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Corticosteroids for Carpal Tunnel Syndrome

Examples

Generic Name
betamethasone
methylprednisolone

Although corticosteroids come in oral (tablets or syrup) form, injections (shots) are most commonly used for treating carpal tunnel syndrome.

How It Works

Corticosteroids relieve inflammation.

Why It Is Used

Corticosteroids are given to relieve inflammation due to carpal tunnel syndrome when other forms of treatment (such as rest, using a wrist splint, or using anti-inflammatories) have not helped relieve pain.

When it should not be used (contraindications)

Some doctors believe that corticosteroids should not be given to children, nor to women who are pregnant or breast-feeding.

If infection is suspected, shots are usually not given.

How Well It Works

Short-term oral corticosteroid treatment has been shown to reduce carpal tunnel syndrome symptoms.1 It is not clear how long the effect of the oral corticosteroids lasts.

Corticosteroid shots have been shown to reduce carpal tunnel symptoms.1 But although they often provide temporary relief (for several weeks or more), they do not typically provide permanent relief from carpal tunnel symptoms.

If three shots over several months have not helped to relieve pain, more shots are not likely to help and may cause harm. Even if the shots help to relieve pain, the number of shots should be limited. Talk to your doctor about corticosteroid shots.

Side Effects

Corticosteroids (oral or injections) have serious side effects and must be used with caution. Side effects include:

  • Nausea.
  • Anxiety.
  • Acne.
  • Menstrual irregularities.
  • Insomnia.
  • Headaches.
  • Mood swings.

Although they may relieve pain and inflammation, corticosteroids can also slow healing and weaken tendons and bones (osteopenia or osteoporosis). Other side effects of corticosteroid injection include:

  • Pain that gets worse after the injection. Applying ice at home for 15 to 20 minutes after the injection may help reduce pain.
  • Loss of strength and movement in the tendon.
  • Breakdown (degeneration), tearing, or rupture of the tendon.
  • Accidental injury to the median nerve in the wrist during injection.
  • Scarring of the tendon.
  • Skin color (pigmentation) changes at or near the injection site.
  • Infection.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Other forms of treatment to relieve pain and inflammation (such as rest, ice, nonsteroidal anti-inflammatories, and splints) are usually tried before corticosteroids are used.

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References

Citations

  1. Ashworth N (2010). Carpal tunnel syndrome, search date March 2009. Online version of Clinical Evidence (3).

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD, MD - Family Medicine
Specialist Medical Reviewer David Pichora, MD, FRCSC - Orthopedic Surgery
Last Revised October 21, 2010

Last Revised: October 21, 2010

Author: Healthwise Staff

Medical Review: Adam Husney, MD, MD - Family Medicine & David Pichora, MD, FRCSC - Orthopedic Surgery

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