Carpal tunnel syndrome is the most common and widely known form of entrapment neuropathy, a painful condition caused by a pinched nerve in your wrist, affecting about 3% of the U.S. population.
Carpal tunnel syndrome is a kind of peripheral nerve entrapment neuropathy, which occurs when one of the body’s peripheral nerves is compressed or pinched.
It happens when the wrist gets forced against or pinched against the median nerves and tendons within the carpal tunnel, a confined space that connects the forearm to the palm of the hand.
As a consequence, the affected individual may experience tingling, numbness, or weakness in their fingers and hands.
About 3% of Americans suffer from carpal tunnel syndrome, the most prevalent and well-known kind of entrapment neuropathy.
When non-surgical treatments like physical therapy or corticosteroid injections are ineffective, surgery is often needed to cure carpal tunnel syndrome.
Cutting the carpal ligament to relieve pressure on the median nerve is the most common and widely used surgery method. This technique requires a wrist incision.
But this new research demonstrates that nerve entrapments may be successfully treated without surgery or corticosteroids using a method called hydrodissection. To separate a nerve from the surrounding tissue, a liquid, often saline, is injected into the nerve. Ultrasound guidance is employed to pinpoint nerves precisely.
“Previously, the studies that have been done on ultrasound-guided hydrodissection for carpal tunnel syndrome,” points out lead author Anindita Bose, “have used corticosteroids either alone or as a part of the injection, making it difficult to assess whether hydrodissection alone was beneficial, or if it was due to the effect of the steroids.”
Dr. Bose and colleagues included 63 carpal tunnel syndrome patients in total for this randomized control experiment.
Before and after the treatment, researchers evaluated patients’ pain and symptoms using the Boston Carpal Tunnel Questionnaire (BCTQ), the Visual Analog of Pain (VAS), and cross-sectional area ultrasounds of the median nerve.
The 63 patients were separated into three separate groups. Group one only got an injection of saline and ultrasound-guided hydrodissection.
Group two got an injection of saline and corticosteroid during an ultrasound-guided hydrodissection procedure. In group three, there was no hydrodissection; just an ultrasound-guided corticosteroid injection was given.
A follow-up was conducted after four, twelve, and six weeks.
At the four-week mark, all three groups of patients reported less pain.
By the 12-week and 6-month marks, both ultrasound-guided hydrodissection treatment groups exhibited continued improvement, but the corticosteroid injection alone group reported a return of symptoms and an increase in BCTQ and VAS scores.
Additionally, ultrasounds revealed that both hydrodissection groups significantly reduced the cross-sectional area of the median nerve. Group one saw a 43% drop, and group two saw a 46% drop. Group three only demonstrated an 11% decrease.
The process is quick and only takes 10 to 15 minutes. Dr. Bose said that because it doesn’t need any expensive equipment, it is also incredibly cost-effective.
“It came as a pleasant surprise when this simple procedure of ultrasound-guided hydrodissection provided patients with long-term relief,” adds co-author Anupama Tandon. “The patients were highly satisfied, as the cost was low, no anesthesia or hospitalization was needed, and they could go back in an hour’s time and resume their routine work.”
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