IRCT2013101313442N4.

 

References

Bahrami, MH, S Shahraeeni, and SA Raeissadat (2015), ‘Comparison between the effects of progesterone versus corticosteroid local injections in mild and moderate carpal tunnel syndrome: a randomized clinical trial.’, BMC Musculoskelet Disord, 16 322. PubMed: 26502966