This clinical trial aims to evaluate the effect of a single local platelet-rich plasma injection Versus local steroid injection in treating mild idiopathic carpal tunnel syndrome regarding pain relief and function improvement and electrophysiological studies of the median nerve as a baseline and during a follow-up period of 3 months. The main question\[s\] it aims to answer are: * Does platelet-rich plasma injection provide better pain relief for CTS symptoms than steroid injection? * Does platelet-rich plasma improve parameters of median nerve conduction study than local steroid? Participants will have: * A complete history and clinical examination, including sensory and motor examination and provocative tests for CTS. * Visual analog scale (VAS), Symptom severity scale (SSS), and functional severity scale (FSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) before local injection and three months after local injection by the same investigator. * Nerve conduction studies (NCS) for median and ulnar nerves were carried out before local injection and three months after local injection by the same investigator. Researchers will compare the efficacy of a single PRP local injection compared to a single corticosteroid local injection for treating mild idiopathic CTS using nerve conduction studies (NCS), Visual Analog Scale (VAS), and Boston Carpal Tunnel Questionnaire (BCTQ) as objective and subjective outcome measures.
Carpal tunnel syndrome (CTS) is the most known entrapment neuropathy. Diagnosis of CTS is clinical, which could be confirmed by nerve conduction study (NCS). Non-operative management is the first line of treatment, including splitting, antiinflammatory, and neurotonics. There is evidence of improvement in CTS after local corticosteroid injection, but complications are still recorded \[5\]. Platelet-rich plasma (PRP) is a novel, promising treatment providing growth factors for nerve regeneration and inflammation relief. This field needs further evaluation and analysis compared to traditional local steroid injection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
Local corticosteroid injection;1 ml of triamcinolone acetonide 40 milligram/1.0 mL
Platelet-rich Plasma (From 2-step centrifugation of patient blood) Local injection.
Faculty of Medicine, Menoufia University
Shibīn al Kawm, Menoufia, Egypt
Visual analog scale
The pain severity was determined by the patients, on a scale of 0 (no pain) to 10 (agonizing pain)
Time frame: before and after three months from injection time
Symptom severity scale of the Boston Carpal Tunnel Questionnaire
Pain severity evaluation
Time frame: before and after three months from injection time
Functional severity scale of the Boston Carpal Tunnel Questionnaire
Hand function evaluation
Time frame: before and after three months from injection time
Median nerve sensory peak latency
Sensory conduction evaluation of median nerve
Time frame: before and after three months from injection time
Median nerve distal motor latency
Motor conduction evaluation of the median nerve.
Time frame: before and after three months from injection time
Median nerve sensory amplitude
Sensory conduction evaluation of the median nerve
Time frame: before and after three months from injection time
Median nerve motor amplitude
Motor conduction evaluation of the median nerve.
Time frame: before and after three months from injection time
Median nerve sensory conduction velocity
Sensory conduction evaluation of the median nerve
Time frame: before and after three months from injection time
Median nerve motor conduction velocity
Motor conduction evaluation of the median nerve.
Time frame: before and after three months from injection time
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