Evaluation of the effectiveness of local Dexamethasone injection in pregnant women with carpal tunnel syndrome

Most medical treatments for carpal tunnel syndrome (CTS) have focused on suppressing the inflammatory process. Injection of dexamethasone acetate might provide the necessary cellular and humoral mediators to induce a healing cascade. Dexamethasone is a water-soluble steroid that is safe to be used in the third trimester, especially as a local treatment. The aim of this study was to evaluate the effectiveness of 4 mg dexamethasone acetate injection for treatment of carpal tunnel syndrome in pregnancy period. Twenty pregnant patients with carpal tunnel syndrome were recruited using strict inclusion and exclusion criteria. All patients were injected with 4 mg of Dexamethasone acetate and 0.5 ml lidocaeine 1% under the carpal tunnel. Pain intensity [based on visual analog scale (VAS)] and electrophysiologic parameters of median nerve (transcarpal median sensory nerve conduction velocity (SNCV), distal motor latency (DML), and distal sensory latency (DSL) were recorded before and 3 weeks after injection. The average pain scores before and 3 weeks after Dexamethasone acetate injection was 8.70 ± 0.92 and 4.30 ± 0.76 respectively (p < 0.005). Also transcarpal sensory nerve conduction velocity of median nerve was 33.7 ± 6.3 m/s and 24.5 ± 6.8 m/s (p = 0.001); distal motor latency of median nerve was 5.16 ± 1.04 ms and 4.70 ± 0.53 ms (p = 0.001) and distal sensory latency of median nerve was 4.84 ± 0.77 ms and 4.2 ± 0.6 ms (p = 0.001), respectively. After Dexamethasone acetate injection, pain intensity and electerophysiologic parameters were significantly improved. This study offers encouraging results for an alternative minimally invasive treatment for CTS in pregnant women.