Indian Journal of Physical Medicine and Rehabilitation

Register      Login

VOLUME 27 , ISSUE 4 ( December, 2016 ) > List of Articles


A Comparative Study of Local Ultrasound Therapy and Local Steroid Injection in Patients of Carpal Tunnel Syndrome

Neeraj Gupta, Sunil Goenka, Manoj Verma

Citation Information : Gupta N, Goenka S, Verma M. A Comparative Study of Local Ultrasound Therapy and Local Steroid Injection in Patients of Carpal Tunnel Syndrome. Indian J Phy Med Rehab 2016; 27 (4):98-103.

DOI: 10.5005/ijopmr-27-4-98

Published Online: 01-12-2016

Copyright Statement:  Copyright © 2016; The Author(s).



Carpal tunnel syndrome is the most common compressive neuropathy of upper extremity affecting predominantly females of middle age group. Symptoms include pain, paracsthesia, numbness in median nerve distribution of hand.

Study design

Comparative type of interventional study.

Study area

Department of Physical Medicine and Rehabilitation, SMS Medical College and attached group of hospitals, Jaipur.

Duration of study

One and a half years April 2014-October 2015.

Aims and objective

To compare the efficacy of local ultrasound therapy and local corticosteroid injection for carpal tunnel syndrome management.

Study population

A total of sixty patients with CTS (agep>18 years) were randomly assigned to the steroid treatment plus splinting(group A) or ultrasound treatment plus splinting(group B).


The mean age of study population was 45.47±12.24 years with males comprising 13.3% and females 86.6% of whole study. At baseline all outcome variables were comparable statistically in both the groups (p>0.05). In follow-up assessment at 8th week, statistically significant improvement was obtained in all clinical and electrophysiological parameters in group A: Grip strength, symptom severity score, functional status score, median DML, sensory nerve conduction velocity (p<0.001 for each). Also the group B showed improvement in all parameters except grip strength. At the end of 24th week all outcome variables showed decline in improvement as comparative to 8th week, but still they were better than baseline in both groups. There was no significant difference between the groups in outcome variables except for the grip strength.


Ultrasound treatment provided improvement comparable to steroid injection in all clinical and electrophysiological parameters in patients with CTS except grip strength. Overall steroid therapy is more effective than ultrasound therapy. Effectiveness of treatment persist for at least 6 months then it lessens, so long follow-up is required.

PDF Share
  1. et al. Occupation and its association with carpal tunnel syndrome-a review. JESP 2011;7:68.
  2. Assessment of work-related risk factors for carpal tunnel syndrome. IMAJ-RAMAT GAN. 2001 1; 3: 569-71.
  3. The usefulness of the Phalen test and the Hoffmann-Tinel sign in the diagnosis of carpal tunnel syndrome. Acta Orthop Belg 2002;68:141-5.
  4. Conservative interventions for carpal tunnel syndrome. J Orthop Sports Phys Ther 2004;34:589-600.
  5. The comparison of ultrasound treatment and local steroid injection plus splinting in the carpal tunnel syndrome: a randomized controlled trial. Bratisl med J 2009;111:659-65.
  6. A prospective study of the long-term efficacy of local methyl prednisolone acetate injection in the management of mild carpal tunnel syndrome. Rheumatology. 2005 1; 44: 647-50.
  7. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2010, 1860.
  8. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin. Neurophysiol 2002;113:1429-34.
  9. Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome. Arch Phys Med Rehabil, 2005;86:1-7.
  10. Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch Phys Med Rehabil 2007;88:1429-35.
  11. Methylprednisolone injections for the carpal tunnel syndrome. Ann Intern Med 2013;159:858.
  12. Comparative effectiveness of ultrasound and paraffin therapy in patients with carpal tunnel syndrome: a randomized trial. BMC Musculoskelet Disord 2014;15:1.
  13. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil. 2007;88:19-24.
  14. Ultrasound treatment for treating the carpal tunnel syndrome: randomised “sham” controlled trial. BMJ. 1998;316:731-5.
  15. Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 2004;50:147-51.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.