A Systematic Review and Meta-Analysis of Randomized Clinical Trials Comparing the Effectiveness of Corticosteroid Injection Versus Night Splints in Patients With Carpal Tunnel Syndrome.

In 30 seconds

This systematic review and meta-analysis of randomized controlled trials compared corticosteroid injection (CSI) with night splinting (NS) for carpal tunnel syndrome. Five studies were reviewed and four contributed to the meta-analysis, covering 407 participants. At 8 weeks, CSI was associated with greater symptom improvement than NS (mean difference = -0.42, 95% CI -0.69 to -0.15, p = 0.002); functional improvement was not significantly different in the main analysis. At 6 months, the meta-analysis found no major difference in clinical improvement between treatments.

Key findings

• At 8 weeks, CSI was associated with greater symptom improvement than NS (mean difference = -0.42, 95% CI -0.69 to -0.15, p = 0.002).
• Functional status showed a marginal difference at 8 weeks (mean difference = -0.18, 95% CI -0.37 to 0.01, p = 0.07).
• In sensitivity analysis of studies with the lowest risk of bias, CSI favoured symptom improvement (mean difference = -0.56, 95% CI -0.97 to -0.15, p = 0.007) and functional improvement (mean difference = -0.27, 95% CI -0.38 to -0.15, p < 0.001).
• At 6 months, the meta-analysis found no major difference in clinical improvement between CSI and NS.

Why it matters

The findings suggest that the relative benefit of these non-surgical options may depend on the time point and outcome assessed: injections were associated with better short-term symptom relief, while longer-term clinical improvement appeared similar. This distinction can help frame discussions about expected symptom course and the evidence available for each approach.

What to keep in mind

The meta-analysis included four studies and 407 participants; the abstract does not report further details on study heterogeneity or certainty of evidence.