comparison of the efficacy of carpal tunnel release vs. local steroid injection in the management of mild to moderate carpal tunnel syndrome: a clinical trial

Background: although carpal tunnel release (ctr) is accepted in severe cases of carpal tunnel syndrome (cts), it is not clear if ctr overweighs the local steroid injection (lsi) in the treatment of patients with mild symptoms. objectives: here, we compared the efficacy of lsi with ctr on improving signs and symptoms of mild to moderate cts. methods: in a randomized clinical trial, we used the boston carpal tunnel questionnaire (bctq) to evaluate the change of functional status scale (fss) and symptom severity scale (sss), in addition to the patients' satisfaction, over a follow up period of 6 months. results: in total, 68 patients (33 in the lsi and 35 in the ctr group), with the mean age of 45.8 ± 8.1 years and mean bmi of 30.5 ± 6.1 kg/m² were included. the baseline clinic demographic characteristics of the patients were not significantly different between the 2 study groups. both treatments significantly improved the fss (p = 0.002 for lsi and p = 0.001 for ctr) and sss (p = 0.001 for both groups). however, no significant difference was observed between fss (p = 0.36) and sss (p = 0.29) of the 2 groups. although the patients' satisfaction was also not significantly different between the 2 groups, the number of completely satisfied patients was more in the lsi group. conclusions: considering no significant difference between the outcome and satisfaction rate of patients treated with lsi or ctr, it can be concluded that both treatments are efficacious in the treatment of mild to moderate cts, at least for a period of 6 months. however, the durability of treatments needs further evaluation.