A Review on Carpal Tunnel Injections Introduction Carpal tunnel syndrome is due to the compression of the median nerve at the level of the wrist.
A Review on Carpal Tunnel Injections Carpal tunnel syndrome is due to the compression of the median nerve at the level of the wrist. Nonoperative treatment typically involves corticosteroid injection into the carpal tunnel to help with hand pain. Ultrasound guided injections are preferred in order to reduce the risk of median nerve injury.
Studies have shown that upwards of 79% of patients have relief of symptoms six weeks after the injection. Patients with diabetes have been identified to be at risk for recurrent symptoms within one year of the injection. Injection Procedure Injections of corticosteroids can be done under ultrasound or palpation guidance into the carpal tunnel.
A palpation guided injection is done at the level of the wrist crease. The palmaris longus is identified and an injection is guided just ulnar to the palmaris longus. Ultrasound injection can be done using an in-plane ulnar approach.
The patient is typically seated and the wrist is supinated and slightly dorsiflexed. The preferred transducer is 15-7 MHz or 17-5 MHz. Typical injection includes 1cc of 1% Lidocaine and 1cc of 40mg/mL Triamcinolone using a 27g needle.
The probe will be placed in a transverse position at the level of the wrist crease. The median nerve is a hypoechoic structure with a hyperechoic rim that is found superficial to the flexor tendons. If there is still confusion regarding whether the provider is evaluating the nerve or a flexor tendon, the probe can be moved more proximal and the median nerve should move deep and radial.
If you are experiencing symptoms that may be related to carpal tunnel injections, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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