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Bilateral carpal tunnel syndrome: contralateral effect following corticosteroid injection


International Physical Medicine & Rehabilitation Journal
Carolina Paiva,1 Sandra Assuncao,1 Sofia Moreira,1 André Ribeiro,1 Yuriy Mazin,2 Nuno Madureira,1 Ana Borges,1 Carolina Lourenço,1 Filipe Carvalho1

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Abstract

Background: Carpal tunnel syndrome (CTS) is the most common compressive mononeuropathy and often presents bilaterally. Corticosteroid injections are a standard conservative treatment. Contralateral improvement following unilateral injection has been reported but remains poorly understood. Case Presentation: We describe the case of an 81-year-old male with bilateral CTS confirmed by electroneuromyography. A single ultrasound-guided corticosteroid injection was administered to the left wrist. At 30-day follow-up, the patient reported complete resolution of symptoms in both hands. At 6 months, he remained asymptomatic and follow- up nerve conduction studies demonstrated bilateral improvement. Conclusion: This case supports the hypothesis that unilateral corticosteroid injection may result in bilateral symptom relief in patients with CTS, possibly mediated by central neural mechanisms. These findings may influence treatment strategies, although further studies are needed to clarify underlying mechanisms and long-term outcomes.

Keywords

carpal tunnel syndrome, electroneuromyography

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