The comparison between effectiveness of ultrasound guided corticosteroid injection above versus below the median nerve in mild to moderate carpal tunnel syndrome: A randomized controlled trial

ABSTRACT Objective In this study the clinical effectiveness of ultrasound-guided corticosteroid injection "above" versus "below" the median nerve for treatment of patients with mild to moderate carpal tunnel syndrome (CTS) was compared. Design This prospective randomized double-blind clinical trial included 44 patients with mild to moderate CTS. The subjects were randomly assigned to two groups to receive ultrasound-guided injection of 40 mg triamcinolone either "above" or "below" the involved median nerve. Outcome measures were the Boston Carpal Tunnel Questionnaire, Visual Analogue Scale, electrophysiological tests, and ultrasonographic measurement of the median nerve cross-sectional area at baseline, 6 weeks and 12 weeks after the injection Results All outcome measures improved significantly in both groups at 6 weeks after intervention, and these improvements were persevered up to 12 weeks follow up (all P-value

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