Although corticosteroids come in oral (tablets or syrup) form, injections (shots) are most commonly used for treating carpal tunnel syndrome.
How It Works
Corticosteroids relieve inflammation.
Why It Is Used
Corticosteroids are given to relieve inflammation due to carpal tunnel syndrome when other forms of treatment (such as rest, using a wrist splint, or using anti-inflammatories) have not helped relieve pain.
How Well It Works
Short-term oral corticosteroid treatment has been shown to reduce carpal tunnel syndrome symptoms.1 It is not clear how long the effect of the oral corticosteroids lasts.
Corticosteroid shots have been shown to reduce carpal tunnel symptoms.2 But although they often provide temporary relief (for several weeks or more), they do not typically provide permanent relief from carpal tunnel symptoms.
If three shots over several months have not helped to relieve pain, more shots are not likely to help and may cause harm. Even if the shots help to relieve pain, the number of shots should be limited. Talk to your doctor about corticosteroid shots.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call911or other emergency services right away if you have:
Call your doctor if you are have a corticosteroid injection and you have:
- Pain and swelling around the injection site that lasts more than 2 days.
Call your doctor if you are taking oral (by mouth) corticosteroids and you have:
One common side effect of injected corticosteroids is pain and swelling the first day or two after the injection. It may help to apply ice at home for 15 to 20 minutes.
Common side effects of oral corticosteroids include:
- Increased appetite.
- Nervousness or restlessness.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Other forms of treatment to relieve pain and inflammation (such as rest, ice, nonsteroidal anti-inflammatories, and splints) are usually tried before corticosteroids are used.
The standard of practice is that steroid injections should be given only 3 or 4 times a year in a single joint area.
Injection of any substance into a joint or tendon has a very small risk of harm, including damage to a tendon, ligament, or nerve; bleeding into the tissue; or infection. Although these rarely happen, your doctor will probably mention the possibilities to you before you get an injection into a joint.
Nobody likes needles. But experienced doctors can usually do a corticosteroid injection in under 30 seconds. It does hurt, but it's quick.
When it should not be used (contraindications)
Some doctors believe that corticosteroids should not be given to children or to women who are pregnant or breast-feeding.
If infection is suspected, shots are usually not given.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Piazzini DB, et al. (2007). A systematic review of the conservative treatment of carpal tunnel syndrome. Clinical Rehabilitation, 21(4): 299-213.
Ashworth NL (2014). Carpal tunnel. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1114/overview.html. Accessed October 2, 2014.
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerHerbert von Schroeder, MD, MSc, FRCSC - Hand and Microvascular Surgery
Current as ofNovember 14, 2014