Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. Among conservative, nonsurgical treatments, local corticosteroid injections have been found to provide symptomatic relief for many patients. As progesterone has been found to have neuroprotective effects, this study compared the effects of local steroid injections with those of local progesterone injections for patients with CTS.

This prospective study included 60 hands of patients with bilateral mild or moderate, idiopathic CTS. Subjects in the corticosteroid group received a single injection of 0.5 mL triamcinolone acetate, 40 mg per mL, and 0.5% of two percent lidocaine. Those in a progesterone group received a single local injection of 0.5 mL 17-alpha hydroxy progesterone (500 mg/2 mL) and 0.5 mL lidocaine (2%). The groups were compared for symptom severity, functional status and electrodiagnostic test results before and 10 weeks after treatment. Pain was assessed on a visual analogue scale. Symptoms and function were assessed using the Bostone/Levine symptom severity and functional status scales. Electrodiagnostic studies were completed before and after treatment.

Pain severity decreased significantly in both groups (P＝0.00001 for both), with no significant difference between the two groups. Median distal sensory latency improved in the corticosteroid as well as the progesterone group (P＝0.0002) and P＝0.009 respectively) as did the motor onset latencies (P＝0.003 and P＝0.014 respectively). There was no meaningful difference in these measures between the two groups. Patient satisfaction with the injections was greater in the corticosteroid group 10 weeks after injection than in the progesterone group (P＝0.005).

This study of patients with carpal tunnel syndrome found that both progesterone and corticosteroids produce significant improvement in patient symptoms, with no significant difference found between the two interventions.