Clinical Role of Corticosteroids Versus Platelet Rich Plasma Injections in the Management of Carpal Tunnel Syndrome: a Narrative Review.

purpose of reviewThis review seeks to assess and compare the mechanisms, effectiveness, safety, and clinical applications of corticosteroid and platelet-rich plasma (PRP) injections in managing Carpal Tunnel Syndrome (CTS). RECENT

findingsRecently, PRP therapy has gained attention as a promising alternative, offering a regenerative approach. PRP, which contains autologous growth factors, supports tissue repair and cellular regeneration, potentially enabling long-term recovery. While corticosteroids offer rapid symptom relief, repeated use carries risks, including tendon degeneration and systemic side effects. In contrast, PRP therapy, though requiring more time for preparation and administration, may provide longer-lasting benefits with fewer associated risks. Despite these advantages, the comparative effectiveness of PRP and corticosteroids remains a subject of ongoing research. CTS is a common condition caused by compression of the median nerve as it passes through the carpal tunnel at the wrist. This pressure, often worsened by inflammation, impairs nerve function, which leads to symptoms such as pain, numbness, and weakness. Corticosteroid injections have long been a standard treatment for CTS, primarily targeting inflammation and reducing pressure within the carpal tunnel by suppressing neutrophilic activity and lymphocyte proliferation. Agents like dexamethasone and betamethasone are commonly used for their strong anti-inflammatory effects. However, prolonged corticosteroid use has been shown to have decreased efficacy and increased risk for tissue damage. Other treatment options for CTS, including wrist splinting, activity modification, and surgical decompression in severe cases, also play a role in comprehensive management. Recently, PRP injections have been seen as a potential alternative because of their components, such as platelet-derived growth factor (PDGF) for wound healing, vascular endothelial growth factor (VEGF) for angiogenesis, and nerve growth factor (NGF) for nerve healing. The components of PRP can address the issue of carpal tunnel by targeting the median nerve to ease pressure and heal any damage to neighboring structures. However, unlike corticosteroids, PRP lacks standardization protocols, which makes it lack consistency and introduces possible risk for adverse side effects. Corticosteroids are the standard choice for clinical use as a treatment for carpal tunnel; however, given their short-term relief and risk for side effects from continuous use, PRP is a possible alternative. Furthermore, further studies are required to determine PRP’s efficacy and long-term use compared to corticosteroids.