Investigating the Effect of Triamcinolone Local Injection on Clinical Outcomes of Patients With Radial Tunnel Syndrome: A Placebo-Controlled Clinical Trial.

PURPOSE: The role of corticosteroid injection for radial tunnel syndrome (RTS) has not been studied in a placebo-controlled clinical trial. The present clinical trial aimed to evaluate the effect of local triamcinolone injection on pain intensity, upper-extremity disability, and elbow function of patients with RTS.

METHODS

Forty-nine patients clinically diagnosed with RTS were randomized into the intervention and placebo groups. The diagnosis of RTS was made based on the following criteria: activity-related pain, maximal tenderness 3 to 5 cm distal to the lateral epicondyle, pain that worsens with forearm supination, pain radiating to the dorsoradial aspect of the forearm, and a positive Lister test. To confirm RTS, patients needed to exhibit at least four of these five criteria, with the requirement that one of the criteria be the tenderness located 3-5 cm distal to the lateral epicondyle. Patients in the intervention group received local injection of a single dose of corticosteroid (0.25 mL lidocaine 1% and 1 mL triamcinolone 40 mg/mL), and the placebo group received injection of single dose of normal saline (0.25 mL lidocaine 1% and 1 mL normal saline). The clinical outcomes, including QuickDASH (Disabilities of the Arm, Shoulder, and Hand), visual analog scale for pain, and Oxford Elbow Score, were evaluated before treatment, as well as 2 weeks and 3 months after the injection.

RESULTS

Visual analog scale pain score, QuickDASH score, and Oxford Elbow Scores were similar between the intervention and placebo groups at 2 weeks and 3 months of follow-up. However, reduction in visual analog scale pain, QuickDASH score, and Oxford Elbow Scores were statistically significant over time among both groups.

CONCLUSIONS

Triamcinolone injection does not have any superior effect on the clinical outcomes of patients with RTS, compared with placebo.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.