Comparison of Ultrasound-Guided Steroid and Platelet-Rich Plasma (PRP) Injection in Patients with Carpal Tunnel Syndrome

Objective: Imaging-guided injection treatments can yield effective results in patients with mild-to-moderate carpal tunnel syndrome (CTS) resistant to conservative methods. Methods: Patients who presented with typical median nerve entrapment findings for at least 3 months, were diagnosed with mild-moderate CTS electrophysiologically, and underwent ultrasound-guided steroid and PRP injection were included in the study. Visual analog scale (VAS) scores, Boston Carpal Tunnel Questionnaire (Functional status scale (FSS) and Symptom severity scale (SSS) parameters) scores were recorded in the pre-procedure, 1st month and 6th month controls of the patients. Sonographically, median nerve cross-sectional area (CSA) measurements were recorded at pre-procedure and post-procedure 1st and 6th month controls. Results: In 27 patients (21 women, 6 men), 40 median nerve injections (9 patients right, 5 patients left, 13 patients bilateral) were evaluated. In all patients, CSA, VAS, FSS, and SSS scores were significantly lower at 1 month and 6 months after the procedure than before the procedure. (p=0.000, p=0.000, p=0.000, P=0.000, respectively). While the VAS scores were found to be significantly lower in the steroid group than in the PRP group at 1 month (p=0.04), there was no significant difference between the two groups in terms of CSA, FSS, and SSS scores (p=0.1, p=0.5, p=0.8, respectively). At 6 months, CSA, VAS, FSS, and SSS scores were significantly lower in the PRP group compared to the steroid group (p=0.000, p=0.000, p=0.000, p=0.000 respectively). Conclusion: In mild-to-moderate carpal tunnel syndrome, steroid injections applied under ultrasonography guidance of the median nerve are effective for a short time, and PRP injections are a superior and safe option to steroids for long-term efficacy.