Comparison of Initial Treatment for Carpal Tunnel Syndrome Related to Rheumatic Diseases: Corticosteroid Injection Versus Nighttime Splinting

Inclusion criteria

• Patients aged no less than 18 years old with unilateral or bilateral carpal tunnel syndrome diagnosed by a specialist according to the Katz diagnostic criteria, and with at least one associated rheumatic disease;
• Patients have had symptoms of CTS for at least six weeks, and the side with more severe symptoms is designated as the target side for the study.
• During the current episode, the target side has not been treated.

Exclusion criteria

• Patients who have plan for surgical treatment on his or her CTS within the following 6 months;
• Received corticosteroid injections in the wrist within the past 6 months;
• Patients who are unable to wear a splint due to trauma or other reasons;
• Patients with clinical manifestations or electrophysiological changes indicative of significant axonal loss or denervation, including thenar muscle atrophy, sensory loss (two-point discrimination greater than 8 mm), absence of SNAP (sensory nerve action potential), absence of CMAP (compound muscle action potential) in the thenar muscles, etc.;
• Patients who require long-term use of any form of opioids.
• Patients who have used opioids (e.g., tramadol) or neuropathic pain medications (gabapentin, pregabalin, etc.) within the past 2 weeks;
• Patients who have received non-recommended wrist injection treatments (e.g., 5% glucose, platelet-rich plasma, ozone, chitosan, hyaluronic acid, etc.) within the past 6 months;
• Patients who have undergone non-recommended physical therapies (e.g., electrotherapy, magnetotherapy, laser therapy, etc.) within the past 6 months;
• Patients who are pregnant or plan to become pregnant within the next 6 months.