Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel
CPT4 code
Name of the Procedure:
Injection, therapeutic (e.g., local anesthetic, corticosteroid), carpal tunnel
Summary
A therapeutic injection for carpal tunnel syndrome involves administering medication directly into the wrist to alleviate pain and inflammation. This procedure typically includes a corticosteroid and/or local anesthetic.
Purpose
This procedure addresses carpal tunnel syndrome, a condition causing pain, numbness, and tingling in the hand and arm. The goal is to reduce inflammation, relieve pain, and improve hand function.
Indications
Specific indications include:
- Persistent pain, numbness, or tingling in the hand and fingers.
- Diagnosed carpal tunnel syndrome unresponsive to conservative treatments like splinting or anti-inflammatory medications.
- Symptoms that interfere with daily activities or sleep.
Preparation
Preparation for the procedure may include:
- Avoiding certain medications, such as blood thinners, as advised by your doctor.
- Undergoing a physical examination and possibly an electrodiagnostic study to confirm carpal tunnel syndrome.
Procedure Description
- The patient is seated comfortably and the hand is prepared with an antiseptic solution.
- A local anesthetic may be applied to numb the injection site.
- Using a fine needle, the healthcare provider injects the medication (corticosteroid, local anesthetic, or both) into the carpal tunnel space.
- The needle is removed and a small bandage is applied to the injection site.
Duration
The procedure typically takes about 10 to 15 minutes.
Setting
This procedure is usually performed in an outpatient clinic setting.
Personnel
The procedure is typically performed by a physician, such as a primary care doctor, rheumatologist, or orthopedist, often with the assistance of a nurse.
Risks and Complications
Common risks include:
- Temporary pain or bruising at the injection site.
- Infection.
- Allergic reaction to the medication.
Rare complications may include:
- Worsening of symptoms.
- Nerve damage.
- Tendon weakening.
Benefits
Expected benefits include:
- Immediate to short-term relief of pain and swelling.
- Improved hand function.
- Potentially delaying or avoiding the need for surgical intervention.
Recovery
Post-procedure care includes:
- Resting the hand for 24 to 48 hours.
- Avoiding heavy lifting or strenuous activities for a few days.
- Follow-up with the healthcare provider to assess the response and plan further treatment if necessary.
Alternatives
Alternative treatment options:
- Wrist splinting, particularly at night.
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
- Physical therapy.
- Carpal tunnel release surgery.
Pros and cons:
- Conservative treatments (splinting, NSAIDs) are non-invasive but may be less effective.
- Surgical options provide a more permanent solution but come with higher risks and a longer recovery period.
Patient Experience
During the procedure, the patient may feel a slight pinch or pressure at the injection site, followed by temporary soreness. Post-injection, the patient should experience relief within a few days, with discomfort managed by over-the-counter pain relievers as needed.