Intraneural steroid injection as a complication in the management of carpal tunnel syndrome. A report of three cases.

Steroid injection can provide symptomatic relief in patients with carpal tunnel syndrome (CTS). Its role should be limited to a diagnostic aid in cases in which symptoms are atypical, a temporizing agent in patients with severe symptoms either who are awaiting surgery or in whom spontaneous remission might be expected, and as a definitive treatment in patients who do not desire surgery. Injection should be performed using proper technique by physicians skilled in carpal tunnel surgery. A soluble preparation of dexamethasone is recommended. Immediate paresthesia in the median nerve distribution or exacerbation of symptoms beyond 48 hours following injection is suspect for inadvertent nerve injury; therefore, early surgical decompression is indicated.