Comparison of pulsed radiofrequency and steroid injection in the treatment of carpal tunnel syndrome guided by USG imaging

Year 2025, Volume: 6 Issue: 4, 388 - 395, 31.08.2025

Zeki Boğa , Mustafa Emre Saraç

https://doi.org/10.47582/jompac.1747756

Abstract

Aims: The research evaluated the effectiveness between ultrasonography-guided pulsed radiofrequency treatment and steroid injection therapy for carpal tunnel syndrome.
Methods: The research included 60 patients who received carpal tunnel syndrome diagnoses. The patients received their treatment based on two distinct approaches which formed separate groups: 30 patients who underwent ultrasonography-guided injection of 40 mg methylprednisolone acetate and 30 patients who underwent ultrasonography-guided application of pulsed radiofrequency targeting the median nerve at 42°C for 120 seconds. Visual Analog Scale (VAS) score, Boston Carpal Tunnel Scale and physical examination findings were evaluated before treatment, at 1, 3 and 6 months. All patients underwent EMG before the procedure and at 6 months.
Results: At baseline, no significant variations were observed across groups regarding demographic characteristics as well as clinical parameters. At the third month, the VAS score decreased to 2.9±1.5 in the RF group while it was still 3.8±2.1 in the steroid group (p=0.048). Functional scores of the Boston scale were 1.6±0.7 in the pulsed radiofrequency group and 2.0±0.8 in the steroid group (p=0.037). In the electrophysiologic evaluation at the sixth month, motor distal latency was 3.9±0.7 ms in the RF group versus 4.3±0.8 ms in the steroid group (p=0.041). The rate of more than 50% improvement in VAS score was 80% in the RF group compared to 60% in the steroid group.
Conclusion: Pulsed radiofrequency therapy delivers superior long-term results than steroid injection does. As a minimally invasive method, it should be evaluated before surgery.

Keywords

Carpal tunnel syndrome , median nerve , pulsed radiofrequency treatment , corticosteroid injection , ultrasonography

Ethical Statement

This study was approved by the Adana Şehir Training and Research Hospital Scientific Ethics Board with approval dated 08.05.2025 with reference number 516.

Thanks

We thank Prof. Dr. Yurdal Gezercan for his contributions.

USG görüntüleme rehberliğinde karpal tünel sendromu tedavisinde pulsed radyofrekans ile steroid enjeksiyonunun karşılaştırılması

Abstract

Amaç: Karpal tünel sendromunun tedavisinde ultrasonografi kılavuzluğunda pulsed radyofrekans ve steroid enjeksiyonunun etkinliğini karşılaştırmak amaçlandı.
Yöntem: Bu retrospektif çalışmaya karpal tünel sendromu tanısı alan 60 hasta dahil edildi. Hastalar tedavi yöntemine göre iki gruba ayrıldı: 30 hastaya ultrasonografi kılavuzluğunda 40 mg metilprednizolon asetat enjeksiyonu, 30 hastaya ise ultrasonografi kılavuzluğunda 42°C'de 120 saniye süreyle median sinire pulsed radyofrekans uygulandı. VAS skoru, Boston Karpal Tünel Ölçeği, fizik muayene bulguları ve elektrofizyolojik parametreler tedavi öncesi, 1, 3 ve 6. aylarda değerlendirildi.
Sonuçlar: Başlangıçta, gruplar arasında demografik özellikler ve klinik parametreler açısından fark yoktu. Üçüncü ayda, VAS skoru pulsed radyofrekans grubunda 2,9±1,5'e düşerken, steroid grubunda 3,8±2,1 olarak kaldı (p=0,048). Boston ölçeğinin fonksiyonel skorları pulsed radyofrekans grubunda 1,6±0,7, steroid grubunda 2,0±0,8 idi (p=0,037). Altıncı ayda yapılan elektrofizyolojik değerlendirmede, motor distal latensi pulsed radyofrekans grubunda 3,9±0,7 ms ve steroid grubunda 4,3±0,8 ms idi (p=0,041). VAS skorunda %50'den fazla iyileşme oranı pulsed radyofrekans grubunda %80 ve steroid grubunda %60 idi.
Sonuç: Pulsed radyofrekans tedavisi, steroid enjeksiyonuna göre uzun vadede daha üstün sonuçlar vermektedir. Minimal invaziv bir yöntem olarak, cerrahi öncesi değerlendirilmelidir.

Keywords

Karpal Tünel Sendromu , Median Sinir , Pulsed Radyofrekans Tedavisi , Ultrasonografi

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