Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder, which is caused by compression of the median nerve as it travels through the wrist. There are several treatments for CTS, including conservative and surgical options. Though local corticosteroid injection has been considered more effective than physical therapy for treatment of CTS and has significant short-term benefits, long term benefits are not evidenced. Several studies in recent years reported significantly superior longer-term benefit of D5W and PRP compared with corticosteroid injections and other conservative managements. In addition, percutaneous release of the transverse carpal ligament (TCL) was developed to treat CTS in recent years. Because the effectiveness of the recently developed techniques in treating CTS has not been well established, the investigators aim to investigate whether combining US-guided partial release of the transverse carpal ligament with a needle plus D5W hydrodissection is more beneficial for CTS comparing to either treatment alone.
age between 20 to 80 years old
diagnosed with CTS on the basis of clinical condition and an electrophysiological analysis
the NRS of pain or paresthesia≧3
with symptoms lasting for a minimum of 3 months.
history of polyneuropathy, thoracic outlet syndrome, brachial plexopathy, or inflammatory arthropathy
onset of CTS during pregnancy, hypothyroidism, or systemic infection
previous corticosteroid injection or wrist surgery for CTS
hypersensitivity to dextrose injection