Valerie Rome, BA
Third Year Medical Student
Rowan-Virtua SOM
Voorhees, New Jersey, United States
Justin Le, BS
Medical Student
Rowan-Virtua SOM
Bronx, New York, United States
Amritjot Dhillon, MS
Medical Student
TouroCOM
Hicksville, New York, United States
Anish Rana, BA
Medical Student
University of Rochester Medical Center, Strong Memorial Hospital
Glen Mills, Pennsylvania, United States
Alexander King, DO
Associate Program Director, Department of Osteopathic Manipulative Medicine
Rowan-Virtua SOM
Sewell, New Jersey, United States
This systematic review aimed to evaluate the efficacy of platelet-rich plasma injections (PRP) versus acupuncture (traditional, electro-, laser-acupuncture) and corticosteroid injections, for treating carpal tunnel syndrome. Carpal tunnel syndrome (CTS) is one of the most common upper extremity conditions that impact daily activity and function. Despite the many non-operative treatment options, there is insufficient evidence to definitively recommend the optimal approach for managing CTS. As a result, there is growing interest in evaluating alternative nonoperative modalities for CTS treatment. The initial database search included 1,494 articles, of which 141 duplicates were removed. Using the inclusion criteria, 1,330 were removed, leaving 29 articles for a full-text review. This resulted in the exclusion of an additional 9 articles. In total, 20 articles were included in the final analysis. For CTS – BCTQ-SSS, BCTQ-FSS, and VAS were compared between acupuncture, PRP, and corticosteroid injections. In the BCTQ-SSS, PRP demonstrated the best outcomes (p < 0.01) compared to other treatments. This was also true in the BCTQ-FSS, with (p < 0.01). There was no significant difference in VAS outcomes (p > 0.05) between the 3 treatments.
Design: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines, utilizing the 5 major databases – PubMed, Embase, Scopus, Cochrane, and Web of Science – to include several studies evaluating both symptom severity and functional outcomes of either PRP, acupuncture, or corticosteroid. These included both Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), as well as the Visual Analog Scale (VAS) at one-month time points.
Results:
Conclusions: At this time, PRP appears to be the most effective in improving symptomatic/functional outcomes; however, there was no significant difference between the 3 groups in the VAS. Further research is needed to evaluate the efficacy of these treatments and their role as a non-operative therapy for CTS.
