Patients with carpal tunnel syndrome reported fewer symptoms several months after receiving steroid injections, but most still opted for surgery within a year to relieve persistent pain, researchers said.

Improvements in carpal tunnel severity scores 10 weeks after initial treatment were greater among patients who received 80 or 40 mg injections of methylprednisolone than in those given placebo injections, with a 0.64-point decrease in the high-dose group (95% CI -1.06 to -0.21, P=0.003) and a 0.88-point decrease with the lower dose (95% CI -1.30-minus 0.46, P<0.001), according to Isam Atroshi, MD, of Hässleholm Hospital in Hässleholm, Sweden, and colleagues.

But these improvements failed to prevent most patients from requiring surgery soon after, the researchers reported in the Sept. 3 issue of the Annals of Internal Medicine. At evaluation 1 year after the injections, surgery rates were 73%, 81% and 92% in the 80-mg steroid, 40-mg steroid, and placebo groups, respectively.

These rates corresponded to a "modestly lower likelihood of surgery within 1 year after treatment" with steroids, they wrote.

The findings confirm that steroid injections provided short-term relief of carpal tunnel pain, but did not result in long-term symptom relief in the majority of patients, the researchers indicated.

"Future research should explore how to obtain a consistent durable effect," they wrote. "The goal is to find a medical treatment that effectively resolves carpal tunnel without the need to divide the transverse carpal ligament."

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