Six-month efficacy of platelet-rich plasma for carpal tunnel syndrome: A prospective randomized, single-blind controlled trial

Recently, a few small reports with a short follow-up period have shown the clinical benefits of platelet-rich plasma (PRP) for peripheral neuropathy, including one pilot study and one small, non-randomized trial.in patients with carpal tunnel syndrome (CTS). Therefore, we conducted a randomized, single-blind, controlled trial to assess the 6-month effect of PRP in patients with CTS. Sixty patients with unilateral mild-to-moderate CTS were randomized into two groups of 30, namely the PRP and control groups. In the PRP group, patients were injected with one dose of 3 mL.of PRP using ultrasound guidance, and the control group received a night splint through the study period. The primary outcome measure was the visual analog scale (VAS), and secondary outcome measures included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score, the cross-sectional area (CA) of the median nerve (MN), electrophysiological findings of the MN, and finger pinch strength. The evaluation was performed.before treatment and at 1, 3, and 6 months post-injection.The PRP group exhibited a significant reduction in the VAS score, BCT score,and CSA of MN compared to those of the control group 6 months post-treatment (p studydemonstrates that PRP is a safe modality that effectively relieves pain and improves disability in patients with CTS.

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. ‘The gradual ischemia resulting from high pressure with accompanying compression of the median nerve (MN) within the carpal tunnel is thought to contribute to the pathophysiology of CTS.” Moreover, CT can cause inflammation of the intra-carpal tendon, including the flexor pollicis longus and deep and superficial flexor tendons. The inflammation of the tendon frequently produces a cycle of intracarpal swelling, causing further compression of the MN. Typical symptoms and signs include numbness, tingling, pain, or burning sensation in the digits controlled by the MN and/or nocturnal paresthesia. ‘Thenar muscle wasting might also occur during the chronic stages’.

Treatments for CTS range from conservative strategies (medication, night splints, steroid injections, and physical therapy) to surgical decompression of the MN. Despite the availability of conservative therapies, their efficacy is usually unfavorable or short-lived. Areport revealed that approximately 60 to 70% of patients with CTS who underwent conservative treatment still had symptoms after 18 months of follow-up. Moreover, a recent study has shown that the treatment failure rate of the wrist splint was reported as 69% after 12 months’ follow-up’. Although surgical intervention is more effective than conservative treatment, conservative therapies are recommended for mild-to-moderate CTS. Surgical therapy is suggested for severe CT’s or patients with poor response to conservative treatments since the failure rate of surgery ranges from 7–75%. Therefore, it is important to explore and develop a novel non-surgical intervention for CTS.

‘Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan, Republic of China ? Integrated Pain Management Center,Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan, Republic of China ‘School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan East Road, Neihu District, Taipei, Taiwan, Republic of China “Department of Radiology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei,Taiwan, Republic of China. Correspondence and requests for materials should be addressed to oL.-C.C. (email: clctsgh@yahoo.com.tw).

Yung-Tsan Wu’,?, Tsung-Yen Ho’, Yu-Ching Chou’, Ming-Jen Ke’, Tsung-Ying Li’?, Guo-Shu Huang*&Liang-Cheng Chen

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