Comparison of the effectiveness of platelet-rich plasma (PRP) injection and steroid injection in patients with bilateral moderate carpal tunnel syndrome: a prospective randomized controlled trial

BACKGROUND AND OBJECTIVE: To compare the effectiveness of platelet-rich plasma (PRP) injection, corticosteroid injection, and wrist splinting in patients with bilateral moderate carpal tunnel syndrome (CTS) using clinical, electrophysiological, and radiological parameters. MATERIAL AND METHODS: This randomized controlled study included 45 patients with bilateral moderate carpal tunnel syndrome, divided equally into three groups: PRP + splint, steroid + splint, and splint-only (control). Assessments were conducted pre-treatment and at 1 and 6 months post-treatment using VAS scores (pain and numbness), pinch and grip strength, QuickDASH questionnaire, EMG, and MRI. RESULTS: VAS scores significantly improved in all groups at both follow-ups, with greater reductions in night pain and numbness in the PRP and steroid groups versus control. All groups showed improved strength at month 1; by month 6, grip strength improved only in the PRP group, while pinch strength improved in both PRP and steroid groups. While A significant reduction in the Quick DASH symptom score was observed in the PRP and steroid groups, EMG findings improved significantly in all groups. MRI showed a significant decrease in palmar bowing in the PRP and steroid groups. CONCLUSION: While both PRP and steroid injections were more effective than splinting alone in improving symptoms and function, PRP demonstrated some indications of more sustained benefits, particularly at the 6-month follow-up.