Evaluating the effectiveness of local dexamethasone injection in pregnant women with carpal tunnel syndrome

BACKGROUND: Most of the medical treatments for carpal tunnel syndrome (CTS) have focused on suppressing the inflammatory process. An injection of dexamethasone acetate might provide the necessary cellular and humoral mediators to induce a healing cascade. Dexamethasone is a water-soluble steroid which is safe to be used in the third trimester, especially as a local treatment. The aim of this study was to evaluate the effectiveness of 4 mg dexamethasone acetate injection to treat carpal tunnel syndrome in pregnancy period. METHODS: Twenty pregnant women with CTS were recruited using strict inclusion and exclusion criteria. All the patients had been injected with 4 mg of dexamethasone acetate and 0.5 ml lidocaine 1% under the carpal tunnel. Pain intensity (based on visual analog scale or VAS) and electro physiologic parameters of median nerve (transcarpal median sensory nerve conduction velocity (SNCV), distal motor latency (DML) and distal sensory latency (DSL) were recorded before and 3 weeks after the injection. RESULTS: The average pain scores before and 3 weeks after the dexamethasone acetate injection was 8.70 ± 0.92 and 4.30 ± 0.76 respectively (p < 0.005). In addition, transcarpal SNCV of median nerve was 33.7 ± 6.3 m/s and 24.5 ± 6.8 m/s (p = 0.001); DML of median nerve was 5.16 ± 1.04 ms and 4.70 ± 0.53 ms (p = 0.001) and DSL of median nerve was 4.84 ± 0.77 ms and 4.2 ± 0.6 ms (p = 0.001), respectively. CONCLUSIONS: After dexamethasone acetate injection, pain intensity and electrophysiological parameters were significantly improved. This study offered encouraging results for an alternative minimally invasive treatment for CTS in pregnant women.