Efficacy of Corticosteroid Injection and Nerve Hydrodissection in Carpal Tunnel Syndrome

NCT06882603 | Recruiting

• 1 other identifier: 2024/470
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 2

Brief Summary

The subject of the study is to use current treatment methods in patients with nerve compression in the wrist and compare their effects. The purpose of the study is to determine the most appropriate method by comparing the benefits of cortisone and serum injection in addition to exercise therapy in volunteers like you who have nerve compression in the wrist and have pain and numbness.

Conditions

Carpal Tunnel Syndrome (CTS)

Keywords

steroid injection; nerve hydrodissection

Outcome Measures

Primary Outcomes (2)

• Electrophysiological Study

  All patients will undergo electroneurophysiological examination at the EMG laboratory of the Neurology Department of Kırşehir Ahi Evran University Education and Research Hospital before treatment and at 12 weeks after treatment.Median sensory nerve action potential amplitude, Compound muscle action potential amplitude, Median sensory distal latency, Median motor distal latency, Median sensory nerve conduction velocity, was evaluated by EMG.

  0 day

• Electrophysiological Study

  All patients will undergo electroneurophysiological examination at the EMG laboratory of the Neurology Department of Kırşehir Ahi Evran University Education and Research Hospital before treatment and at 12 weeks after treatment.Median sensory nerve action potential amplitude, Compound muscle action potential amplitude, Median sensory distal latency, Median motor distal latency, Median sensory nerve conduction velocity, was evaluated by EMG.

  12th week

Secondary Outcomes (9)

• Measurement of the median nerve cross-sectional area with USG

  0 day

• Measurement of the median nerve cross-sectional area with USG

  4th week

• Measurement of the median nerve cross-sectional area with USG

  12th week

• Boston Carpal Tunnel Questionnaire

  0 day

• Boston Carpal Tunnel Questionnaire

  4th week

Study Arms (3)

Steroid injection

EXPERIMENTAL

The Group 1 under steroid injection + tendon and median nerve gliding exercise

Other: Steroid injection; Other: Exercise

Hydrodissection

EXPERIMENTAL

The Group 2 under hydrodissection + tendon and median nerve gliding exercise

Other: hydrodissection; Other: Exercise

Exercise

OTHER

Group 3 under tendon and median nerve gliding exercise

Other: Exercise

Interventions

Exercise OTHER

Performed with 6 different consecutive positions of the hand and wrist. 1- Wrist in neutral position, fingers and thumb in flexion 2- Wrist in neutral position, fingers and thumb in extension 3- Wrist and fingers in extension, thumb in neutral position 4- Wrist, fingers and thumb in extension 5- Forearm in supination, wrist and fingers in extension 6- Forearm in supination, wrist and fingers in extension, gentle stretching is applied to the thumb with the hand. Tendon gliding exercises: Performed to ensure isolated mobility of the flexor digitorum superficialis and profundus muscles in the canal. Tendon gliding exercises are performed in 5 different consecutive positions, respectively. 1- Fingers straight 2- Fingers in hook position 3- Fingers in fist position 4- Fingers in table shape position 5- Fingers in straight fist. The exercises will be asked to be done 10 times, once a day, every day for 3 weeks.

Exercise; Hydrodissection; Steroid injection

hydrodissection OTHER

5 ml of 0.9% isotonic sodium chloride solution will be applied to the intracarpal area median nerve area once with the USG probe.

Hydrodissection

Steroid injection OTHER

1 ml of 3mg/ml betamethasone sodium phosphate or 3mg/ml betamethasone acetate solution will be applied with the USG probe.

Steroid injection

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Female and male patients aged 18-65 who applied to Ahi Evran University Physical Medicine and Rehabilitation Polyclinic and diagnosed with carpal tunnel syndrome through clinical and EMG
• Patients who can understand the information form correctly and are cooperative
• Patients who consented to participate in the study according to the informed consent form

You may not qualify if:

• Cervical radiculopathy
• Polyneuropathy
• Brachial plexopathy
• Systemic corticosteroid use
• History of fracture and trauma in the forearm and wrist on the treated side 6- Inflammatory rheumatic disease
• Pregnant and breastfeeding patients 8- Systemic diseases such as renal failure, peptic ulcer, diabetes, hypothyroidism, coagulation disorders 9- Patients who have undergone carpal tunnel syndrome surgery 10- Thoracic outlet syndrome 11- Thenar atrophy, severe carpal tunnel syndrome 12- Patient is unwilling or states that they cannot participate for any reason

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

Study Sites (2)

Ahi Evran University

Kırşehir, City Centre, 40100, Turkey (Türkiye)

RECRUITING

Ahi Evran University

Kırşehir, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Sahin MA, Cigdem-Karacay B, Konar NM, Tuncay F. Comparison of the Effectiveness of 2 Different Kinesio Taping Techniques Added to Exercises in the Treatment of Carpal Tunnel Syndrome: Randomized Controlled Trial, Double-Blind, Parallel Groups. Arch Phys Med Rehabil. 2024 Sep;105(9):1657-1665. doi: 10.1016/j.apmr.2024.05.023. Epub 2024 Jun 6.

  PMID: 38851555 BACKGROUND

• Wu YT, Chen SR, Li TY, Ho TY, Shen YP, Tsai CK, Chen LC. Nerve hydrodissection for carpal tunnel syndrome: A prospective, randomized, double-blind, controlled trial. Muscle Nerve. 2019 Feb;59(2):174-180. doi: 10.1002/mus.26358. Epub 2018 Dec 4.

  PMID: 30339737 BACKGROUND

• Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician. 2016 Dec 15;94(12):993-999.

  PMID: 28075090 BACKGROUND

MeSH Terms

Conditions

Carpal Tunnel Syndrome

Interventions

Steroids; Exercise

Condition Hierarchy (Ancestors)

Median Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Fused-Ring Compounds; Polycyclic Compounds; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Basak Cigdem Karacay, Assoc. Prof

  Kirsehir Ahi Evran Universitesi

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Basak Cigdem Karacay, Assoc. Prof.

CONTACT

+905445094803; basakcigdem@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Investigator and outcomes assessor are different people.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: associate professor

Model Details: randomized controlled trial

Study Record Dates

• First Submitted: March 11, 2025
• First Posted: March 18, 2025
• Study Start: October 14, 2025
• Primary Completion: February 5, 2026
• Study Completion: May 5, 2026
• Last Updated: December 10, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (2)