Moderate evidence supports that oral steroids could improve patient reported outcomes as compared to placebo.
Management of Carpal Tunnel Syndrome
Endorsed by: ASSH, ASPS, ACR, ACS, ASA
Two high quality studies (Chang 1998 and Hui 2011) compare various oral regimens to treat carpal tunnel syndrome. In a prospective randomized double-blind study placebo controlled study, Chang 1993 compare various 4 week oral medication regimens (diuretic [trichlormethiazide 2mg daily] versus NSAID [tenoxicam-SR 20mg daily] versus steroid [2 weeks of prednisolone 20mg daily followed by 2 weeks of 10mg daily]) to placebo. No significant changes from baseline were noted in the placebo, diuretic, or NSAID arms. However, the steroid arm improved significantly at 4 weeks, based on GSS Questionnaire. A review of the data provided indicates that at 4 weeks, the steroid arm had statistically significant improvement over the NSAID and diuretic arms based on GSS Questionnaire. Hui 2011 failed to show any significance when comparing oral Gabapentin to placebo.
- Chang,B., Dellon,A.L. Surgical management of recurrent carpal tunnel syndrome. J Hand Surg Br 1993/8; 4: 467-470
- Chang,M.H.; Chiang,H.T.; Lee,S.S.; Ger,L.P.; Lo,Y.K. Oral drug of choice in carpal tunnel syndrome. ; 1998/8: 2
- Hui,A.C.; Wong,S.M.; Leung,H.W.; Man,B.L.; Yu,E.; Wong,L.K. Gabapentin for the treatment of carpal tunnel syndrome: a randomized controlled trial. Eur.J Neurol; 2011/5: 5