Muscle & nerve · 2026
Efficacy of Perineural Dextrose Versus Corticosteroid Injection for Carpal Tunnel Syndrome: A Randomized, Double-Blind Clinical Trial.
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Omejec G, Tumpaj VP, Dolinar G, Podnar S, Snoj Ž
Аннотация
INTRODUCTION/AIMS: Ultrasound (US)-guided perineural injection therapy (PIT) with corticosteroids (CS) or 5% dextrose in water (D5W) is commonly used to relieve symptoms in carpal tunnel syndrome (CTS). However, comparative data beyond short-term follow-up are limited. This study aimed to compare the efficacy of US-guided PIT using D5W and CS over a 12-month follow-up period.
METHODS: Patients with bilateral mild to moderate CTS participated in a randomized, double-blind, within-subject trial. Each patient's right hand was randomly assigned to receive D5W or CS, while the contralateral hand received the alternate treatment. Primary outcomes included the Boston Carpal Tunnel Questionnaire symptom severity (BCTQs) and functional status (BCTQf) scales and the Visual Analogue Scale (VAS). A single US-guided PIT was performed using 6 mL of injectate: 5% dextrose or triamcinolone acetonide diluted with saline. Clinical assessment, nerve conduction studies, and ultrasonography were performed at baseline and at 1, 3, 6, and 12 months.
RESULTS: Fifty-seven patients (114 hands) were included in the analysis. Both D5W and CS produced similar improvements, with the greatest symptom relief observed within the first 3 months. Clinically meaningful improvement in BCTQs was observed in approximately 50% of hands in both groups at 1 and 3 months, and in 29% (D5W) and 25% (CS) at 12 months.
DISCUSSION: US-guided PIT with D5W and CS provides comparable clinical benefit over 12 months in mild to moderate CTS, with maximal improvement occurring early after treatment. These results support D5W as a reasonable non-steroidal alternative for perineural injection therapy in CTS.
METHODS: Patients with bilateral mild to moderate CTS participated in a randomized, double-blind, within-subject trial. Each patient's right hand was randomly assigned to receive D5W or CS, while the contralateral hand received the alternate treatment. Primary outcomes included the Boston Carpal Tunnel Questionnaire symptom severity (BCTQs) and functional status (BCTQf) scales and the Visual Analogue Scale (VAS). A single US-guided PIT was performed using 6 mL of injectate: 5% dextrose or triamcinolone acetonide diluted with saline. Clinical assessment, nerve conduction studies, and ultrasonography were performed at baseline and at 1, 3, 6, and 12 months.
RESULTS: Fifty-seven patients (114 hands) were included in the analysis. Both D5W and CS produced similar improvements, with the greatest symptom relief observed within the first 3 months. Clinically meaningful improvement in BCTQs was observed in approximately 50% of hands in both groups at 1 and 3 months, and in 29% (D5W) and 25% (CS) at 12 months.
DISCUSSION: US-guided PIT with D5W and CS provides comparable clinical benefit over 12 months in mild to moderate CTS, with maximal improvement occurring early after treatment. These results support D5W as a reasonable non-steroidal alternative for perineural injection therapy in CTS.