Back to Journals » Journal of Pain Research » Volume 12

Comparing the Efficacy of Local Triamcinolone Injection in Carpal Tunnel Syndrome Using Three Different Approaches with or without Ultrasound Guidance [Letter]

Authors Zhou J, Xue Y

Received 10 November 2019

Accepted for publication 17 December 2019

Published 24 December 2019 Volume 2019:12 Pages 3467—3468

DOI https://doi.org/10.2147/JPR.S238017

Checked for plagiarism Yes

Editor who approved publication: Dr Michael A Überall


Jiaming Zhou, Yuan Xue

Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China

Correspondence: Yuan Xue
Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Tel +86 22 60814688
Fax +86 22 27219052
Email xueyuanzyy@163.com
 
We read the article by Rayegani et al with great interest.1 In their study, the authors compared three methods (landmark-guided, conventional ultrasound-guided midline approach and ultrasound-guided ulnar in-plane method) in the treatment of carpal tunnel syndrome (CTS) and found that all of these three methods could improve pain intensity, function and electrophysiologic and radiographic outcomes. In addition, no statistical differences were found among the three groups in any outcomes.
 
View the original paper by Zhou J and colleagues


Dear editor

We read the article by Rayegani et al with great interest.1 In their study, the authors compared three methods (landmark-guided, conventional ultrasound-guided midline approach and ultrasound-guided ulnar in-plane method) in the treatment of carpal tunnel syndrome (CTS) and found that all of these three methods could improve pain intensity, function and electrophysiologic and radiographic outcomes. In addition, no statistical differences were found among the three groups in any outcomes.

However, the unreasonable P values in the study should be noted. In Table 2, five P values were greater than 0.05.1 For example, the P value in the ulnar in-plane group regarding Boston questionnaire symptom severity scale (BQ-SSS) was 0.542, meaning no significant difference was found in symptom severity before and after ultrasound-guided ulnar in-plane triamcinolone injection. But according to our clinical and statistical experience, nearly 50% improvement showed a non-significant difference was inconceivable. Meanwhile, previous studies all showed statistical improvements in BQ-SSS after ultrasound-guided corticosteroid injection treatment.25 Considering the authors used paired t-test through SPSS software in the study, P values in the Paired Samples Correlations and in the Paired Samples Test could be confused in the output document if not careful, so the P values in the Paired Samples Correlations may be recorded as original P values in the Paired Samples Test.

Hence, we advise the authors recalculate the data in this part. If all the P values in Table 2 were less than 0.05, the “Discussion” and “Conclusion” section should be corrected appropriately.

Disclosure

The authors report no conflicts of interest in this communication.

References

1. Rayegani SM, Raeissadat SA, Ahmadi-Dastgerdi M, Bavaghar N, Rahimi-Dehgolan S. Comparing the efficacy of local triamcinolone injection in carpal tunnel syndrome using three different approaches with or without ultrasound guidance. J Pain Res. 2019;12:2951–2958. doi:10.2147/JPR.S212948

2. Babaei-Ghazani A, Nikbakht N, Forogh B, et al. Comparison between effectiveness of ultrasound-guided corticosteroid injection above versus below the median nerve in mild to moderate carpal tunnel syndrome: a randomized controlled trial. Am J Phys Med Rehabil. 2018;97(6):407–413. doi:10.1097/PHM.0000000000000877

3. Eslamian F, Eftekharsadat B, Babaei-Ghazani A, Jahanjoo F, Zeinali M. A randomized prospective comparison of ultrasound-guided and landmark-guided steroid injections for carpal tunnel syndrome. J Clin Neurophysiol. 2017;34(2):107–113. doi:10.1097/WNP.0000000000000342

4. Lee JY, Park Y, Park KD, Lee JK, Lim OK. Effectiveness of ultrasound-guided carpal tunnel injection using in-plane ulnar approach: a prospective, randomized, single-blinded study. Medicine. 2014;93(29):e350. doi:10.1097/MD.0000000000000350

5. Ustün N, Tok F, Yagz AE, et al. Ultrasound-guided vs. blind steroid injections in carpal tunnel syndrome: A single-blind randomized prospective study. Am J Phys Med Rehabil. 2013;92(11):999–1004. doi:10.1097/PHM.0b013e31829b4d72

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]