carpal tunnel injection

Jammie
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I have recently been diagnosed with CTS, It started about 4 mths ago. I kept getting severe pins and needles in my left hand, lost sensation in fingers and thumb, constant shaking of hand, shooting pains from palm to elbow., and pains in triceps muscle and lost all strength in hand could not hold anything. I was given a wrist splint to wear and waited for appointment to see consultant. I was given Nerve conduction test, which confirmed CTS in both hands. I have recently (2 days ago) have had the injection, which has relieved some of the symptoms, the pins and needles and shooting pains and triceps pain and my had does feel stronger, but i still have no sensation in fingers and still have ache in thumb and fingers. I dont know if because the pain was so severe in my left hand or that i have over used my right hand but the pins and needles and pains in my right hand have gotten more noticeable

I would like to know if this will get any better or will more injections be required or surgery.

Help !!!

jeremydpbland
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I would be better able to answer that if I knew what your nerve conduction studies looked like but from the information available in that posting it does rather sound as though you are likely to require further treatment. Either a second dose of steroids or surgery are really the only options. More is known about surgery and you can read the surgical treatment page here to get a fairly good idea of what is involved and what the likely outcomes are (again it helps if you know your nerve conduction results).

Much less is known about second injections, especially in the situation where one has just been given and either been ineffective or only partially effective, as here. In a Spanish study a few years ago a treatment protocol was used where on in jection was given and the patient was see two weeks later. If there were any residual symptoms at that 2-week review a second dose was given. That study is unusual in that the clinical outcomes were unusually good in the injection group (they were comparing with surgery and had similar outcomes at one year). There is no other formal work on whether a quick second injection is worth a try in this situation. It would be useful to know what steroid and dose they used - some people use very small doses and if that was the case then there would probably be a better argumant for trying again.

I would not quite give up on this injection yet as we do see some late responses - we usually review at 6 weeks, by which time I fee that all of the patients who are going to respond to our initial injection probably have done so. JB

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