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Study aim
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compare the effect of ultrasound guided corticosteroid injection with ozone injection in patients with carpal tunnel syndrome.
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Design
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in this study forty patients with carpal tunnel syndrome referred to Firuzgar physical medicine and rehabilitation clinic, Tehran, Iran will be included in the study after qualifying the inclusion and exclusion criteria and obtaining the informed consent . (3) Setting and conduct: patients will be randomly divided to two groups of twenty. For randomization we will use randomized blocking method. (4) Interventions: ultrasound-guided local injection of forty mg of triamcinolone with the in-plane method; in the first group around the median nerve and in t in another group under sterile conditions, 3 cc oxygen ozone (O2O3), (10 mg / ml) under ultrasound guided to the median nerve will be done by a physical medicine and rehabilitation specialist. Routine treatments including wrist splint for 6 weeks will be performed for all patients. (5) Main outcome measures: electrodiagnostical and sonographic criteria, Boston questionnaire scores and VAS will be assessed in the 0, 6th week and 12th weeks.
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Settings and conduct
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in this study forty patients with carpal tunnel syndrome referred to Firuzgar physical medicine and rehabilitation clinic, Tehran, Iran will be included in the study after qualifying the inclusion and exclusion criteria and obtaining the informed consent . (3) Setting and conduct: patients will be randomly divided to two groups of twenty. For randomization we will use randomized blocking method. (4) Interventions: ultrasound-guided local injection of forty mg of triamcinolone with the in-plane method; in the first group around the median nerve and in t in another group under sterile conditions, 3 cc oxygen ozone (O2O3), (10 mg / ml) under ultrasound guided to the median nerve will be done by a physical medicine and rehabilitation specialist. Routine treatments including wrist splint for 6 weeks will be performed for all patients. (5) Main outcome measures: electrodiagnostical and sonographic criteria, Boston questionnaire scores and VAS will be assessed in the 0, 6th week and 12th weeks.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria: patients with signs and symptoms of carpal tunnel syndrome (including pain and sensory disturbances in the territory of median nerve) which is confirmed through EMG-NCS and by electrodiagnostic criteria are mild to moderate carpal tunnel syndromes. Exclusion criteria: severe carpal tunnel syndrome in EMG-NCV; tenar atrophy; contraindications for corticosteroid injection (including sensitivity to corticosteroids and symptoms of skin infection at the injection site); diseases which mimic CTS symptoms such as polyneuropathy, cervical radiculopathy, thoracic outlet syndrome; surgery or local injection treatments in last six months; neoplastic or traumatic source of pain; wrist bones fracture.
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Intervention groups
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In the first group,corticosteroid inject under the ultrasound-guid around the median nerve which will be done by an experienced physical medicine and rehabilitation specialist using in-plane approach
In the first group, ozon inject under the ultrasound-guid around the median nerve which will be done by an experienced physical medicine and rehabilitation specialist using in-plane approach
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Main outcome variables
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The severity of symptoms and functional limitations by Boston questionnare
The severity of symptoms by Visual Analog Scale(VAS)
Electrodiagnostic criteria by using EMG-NCV device
Sonographic criteria by using Sonographic device
Side effects by questionnaire