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A randomized study camparing oral versus injection triamcinolone in carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy found in clinical practice. Corticosteroids are effective in treating CTS. The purpose of this study was to evaluate the effi cacy of oral versus local injection of triamcinolone in relieving symptoms and improving neurophysiological parameters in CTS. This is a randomized controlled trial performed at Hasan Sadikin Hospital, Bandung. Inclusion criteria were idiopathic CTS patients without thenar atrophy and no contraindications to corticosteroids. Subjects were divided into oral or injection groups. The oral group was given 16 mg triamcinolone daily for 2 weeks followed by 8 mg daily for the next 2 weeks and local placebo injection. The injection group was given 15 mg local injection triamcinolone and oral placebo. The outcome was assessed using Global Symptom Score and nerve conduction studies. Fifty subjects were randomized to oral or injection group. The injection group show signifi cant improvement at 2 and 4 weeks while the oral group showed signifi cant improvement only at 2 weeks. Comparing both groups, improvement in neurophysiological parameters were signifi cantly greater in the injection group. In conclusion, local injection triamcinolone show better neurophysiologic outcome and effi cacy in relieving symptoms compared to oral triamcinolone in CTS.