Surgery vs. Local injections in Carpal Tunnel syndrome. Study in Routine Clinical Practice in a Primary Care Centre
Bibliographic record
Abstract
Background: Carpal Tunnel Syndrome (CTS) is a prevalent entrapment neuropathy that significantly impacts patients' quality of life. Traditional treatment modalities include local corticosteroid injections (I) and surgery (S), with varying degrees of efficacy reported in the literature. Despite numerous studies, the relative effectiveness of these treatments in routine clinical practice remains inadequately explored. Objective: To compare the effectiveness of local injections versus surgery in the treatment of CTS within a primary care context, emphasizing the outcomes in a real-world clinical setting. Methods: This prospective observational study included 160 naïve patients with idiopathic CTS treated in the 4th Sanitary Area of Madrid. Participants were allocated to receive either local injections of triamcinolone acetonide (I) or surgical treatment (S) based on patient-physician consensus. The primary outcomes measured were changes in the Visual Analogue Scale (VAS) for pain, Functional Status Scale, and Symptoms Severity Scale from baseline to 6 and 26 weeks post-treatment. Statistical significance was determined using Student's T-test and paired samples T-test. Results: At baseline, both groups were comparable in terms of demographic and clinical characteristics. By the 6-week follow-up, the I group demonstrated a significant reduction in pain VAS (56.2, CI 50.9–61.6, p<0.001), improved functional status (1.25, CI 1.08–1.43, p<0.001), and decreased symptoms severity (1.97, CI 1.79–2.16, p<0.001) compared to the S group. However, at the 26-week follow-up, there were no significant differences between the two groups in pain VAS reduction (I: 52.8, CI 46.1–59.4 vs. S: 46.3, CI 39.3–53.3, p=0.196), functional status improvement (I: 1.16, CI 0.95–1.36 vs. S: 1.24, CI 0.99–1.48, p=0.601), or symptoms severity decrease (I: 1.88, CI 1.64–2.13 vs. S: 1.96, CI 1.70–2.21, p=0.662). Conclusion: In the short term, local corticosteroid injections offer a significant advantage over surgery in alleviating the symptoms of CTS, as evidenced by improvements in pain, functional status, and symptoms severity. However, these differences diminish over time, with both treatments showing comparable effectiveness at 26 weeks. These findings highlight the importance of personalized treatment strategies in managing CTS and underscore the potential for early intervention in a primary care setting to effectively address this condition.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".