A study that will be presented today at the annual conference of the Radiological Society of North America suggests that an unique non-surgical treatment approach could put an end to the sufferings of those who have carpal tunnel syndrome (RSNA).
Pressure on the median nerve and tendons inside the carpal tunnel results in carpal tunnel syndrome, a nerve entrapment neuropathy. Due to a loss of proprioception, its symptoms, which include tingling, numbness, or weakness in the fingers or hand, can significantly impact one’s everyday life.
Bracing, splinting, nerve gliding exercises, or steroid injections are some of the syndrome’s current treatments. However, if nonsurgical treatment is ineffective at relieving symptoms, surgery may be required. The surgical procedure that is most frequently performed involves making a wrist incision & cutting the carpal ligament in order to relieve pressure on the median nerve.
The new study is important because it provides a non-surgical, corticosteroid-free method for treating nerve entrapments. It involves injecting a liquid – usually saline – into a nerve to-cut-it loose from surrounding tissue, and uses ultrasound guidance to identify nerves accurately.
“Previous studies of ultrasound-guided hydrodissection for carpal tunnel syndrome used corticosteroids alone or as part of the injection, making it difficult to assess whether hydrodissection was beneficial alone or if it was due to the effects of steroids. said study lead author Anindita Bose, M.B.B.S., M.D., Senior Resident at University College of Medical Sciences and Guru Teg Bahadur Hospital in Delhi, India.
A short and cost-effective procedure
Researchers used the Boston Carpal Tunnel Questionnaire (BCTQ), the Visual Analog of Pain (VAS), and cross-sectional area ultrasounds of the median nerve during the clinical trial, which included 63 patients with carpal tunnel syndrome, to evaluate the patients’ symptoms and pain before and after the procedure.
The researchers divided the 63 patients into three groups and gave group one ultrasound-guided hydrodissection with only a saline injection, whereas group two received ultrasound-guided hydrodissection with a saline and corticosteroid as injection. Group three, on the other hand, received only an ultrasound-guided corticosteroid injection with no hydrodissection.
The researchers reported a reduction in pain in all three groups after four weeks, 12 weeks, and six months of follow-up. The first two groups who underwent ultrasound-guided hydrodissection improved further, The second group, which received merely a corticosteroid injection, appeared to have a return of symptoms as well as an increase in BCTQ & VAS scores.
According to Dr. Bose, the process takes only 10-15 minutes and is also cost-effective because it does not require any high-tech equipment.
Anupama Tandon, M.B.B.S., M.D., co-author and professor at the University College of Medical Sciences and Guru Teg Bahadur Hospital, said, “It came as a nice surprise when this simple procedure of ultrasound-guided hydrodissection provided patients with long-term comfort.”
“Patients were very satisfied as the cost was low, no anesthesia or hospitalization was required and they could return and resume their routine work within an hour.”
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