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Carpal tunnel syndrome

Carpal tunnel syndrome

How effective are steroids?

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Treating carpal tunnel syndrome with steroids (also known as corticosteroids) can provide temporary relief. But they hardly have any long-term effect. 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. The median nerve – which runs through the carpal tunnel in your wrist to the ball of the thumb and other parts of the hand – is squashed. 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 helped. 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. This reduces swelling in the connective tissue of the carpal tunnel and decreases the pressure on the median nerve.

The benefits of steroid injections have been tested in several studies. They found that symptoms improved in many people within the first 2 to 4 weeks after having the treatment. The effect of the steroid injections may last up to six months. They are hardly effective in the long term, though. The symptoms often return after a while.

The treatment is more effective and has fewer side effects if a doctor is monitoring the injection using ultrasound.

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 happens in fewer than 1 out of 1,000 people. Overall, serious side effects are very rare.

Steroid injections or surgery?

It isn't yet clear enough how effective steroid injections are compared to surgery. The research suggests that both methods can relieve the symptoms equally well for the first few months.

But steroid injections sometimes help to avoid surgery or put it off for a while. Some people with persisting symptoms still consider having surgery though, because the injections either aren't effective enough or the effect doesn't last long enough.

It is possible to have steroid injections again at regular intervals, but isn't clear how effective or safe this is over the long term. 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 also help to relieve the symptoms in some people. The tablets 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.

Ashworth NL, Bland JD, Chapman KM et al. Local corticosteroid injection versus placebo for carpal tunnel syndrome. Cochrane Database Syst Rev 2023; (2): CD015148.

Ashworth NL, Bland JD, Chapman KM et al. Local corticosteroid injection versus surgery for carpal tunnel syndrome. Cochrane Database Syst Rev 2024; 8(8): CD015101.

Bland JD. Carpal tunnel syndrome. BMJ 2007; 335(7615): 343-346.

Deutsche Gesellschaft für Handchirurgie (DGH), Deutsche Gesellschaft für Neurochirurgie (DGNC). Diagnostik und Therapie des Karpaltunnelsyndroms (S3-Leitlinie). AWMF-Registernr.: 005-003. 2022.

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.

Lusa V, Karjalainen TV, Pääkkönen M et al. Surgical versus non-surgical treatment for carpal tunnel syndrome. Cochrane Database Syst Rev 2024; (1): CD001552.

Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev 2007; (2): CD001554.

Shi Q, MacDermid JC. Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? A systematic review. J Orthop Surg Res 2011; 6: 17.

Wang H, Zhu Y, Wei H, Dong C. Ultrasound-guided local corticosteroid injection for carpal tunnel syndrome: A meta-analysis of randomized controlled trials. Clin Rehabil 2021; 35(11): 1506-1517.

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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How effective are steroids?

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Updated on December 17, 2024

Next planned update: 2027

Publisher:

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

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