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AB1181 Local steiod and insulin injection in management of carpal tunnel syndrome; a comparative study
  1. MH Abu-Zaid,
  2. S El morsy,
  3. SA Hablas
  1. Rheumatology and Rehabilitation, Faculty of Medicine Tanta University Egypt, Tanta, Egypt


Background Carpal tunnel syndrome (CTS) is the most common focal nerve entrapment; local corticosteroid (CS) injection has been widely used to treat CTS. Recently; Local insulin Injection in CTS has been studied as insulin has anti-inflammatory anti-edematous effects.

Objectives To compare the effectiveness of local steroid and insulin injections in management of CTS

Methods Forty patients complaining of mild or moderate idiopathic CTS (diagnosed clinically & electrophysiologically and classified according to American association of neuromuscular diagnostic medicine monograph) divided into 2 equal groups.

Group I received two local injections of 10 IU NPH insulin into the affected carpal tunnel 2 weeks intervals. Group II: received single injection of triamcinolone acetonide (20 mg/0.5 ml) all procedures done after informed consent. Patients with severe or secondary type of CTS were excluded from this study. Evaluation of the patients was done at baseline, 2 and 4 months later clinically by measuring visual analogue scale (VAS), Phallen and compression tests and electrophysiologically by measuring motor and sensory nerve conduction studies of median and ulnar nerves using a standardized technique.

Results There was significant improvement in all clinical parameters in both groups after 2 and 4 months from injection (p<0.01) including VAS, Phallen and compression tests with more improvement was noticed in group I. Also there was significant improvement in electrophysiological parameters such as distal motor latency (DML) and distal sensory velocity of median nerve 2 and 4 months after treatment (p<0.01).However the improvement was more in group I but the difference between results in both groups were statistically nonsignificant.

Table 1.

clinical and electrophysiological results

Conclusions Local insulin injection is as effective as (or even better than) local steroid injection in management of CTS


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  2. Ginanneschi F, Filippou G, Bonifazi M, Frediani B, Rossi A. Effects of Local Corticosteroid Injection on Electrical Properties of Aβ-Fibers in Carpal Tunnel Syndrome. J Mol Neurosci, 2014; 52:525–530.

  3. Ashraf A, Yazdani A, Mirshams S. Evaluation of the effectiveness of local insulin injection in type 2 diabetic patients with CTS. Electromyogr Clin Neurophysiol. 2009 May-Jun;49(4):161–6.


Acknowledgements Thanks a lot to Dr. Samar Abd Alhamed for her great efforts in completing statistical analysis in this study.

Disclosure of Interest None declared

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