Comparative Study of Ultrasound-Guided Corticosteroid Injection with Acupotomy Release Versus Injection Alone in Carpal Tunnel Syndrome: A Randomized Controlled Trial.

Carpal tunnel syndrome (CTS) is a common and often painful condition caused by pressure on the median nerve in the wrist. It can cause numbness, tingling, and weakness in the hand, making everyday tasks difficult. Researchers wanted to find out whether adding a minimally invasive needle-based procedure called acupotomy to a standard corticosteroid (steroid) injection could help patients recover faster and more completely than a steroid injection alone.

In this study, 68 patients with CTS were randomly divided into two groups. One group received an ultrasound-guided steroid injection combined with acupotomy — a technique where a specialized needle is used to gently release the tight ligament pressing on the nerve. The other group received only the steroid injection. Patients were followed up at 2 weeks, 1 month, and 3 months.

Both groups felt better after treatment, but the combination group pulled ahead over time. At the one-month mark, patients who received acupotomy plus the injection reported significantly better symptom relief and hand function than those who had the injection alone. These improvements continued and were even more pronounced at three months. Ultrasound scans also confirmed that the nerve itself looked healthier in the combination group — it was less compressed and had a more normal shape.

Importantly, no complications were reported in either group, suggesting the combined approach is both effective and safe.

What does this mean for patients? If you are living with carpal tunnel syndrome and haven't found lasting relief from injections alone, a combined approach involving acupotomy may offer greater and longer-lasting benefits. Acupotomy is a specialized skill, so if you are interested in exploring this option, seek out a licensed, qualified practitioner with specific training in acupotomy or minimally invasive needle therapies.

This randomized controlled trial (n=68) published in Medical Science Monitor evaluated ultrasound-guided corticosteroid injection combined with acupotomy release of the transverse carpal ligament versus corticosteroid injection alone in patients with carpal tunnel syndrome (CTS). Patients were assessed using the Boston Carpal Tunnel Questionnaire Symptom Severity Score (BCTQ-S) and Functional Status Scale (BCTQ-F) at 2 weeks, 1 month, and 3 months post-treatment. Ultrasound measurement of median nerve cross-sectional area (CSA) and flattening ratio served as objective endpoints at 3 months.

Both groups demonstrated significant within-group improvements at all follow-up points. No between-group differences were observed at 2 weeks; however, the combination group showed significantly superior BCTQ-S (P=0.017) and BCTQ-F (P=0.039) scores at 1 month, with continued superiority at 3 months (P<0.01). Sonographic outcomes also favored the combination group, with greater reductions in CSA (P=0.009) and flattening ratio (P=0.038). No complications were reported. Clinically, acupotomy release added to corticosteroid injection provides measurably better symptom control, functional recovery, and nerve decompression in CTS, with a favorable safety profile.