Musculoskeletal care
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
By Koskiniotis A, Tatsis CF, Mylonas T and 5 others.
Abstract
Background
The objective of our study was to conduct a systematic review and meta-analysis of randomized controlled trials to compare the effectiveness of corticosteroid injections (CSI) and night splinting (NS) in patients with carpal tunnel syndrome (CTS).
Methods
A thorough review of the literature was carried out from the beginning of records until July 31st, 2025. The two interventions were evaluated by comparing the mean differences in the BCTQ questionnaire. Sensitivity analysis was used to assess studies with the lowest risk of bias. The certainty of evidence for each outcome and time point was rated using the GRADE approach.
Results
Five studies were included in the systematic review and four in the meta-analysis. Among 407 participants, CSI was associated with significantly greater symptom improvement than NS (mean difference = -0.42, 95% CI -0.69 to -0.15, p = 0.002) and marginally significant difference in functional status between the treatments (mean difference = -0.18, 95% CI -0.37 to 0.01, p = 0.07) at a follow-up of 8 weeks. Sensitivity analysis, focussing on studies with the lowest risk of bias, showed that CSI favoured both symptom (mean difference = -0.56, 95% CI -0.97 to -0.15, p = 0.007) and functional status improvement (mean difference = -0.27, 95% CI -0.38 to -0.15, p < 0.001). The meta-analysis did not reveal a major difference in clinical improvement between the two groups at 6 months.