The NOR-CACTUS Trial - A Norwegian Trial Comparing Treatment Strategies for Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) causes numbness and pain in the hand and arm, and is an important cause of work absence and disability. The aim of the NOR-CACTUS Trial is to compare outcomes of a treatment strategy where the initial treatment is up to two ultrasound-guided corticosteroid injections, followed by scheduled clinical assessment of treatment effect, and subsequent surgery if needed, to a treatment strategy where surgery is the first-line treatment. Participants will be randomized to one of the treatment strategies, and followed up for two years after start of the study intervention. Outcomes will include patient-reported, clinical, functional and neurophysiological measures, and health-economic aspects. The hypothesis of the study is that there is no difference between the two treatment groups in the percentage of patients with a satisfactory symptom relief (treatment success) one year after the initial therapeutic intervention.
• Adult (≥18 years of age)
• Patient history indicating CTS
• Neurophysiological examination performed within 6 months
• Diagnosis of CTS based on:
‣ Classic/probable or possible symptoms, and neurophysiological findings consistent with CTS
‣ Or, in case of normal neurophysiological findings:
⁃ Classic/probable symptoms and positive physical exam findings and/or nighttime symptoms
• Mild to moderate symptoms (intermittent, interfering with everyday life, and/or disturb sleep)