Peer-reviewed research
Local corticosteroid injection versus placebo for carpal tunnel syndrome
NL Ashworth et al., Cochrane Database of Systematic Reviews, 2023 · DOI 10.1002/14651858.CD015148
Read the originalRead on October 16, 2026
- What it is
- A Cochrane review, 2023 Issue 2, of randomised trials comparing a local corticosteroid injection into the wrist with placebo or no treatment for carpal tunnel syndrome. Nine studies with 639 people contributed usable data.
- How much weight it carries
- Systematic review of randomised trials, searched to May 2022. Excludes people with arthritis or diabetes, so the results may not apply to them. Serious complications were reported in only 66% of the studies.
Facts taken from this source
- The 2023 Cochrane review of steroid injection for carpal tunnel syndrome found nine studies with 639 people that provided usable data.
“We found nine studies involving 639 people conducted in hospital-based clinics” (What did we find?)
- The 2023 Cochrane steroid review found that the symptom improvement from a steroid injection was still evident up to six months, with a standardised mean difference of -0.58 favouring the injection.
“Up to six months this was still evident favouring LCI (SMD -0.58, 95% CI -0.89 to -0.28; 4 RCTs, 234 participants/hands; moderate-certainty evidence).” (Abstract, main results)
- In one trial of 111 people, 65% of those given a steroid injection had mild to moderate pain lasting under two weeks, against 16% of those given a placebo injection.
“One study (111 participants) reported no serious adverse events, but 65% of LCI-injected and 16% of the placebo-injected participants experienced mild-to-moderate pain lasting less than two weeks.” (Abstract, adverse events)
- Carpal tunnel symptoms can improve without treatment in up to a third of people, according to the 2023 Cochrane steroid review.
“spontaneous improvement without treatment can occur in up to a third of people.” (Key messages)
- The 2023 Cochrane steroid review found that the need for surgery probably falls slightly after an injection, with a risk ratio of 0.84 at one year.
“The requirement for surgery probably reduces slightly in the LCI group at one year (risk ratio 0.84, 95% CI 0.72 to 0.98; 1 RCT, 111 participants, moderate-certainty evidence).” (Main results)
- The 2023 Cochrane review found that a wrist steroid injection probably improves symptoms at up to three months, with a standardised mean difference of -0.77 favouring the injection.
“There is probably an improvement in symptoms measured at up to three months of follow-up favouring LCI (standardised mean difference (SMD) −0.77, 95% confidence interval (CI) −0.94 to −0.59; 8 RCTs, 579 participants; moderate-certainty evidence).” (Main results)