Isam Atroshi, MD, PhD; Jonas Ranstam, PhD
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3068.
Atroshi I, Ranstam J. Methylprednisolone Injections for the Carpal Tunnel Syndrome. Ann Intern Med. 2013;159:858-859. doi: 10.7326/0003-4819-159-12-201312170-00020
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Published: Ann Intern Med. 2013;159(12):858-859.
We appreciate the interest in our randomized, double-blind, placebo-controlled trial that assessed the efficacy of a single injection of methylprednisolone in patients with CTS not previously treated with steroid injections. Dr. Ramirez-Lafita refers to findings derived from observational studies and 1 randomized, surgery-controlled study. As we highlighted in our article, the Cochrane review of “randomized or quasi-randomized studies” published up to May 2006 that aimed to “evaluate the effectiveness of local corticosteroid injection for carpal tunnel syndrome versus placebo injection or other non-surgical interventions” concluded that “local corticosteroid injection for carpal tunnel syndrome provides greater clinical improvement in symptoms one month after injection compared to placebo,” “significant symptom relief beyond one month has not been demonstrated,” and “two local corticosteroid injections do not provide significant added clinical benefit compared to one injection” (1).
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