Can ultrasound-guided steroid injection lead to an improvement in the symptoms of pregnancy-related carpal tunnel syndrome? With splint or alone?

Abstract

Background: Pregnancy-related carpal tunnel syndrome (PRCTS) is the most common mononeuropathy during pregnancy. Objective: to compare the efficacy of ultrasound (US)-guided steroid injection alone versus wiht splinting on symptom severity on PRCTS. Methods: This retrospective cohort study included 37 pregnant women in their third trimester with PRCTS, treated with ultrasound-guided steroid injection of 4 mg dexamethasone into the median nerve (Group I, n = 15), volar splinting in a neutral position while sleeping and during the day whenever possible for at least ten weeks (Group S, n = 12), or both injection and splinting (Group I + S, n = 10). Patient data were collected from hospital records, and symptoms were assessed using the Boston Carpal Tunnel Symptom Questionnaire (BCTQ), the Douleur Neuropathique 4 (DN4) and the Numeric Rating Scale (NRS). Statistical analyses included Student's t-test, Mann-Whitney U test, Fisher's exact test, ANOVA, Kruskal-Wallis test, descriptive analyses, and power analyses. Results: During the first month of intervention, group S had higher BCTQ scores than the other two groups (p < 0.001). In the postpartum period, the order of scores was Group S > Group I > Group I + S (p < 0.001). The effect size was significant with Partial eta squared = 0.369. Conclusion: The combination of splinting and injection seems to be more effective in the short term period. But still, to validate our findings, Additional randomized controlled trials are recommended.