How effective are steroids?

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Treating carpal tunnel syndrome with steroids (also known as corticosteroids) can provide temporary relief. Steroid injections into the carpal tunnel are more effective than steroids taken as tablets.

Pain, tingling or numbness in your hand may possibly be caused by carpal tunnel syndrome. In carpal tunnel syndrome, the median nerve that runs through the carpal tunnel in your wrist is squashed. This nerve leads to the ball of the thumb and other parts of the hand. Injecting steroids is one of the most effective treatments available.

Natural steroids are made in the adrenal glands. They have various effects, such as reducing inflammation and swelling. The steroids used in medications are made artificially. In the treatment of carpal tunnel syndrome, steroids are typically considered if wearing a splint hasn't made any difference. They can either be injected into the tissue as a solution or taken as a tablet. The injections are usually the preferred form of treatment because they are more effective than tablets.

How effective are steroid injections?

Injecting steroids near the carpal tunnel is a common treatment. Steroids reduce swelling in the connective tissue in the carpal tunnel, which relieves the pressure on the median nerve. The benefits of steroid injections have been tested in several studies. In these studies, the steroid injections were either compared with other non-surgical treatments or with injections that didn't contain any medication (placebo injections).

They found that symptoms improved in many people within the first 2 to 4 weeks after having the treatment: The symptoms got better in

  • about 30 out of 100 people who didn't have a steroid injection, and in
  • about 75 out of 100 people who had a steroid injection.

In other words, the treatment provided noticeable short-term symptom relief in about 45 out of 100 people.

What are the possible side effects?

The injections can temporarily cause mild or moderate pain in the hand, but it disappears after a few days. Injections are also always associated with a risk of . An may damage tendons and nerves. Serious complications such as affecting the entire hand are quite rare. If the injection isn't given properly, the nerves may be damaged. But this is estimated to occur in fewer than 1 out of 1,000 cases. Overall, serious side effects are very rare.

How long will the improvement last?

Previous research suggests that the benefits of steroid injections are still noticeable ten weeks later. Steroid injections aren't effective in the long term, though. The symptoms often return after a while.

Some people who have very persistent symptoms may consider surgery. Surgery is often more effective than regular steroid treatment, but steroid injections sometimes help to avoid surgery or put it off for a while. It is also possible to have steroid injections again at regular intervals. It isn't clear how effective or safe this is over the long term, though. Regular injections are thought to possibly increase the risk of nerve and tendon damage as well as other side effects.

How effective are steroid tablets?

Steroid tablets can somewhat relieve carpal tunnel syndrome in some people. They may be worth trying if you have symptoms for the first time and they aren't too severe. People are advised not to take the tablets for over two weeks because longer use probably doesn't offer any benefits. But steroid tablets can cause side effects, including stomach problems, skin problems, or weight gain.

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Deutsche Gesellschaft für Handchirurgie (DGH), Deutsche Gesellschaft für Neurochirurgie (DGNC). S3-Leitlinie: Diagnostik und Therapie des Karpaltunnelsyndroms. AWMF-Registernr.: 005-003. June 2012.

Huisstede BM, Randsdorp MS, Coert JH, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part II: effectiveness of surgical treatments - a systematic review. Arch Phys Med Rehabil 2010; 91(7): 1005-1024.

Huisstede BM, Randsdorp MS, van den Brink J et al. Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review. Arch Phys Med Rehabil 2018; 99(8): 1609-1622.

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IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on May 20, 2021
Next planned update: 2024

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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