Ultrasound-Guided Injection of Carpal Tunnel Syndrome Using Hyaluronic Acid vs Corticosteroid vs Glucose 5%

Summary

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder caused by compression of the median nerve at the wrist. This study is a comparative study designed to evaluate the efficacy of three ultrasound-guided injection treatments for patients with mild to moderate CTS: hyaluronic acid (HA), corticosteroid, and 5% glucose (D5W). A total of 60 adult patients with clinically and electrophysiologically confirmed mild to moderate CTS will be enrolled and divided into three groups of 20 patients each. Participants will receive a single ultrasound-guided injection using one of the three study interventions. Clinical assessment will include Phalen's test and Tinel's sign. Electrophysiological assessment will include median nerve sensory and motor nerve conduction parameters, while ultrasonographic assessment will include measurement of the median nerve cross-sectional area. Participants will be reassessed three months after the intervention using the same clinical, electrophysiological, and ultrasonographic measures. The study will compare changes in these outcomes among the three treatment groups to evaluate their relative efficacy in the management of mild to moderate CTS.

Timeline

Start

2026-03-15

Primary completion

2026-06-20

Completion

2026-10-30

Publications

• Results 1- Klauser AS, Halpern EJ, De Zordo T, et al. Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology. 2009;250(1):171-177250 (1): 171-177 2- Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology. 2016;15(12):1273-1284;15 (12): 1273-1284 3- Atroshi I, Gummesson C, Johnsson R, et al. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-158;282 (1): 153-158 4- Wang H, Zhu Y, Wei H, rt al. Ultrasound guided local corticosteroid injection for carpal tunnel syndrome: a meta analysis of randomized controlled trials. Clin Rehabil. 2021;35(11):1506-1517 5- Raeissadat SA, Shakoori M, Cheraghi M., et al. High molecular weight hyaluronic acid for CTS: randomized controlled trial. 2025; 12(3): e149480 6- Babaei-Ghazani A, Moradnia S., Azar M., et al. 5% dextrose versus corticosteroid injection in CTS: RCT. Pain Manag. 2022; 12(6): 687-697 7- Kwon HK, Kim J, Lee J, et al. Ultrasonography of the median nerve and electrophysiologic severity in carpal tunnel syndrome. Ann Rehabil Med. 2012;36(1):72-79 8- Ramadan M, Hussein W, Salem M, et al. Conventional ultrasound and shear wave elastography in diagnosing and differentiating the severity of carpal tunnel syndrome: correlation with electrodiagnostic studies. Egypt J Radiol Nucl Med. 2024;55(1):47-55. 9- Su, Y. C., Shen, Y. P., Li, T. Y., et al. The efficacy of hyaluronic acid for carpal tunnel syndrome: A randomized, double-blind, placebo-controlled trial. Pain Medicine, 2021; 22(6), pp. 1384-1393. 10- Chappell CD, Beckman JP, Baird BC, et al. Ultrasound (US) Changes in the Median Nerve Cross-Sectional Area After Microinvasive US Guided Carpal Tunnel Release. J Ultrasound Med. 2020 Apr;39(4):693 702

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