The subject of the study is to use current treatment methods in patients with nerve compression in the wrist and compare their effects. The purpose of the study is to determine the most appropriate method by comparing the benefits of cortisone and serum injection in addition to exercise therapy in volunteers like you who have nerve compression in the wrist and have pain and numbness.
Female and male patients aged 18-65 who applied to Ahi Evran University Physical Medicine and Rehabilitation Polyclinic and diagnosed with carpal tunnel syndrome through clinical and EMG
Patients who can understand the information form correctly and are cooperative
Patients who consented to participate in the study according to the informed consent form
Cervical radiculopathy
Polyneuropathy
Brachial plexopathy
Systemic corticosteroid use
Parallel
hydrodissection
Other intervention5 ml of 0.9% isotonic sodium chloride solution will be applied to the intracarpal area median nerve area once with the USG probe.
Steroid injection
Other intervention1 ml of 3mg/ml betamethasone sodium phosphate or 3mg/ml betamethasone acetate solution will be applied with the USG probe.
Exercise
Other interventionPerformed with 6 different consecutive positions of the hand and wrist. 1- Wrist in neutral position, fingers and thumb in flexion 2- Wrist in neutral position, fingers and thumb in extension 3- Wrist and fingers in extension, thumb in neutral position 4- Wrist, fingers and thumb in extension 5- Forearm in supination, wrist and fingers in extension 6- Forearm in supination, wrist and fingers in extension, gentle stretching is applied to the thumb with the hand. Tendon gliding exercises: Performed to ensure isolated mobility of the flexor digitorum superficialis and profundus muscles in the canal. Tendon gliding exercises are performed in 5 different consecutive positions, respectively. 1- Fingers straight 2- Fingers in hook position 3- Fingers in fist position 4- Fingers in table shape position 5- Fingers in straight fist. The exercises will be asked to be done 10 times, once a day, every day for 3 weeks.
Electrophysiological Study
All patients will undergo electroneurophysiological examination at the EMG laboratory of the Neurology Department of Kırşehir Ahi Evran University Education and Research Hospital before treatment and at 12 weeks after treatment.Median sensory nerve action potential amplitude, Compound muscle action potential amplitude, Median sensory distal latency, Median motor distal latency, Median sensory nerve conduction velocity, was evaluated by EMG.
Electrophysiological Study
All patients will undergo electroneurophysiological examination at the EMG laboratory of the Neurology Department of Kırşehir Ahi Evran University Education and Research Hospital before treatment and at 12 weeks after treatment.Median sensory nerve action potential amplitude, Compound muscle action potential amplitude, Median sensory distal latency, Median motor distal latency, Median sensory nerve conduction velocity, was evaluated by EMG.
Measurement of the median nerve cross-sectional area with USG
The use of ultrasonography in the evaluation of CTS is increasing. To measure the median nerve cross-sectional area, the nerve is determined with a continuous line along the hyperechoic border, and the cross-sectional area of the circled area will be calculated with USG.
Measurement of the median nerve cross-sectional area with USG
The use of ultrasonography in the evaluation of CTS is increasing. To measure the median nerve cross-sectional area, the nerve is determined with a continuous line along the hyperechoic border, and the cross-sectional area of the circled area will be calculated with USG.
Measurement of the median nerve cross-sectional area with USG
The use of ultrasonography in the evaluation of CTS is increasing. To measure the median nerve cross-sectional area, the nerve is determined with a continuous line along the hyperechoic border, and the cross-sectional area of the circled area will be calculated with USG.
Boston Carpal Tunnel Questionnaire
The Boston Carpal Tunnel Syndrome Questionnaire, which has been validated and reliable in Turkish (10), has been proposed for clinical standardization of carpal tunnel syndrome patients. The questionnaire consists of nineteen questions and the answers are evaluated with a minimum of one and a maximum of five points. The lowest score is 5 and the highest score is 95. A high average score indicates that the patient's complaints are severe or that their functional capacity is inadequate.
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