Ultrasound-guided vs. blind steroid injections in carpal tunnel syndrome: A single-blind randomized prospective study

Am J Phys Med Rehabil. 2013 Nov;92(11):999-1004. doi: 10.1097/PHM.0b013e31829b4d72.


Objective: The aim of this study was to compare the efficacy and the safety of ultrasound (US)-guided vs. blind steroid injections in patients with carpal tunnel syndrome (CTS).

Design: This prospective randomized single-blind clinical trial included 46 patients with CTS (46 affected median nerves). The subjects were randomized-to either the US-guided or the blind injection group-before they received 40 mg of methylprednisolone. They were evaluated using the Boston Carpal Tunnel Questionnaire symptom/function at baseline and at 6 wks and 12 wks after injection, and the side effects were noted.

Results: The symptom severity and functional status scores improved significantly in both groups at 6 wks after treatment, and these improvements persisted at 12 wks after treatment (all P < 0.05). The improvement in symptom severity scores in the US-guided group at 12 wks was higher than in the palpation-guided group (P < 0.05). Average time to symptom relief was shorter in the US-guided group (P < 0.05). There was no significant difference between the two groups in terms of side effects (P > 0.05).

Conclusions: Although both US-guided and blind steroid injections were effective in reducing the symptoms of CTS and improving the function, an earlier onset/better improvement of symptom relief suggests that US-guided steroid injection may be more effective than are blind injections in CTS.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / diagnostic imaging*
  • Carpal Tunnel Syndrome / drug therapy*
  • Carpal Tunnel Syndrome / physiopathology
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Injections, Intra-Articular
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Prospective Studies
  • Recovery of Function
  • Single-Blind Method
  • Treatment Outcome
  • Ultrasonography, Interventional*


  • Glucocorticoids
  • Methylprednisolone