Dextrose, Corticosteroids and Surgical Release in Carpal Tunnel Syndrome
Peripheral Nervous System Diseases, Nerve Compression Syndromes, Carpal Tunnel Syndrome
About this trial
This is an interventional treatment trial for Peripheral Nervous System Diseases focused on measuring Carpal Tunnel Syndrome, Electromyography, Ultrasonography, Surgery, Dextrose, Corticosteroids
Eligibility Criteria
Inclusion Criteria (subject diagnosed as CTS if meeting criterion 1 + at least one of criteria 2 or 3):
- numbness and tingling in at least two out of the first four digits;
- symptoms exacerbated during the night or in the morning, on holding the objects or repetitive use of the hand;
- symptoms relieved by shaking the hand or reposition of the arm.
In addition to these clinical criteria for recruitment EDx confirmation will also be needed. Only patients with bilateral EDx mild to moderate CTS will be included.
Exclusion Criteria:
- polyneuropathy, symptoms of polyneuropathy, and all conditions causing polyneuropathy (e.g., diabetes);
- multiple mononeuropathy (e.g., hereditary neuropathy with liability to pressure palsies, syndrome Lewis Sumner);
- motor neuron disorders (e.g., monomelic amyotrophy, amyotrophic lateral sclerosis - ALS);
- brachial plexopathy;
- other focal neuropathies affecting upper limbs (e.g., other median neuropathies, ulnar neuropathies, thoracic outlet syndrome); or
- previous surgery or local injections for CTS.
Sites / Locations
- University Medical Center Ljubljana, Department of Neurology, Institute of Clinical NeurophysiologyRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Corticosteroids vs. Dextrose
Corticosteroids or Dextrose vs. Surgery
In the first part of the study examiner will randomize substance for left hand infiltration using a dice (odd number - corticosteroids; even number - 5% glucose). Right hand will be infiltrated with the remaining substance.
In the second part of the study examiner will randomize treatment procedure for left hand using a dice (odd number - corticosteroids or 5% glucose; even number - surgery). Substance for injection will be determined according to the results of the first part of the study - more effective one, or in case of non-inferiority 5% glucose will be used. Surgical release will be performed by the same plastic surgeon. Both treatments will be performed maximally 2 months after diagnosis, with maximum period between them of 1 week.