Short-term effectiveness of 5% dextrose injection with ultrasound-guided nerve hydrodissection method in carpal tunnel syndrome: A randomized controlled study

Abstract

Background

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. The effects of ultrasound-guided nerve hydrodissection in the treatment of CTS are controversial.

Objective

To evaluate the short-term effectiveness of 5% dextrose (D5 W) injection with ultrasound-guided nerve hydrodissection method together with wrist orthosis treatment in mild and moderate CTS patients and the contribution of this treatment to wrist orthosis treatment.

Methods

In this prospective randomized controlled trial, forty-four participants with mild to moderate CTS were randomly assigned the wrist orthosis treatment group (control) and wrist orthosis with D5 W injection treatment group (study) using stratified block randomization. All patients were evaluated via the Visual Analog Scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), grip strength (GST), and median nerve cross-sectional area (CSA).

Results

Within-group analysis demonstrated statistically significant improvements in VAS, BCTQS, and BCTQF scores in the control group, and in all evaluated parameters in the study group (p < 0.05). Between-group comparisons of change scores revealed no statistically significant differences for VAS (MD −0.8, 95% CI −1.74 to 0.14), BCTQS (MD −2.95, 95% CI −6.38 to 0.48), CSA (MD −0.46, 95% CI −1.20 to 0.28), or GST (MD 1.33, 95% CI −0.43 to 3.09). However, a statistically significant between-group difference was observed for the BCTQF score, favoring the study group (MD −1.65, 95% CI −3.65 to −0.35; p < 0.05).

Conclusion

USG-guided hydrodissection injection with D5 W in CTS improves wrist orthosis treatment. This injection helps patients perform functions that affect daily activities, such as grasping more effectively. For patients who use wrist orthoses but do not achieve sufficient improvement in their functions, hydrodissection injection with D5 W can be recommended.