Corticosteroid injection in patients with ulnar neuropathy at the elbow: A randomized, double-blind, placebo-controlled trial

Muscle Nerve. 2015 Sep;52(3):380-5. doi: 10.1002/mus.24551. Epub 2015 Jun 18.

Abstract

Introduction: We conducted a randomized, double-blind, placebo-controlled trial to evaluate the effect of ultrasound-guided corticosteroid injection in patients with ulnar neuropathy at the elbow (UNE).

Methods: Fifty-five patients were randomized between an ultrasound-guided injection of 1 ml containing 40 mg methylprednisolone acetate and 10 mg lidocaine hydrochloride or a placebo injection. The primary outcome was the subjective change of symptoms after 3 months. The secondary outcomes were change in electrodiagnostic studies and ultrasonography findings.

Results: A success rate of 30% was found in the corticosteroid injection group versus 28% in the placebo injection group. Only the nerve cross-sectional area changed significantly in the intervention group, from a mean of 11.9 mm(2) to 10.9 mm(2) .

Conclusions: We could not demonstrate a positive effect of ultrasound-guided corticosteroid injection in UNE compared with placebo. Favorable outcomes may be attributed to the natural course of UNE or the effect of patient education.

Keywords: corticosteroid; injection; neuropathy; ulnar; ultrasonography.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use*
  • Cubital Tunnel Syndrome / diagnostic imaging
  • Cubital Tunnel Syndrome / drug therapy*
  • Double-Blind Method
  • Elbow
  • Female
  • Humans
  • Injections
  • Lidocaine
  • Male
  • Methylprednisolone / analogs & derivatives*
  • Methylprednisolone / therapeutic use
  • Methylprednisolone Acetate
  • Middle Aged
  • Treatment Outcome
  • Ulnar Neuropathies / diagnostic imaging
  • Ulnar Neuropathies / drug therapy
  • Ultrasonography, Interventional
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Methylprednisolone Acetate
  • Lidocaine
  • Methylprednisolone