PRP and steroid injections improve symptoms in moderate bilateral CTS.

PRP shows more sustained functional benefits than steroid at 6 months.

MRI and EMG provide objective evaluation of treatment effectiveness.

PRP may be a safe and promising alternative to steroid injection.

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.

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.

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.

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.

Carpal tunnel syndrome

Magnetic resonance imaging

Platelet rich plasma

Steroid

© 2026 The Authors. Published by Elsevier Ltd.