Corticosteroid Injection Effectiveness in Carpel Tunnel Patients With Negative or Mild EMG Studies

Study Overview
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Brief Summary
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Carpal Tunnel Syndrome (CTS) is the most common nerve entrapment syndrome worldwide. There are currently no studies examining the effectiveness of corticosteroid injections in patients with normal (negative) EMG studies. The purpose of this study is to gain a better understanding of the duration of symptom improvement post corticosteroid injection in patients with negative or mild EMG studies. The Boston Carpal Tunnel Questionnaire will be given to patients undergoing corticosteroid injections for the treatment of carpal tunnel syndrome to assess their response to the injection. Investigators will collect data retrospectively. The Boston Carpal Tunnel Questionnaire (BCTQ) is administered as per standard protocol to all patients with CTS who have a negative or mild EMG study. The BCTQ assesses the patient's self-reported symptom severity and functional status. Investigators will analyze this data with respect to demographics as well as numbness in the median n. distribution, nocturnal numbness, weakness/atrophy of the thenar musculature, Tinel's sign, Phalen's test, loss of 2-point discrimination, Quick-Dash score, and grip strength score. The primary outcome will be the Boston Carpal Tunnel Questionnaire outcome score under the different EMG conditions.The secondary outcomes will be numbness in the median n. distribution, nocturnal numbness, weakness/atrophy of the thenar musculature, Tinel's sign, Phalen's test, loss of 2-point discrimination, QuickDash score, and grip strength score. Both outcomes will be examined in patients with negative or mild EMG readings. This information will allow orthopedic physicians to gain a better understanding of the duration of symptom improvement post-corticosteroid injection, allowing them to fine tune their treatment plans for CTS patients.

Official Title
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Corticosteroid Injection Effectiveness in Carpel Tunnel Patients With Negative or Mild EMG

Conditions
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Carpal Tunnel Syndrome

Intervention / Treatment
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* Other: Corticosteroid injections for CTS treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who speak English Patients who are 18 years or older Patients who are clinically diagnosed with CTS Patients who have a negative or mild EMG study Patients who receive a corticosteroid injection after obtaining a negative or mild EMG study Exclusion Criteria: Patients who do not speak English Patients who are younger than 18 years of age Patients who have experienced previous trauma to the wrist Patients who have had previous treatment for CTS including but not limited to corticosteroid injection or surgery Patients with a moderate or severe EMG study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patient with CTS/Mild EMG<br> | Other: Corticosteroid injections for CTS treatment<br>* Treatment of carpel tunnel syndrome with corticosteroid injections for EMG mild and EMG negative patients<br>|
| Patient with CTS/Negative EMG<br> | Other: Corticosteroid injections for CTS treatment<br>* Treatment of carpel tunnel syndrome with corticosteroid injections for EMG mild and EMG negative patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Boston Carpel Tunnel Questionnaire | Scaled 1-5, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with numbness in the median n. distribution | Positive test includes numbness in parts of palm, thumb, second and third finger, assessed by physician | Dec 23 2020-Dec 22 2021 | 
| Number of patients with weakness/atrophy of the thenar musculature | Positive test includes weakness in grip or holding objects as described by participant, assessed by physician | Dec 23 2020-Dec 22 2021 | 
| Number of patients with positive Tinel's Sign | Positive sign includes 'pins and needles' in parts of palm, thumb, second and third finger upon percussion of median nerve, assessed by physician | Dec 23 2020-Dec 22 2021 | 
| Number of patients with positive Phalen's Test | Positive test includes pain in parts of palm, thumb, second and third finger associated with compression of the median nerve, assessed by physician | Dec 23 2020-Dec 22 2021 | 
| 2-point discrimination Test | Scaled 2-8mm, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 | 
| QuickDash score | Scaled 1-100, higher scores indicate worse outcomes | Dec 23 2020-Dec 22 2021 | 
| Grip Strength score | Scored in pounds(lbs), higher scores indicate better outcomes | Dec 23 2020-Dec 22 2021 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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corticosteroid injection, electromyography