Ultrasound-Guided High Molecular Weight Hyaluronic Acid Injection for Carpal Tunnel Syndrome: A Randomized Controlled Trial
| Author | Seyed Ahmad Raeissadat | en |
| Author | Marzieh Shakoori | en |
| Author | Hadi Esmaily | en |
| Author | Mohsen Cheraghi | en |
| Author | Mohammadreza Omid Zohor | en |
| Author | Seyyede Elahe Mousavikhah | en |
| Author | Alireza Parhizgar | en |
| Author | Saeed Mohammad Soleymani | en |
| Orcid | Seyed Ahmad Raeissadat [0000-0003-1512-0921] | en |
| Orcid | Hadi Esmaily [0000-0001-6915-6028] | en |
| Orcid | Mohsen Cheraghi [0009-0005-5882-3282] | en |
| Orcid | Saeed Mohammad Soleymani [0000-0003-1462-3930] | en |
| Issued Date | 2025-07-31 | en |
| Abstract | Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Objectives: The present study aims to investigate the effects of high molecular weight hyaluronic acid (HA) injections in treating CTS, as HA is frequently used for various musculoskeletal conditions but has not been studied for this specific application. Methods: A randomized controlled trial was conducted involving 60 patients diagnosed with mild to moderate CTS with a 1:1 allocation ratio. The patients were randomly assigned to two groups: A control group received lidocaine and normal saline injections, while an HA group received lidocaine and 2% HA injections. Splints were provided to both groups. The injections were administered under ultrasound (US) guidance using an in-plane ulnar approach, and outcome assessments were carried out by blinded investigators. The Boston Carpal Tunnel Questionnaire (BCTQ), Visual Analog Scale (VAS), and electrodiagnostic and sonographic measures were evaluated before treatment and at a 10-week follow-up. Results: Forty-eight patients completed the study (25 in the HA group, 23 in the control group). Both groups demonstrated statistically significant improvements over 10 weeks. However, the HA group achieved a notably greater reduction in pain, with VAS scores declining from 6.08 ± 1.68 to 2.44 ± 1.04 (mean difference: 3.64 ± 1.32) compared to a decrease from 6.39 ± 0.99 to 3.96 ± 1.67 (mean difference: 2.44 ± 1.59; P = 0.006). Similarly, improvements in both the symptom severity and functional status components of the BCTQ were significantly superior in the HA group (P = 0.005 and P = 0.004, respectively). Although both groups exhibited significant within-group improvements in electrophysiological parameters (DSL and DML) and reductions in the median nerve (MN) cross-sectional area, no significant between-group differences were observed. Notably, a higher percentage of patients in the HA group attained a normal CTS severity state (32% vs. 8.7%), although this difference was not statistically significant (P = 0.103). Conclusions: The findings suggest that ultrasound-guided HA injection via an in-plane ulnar approach significantly alleviates pain and improves functional status in patients with mild to moderate CTS, whereas electrodiagnostic and sonographic outcomes did not differ significantly between the treatment and control groups. | en |
| DOI | https://doi.org/10.5812/mejrh-159480 | en |
| Keyword | Carpal Tunnel Syndrome | en |
| Keyword | Visual Analog Scale | en |
| Keyword | Hyaluronic Acid | en |
| Keyword | Splints | en |
| Keyword | Ultrasonography | en |
| Publisher | Brieflands | en |
| Title | Ultrasound-Guided High Molecular Weight Hyaluronic Acid Injection for Carpal Tunnel Syndrome: A Randomized Controlled Trial | en |
| Type | Research Article | en |
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