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Evidence-Based Medicine 2008;13:38; doi:10.1136/ebm.13.2.38-a
Copyright © 2008 by the BMJ Publishing Group Ltd.

EBM NOTEBOOK

Response

Adnan J Al-Khuraibet

Ibn Sina Hospital, Kuwait, Kuwait

The first 100% of the full text of this article appears below.

I agree with Dr Bland that steroid injection has a place in the management of CTS, but only in certain situations as I pointed out previously.1 Hui et al in 2005 reported a randomised controlled trial comparing surgery and steroid injections in CTS. This study showed better outcome of surgery compared with steroid injection.2 Also, steroid injection did not prove superior to other safer conventional options such as splint at least in mild cases and there is evidence that single and certainly repeated steroid injections can be harmful.3 4

  1. Al-Khuraibet AJ. Commentary on "Review: local corticosteroid injection relieves symptoms in carpal tunnel syndrome." Evid Based Med 2008; 13: 16. Comment on Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev 2007 (2): CD001554.
  2. Hui A, Wong S, Leung CH, et al. A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome. Neurology 2005; 61: 2074–8.
  3. Hoffman DE. Treatment of carpal tunnel syndrome: Is there a role for local corticosteroid injection? Neurology 2006; 66: 459–60.[Free Full Text]
  4. Gooch CL, Mitten DJ. Treatment of carpal tunnel syndrome: Is there a role for local corticosteroid injection? Neurology 2005; 64: 2006–7.

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Letter
Jeremy D P Bland
Evid. Based Med. 2008 13: 38. (in EBM notebook) [Extract] [Full Text] [PDF]

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