Clinical reference

Carpal Tunnel Syndrome

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

AAOS Clinical Practice Guideline on Carpal Tunnel Syndrome 2016 for the indication, with the dose from Egyptian National Drug Formulary - Endocrine System Drugs 2024, Prednisolone monograph (printed pages 169-170): "Oral: Usual Initial doses: 5 to 60 mg/day given in a single daily dose or in 2 to 4 divided doses." The formulary states a general adult range rather than a carpal tunnel regimen; the two-week course is from the AAOS guideline, which is not held in this corpus. · AAOS Clinical Practice Guideline on Carpal Tunnel Syndrome 2016 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Verified against4 documents

AAOS Clinical Practice Guideline on Carpal Tunnel Syndrome 2016 for the indication, with the dose from Egyptian National Drug Formulary - Endocrine System Drugs 2024, Prednisolone monograph (printed pages 169-170): "Oral: Usual Initial doses: 5 to 60 mg/day given in a single daily dose or in 2 to 4 divided doses." The formulary states a general adult range rather than a carpal tunnel regimen; the two-week course is from the AAOS guideline, which is not held in this corpus.
Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)
AAOS Clinical Practice Guideline on Carpal Tunnel Syndrome 2016
Carpal Tunnel Syndrome - disease-level clinical article (carpal-tunnel-syndrome-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

Symptoms start intermittently with activities like driving, reading, or painting, and often ease with shaking the hand or wrist
Advanced disease brings permanent sensory loss, weakness, clumsiness, and trouble with doorknobs or buttons [numbness]
Though often bilateral, the dominant hand is usually affected first
Numbness reaching the little finger, thenar eminence, hand dorsum, or neck points to a different diagnosis [numbness]

Signs — what you find (9)

Exam may show sensory loss or weakness in the median nerve distribution [numbness]
Thenar eminence sensation is typically spared, since its cutaneous branch runs outside the tunnel
Weak thumb abduction and opposition with thenar atrophy may also be found [atrophy]
Carpal compression test: steady pressure over the tunnel for 30 seconds, positive if it reproduces median-distribution symptoms
Carpal compression test runs 64% sensitivity and 83% specificity
Phalen (reverse prayer) test: wrist dorsa pressed together, elbows flexed, held one minute; positive if it reproduces symptoms
Phalen test runs 68% sensitivity and 73% specificity
Tinel test: tapping directly over the tunnel to elicit median-nerve symptoms
Tinel test runs 50% sensitivity and 77% specificity

Tests (5)

A clinical diagnosis of mild CTS usually needs no further testing
Electrodiagnostic testing (nerve conduction studies, sometimes EMG) is used for atypical symptoms, sleep-disrupting pain, persistent numbness/weakness, or hand dysfunction outside of pregnancy
Abnormal electrodiagnostic testing, matched with symptoms and signs, is the diagnostic gold standard
Mild CTS shows sensory abnormalities alone on electrophysiology; moderate CTS shows both sensory and motor abnormalities
Imaging (ultrasound or MRI) is reserved for a suspected structural cause, such as a tumor or ganglion cyst

If not this — what else fits (4)

Neurologic and vascular mimics: brachial plexopathy, cervical myofascial pain or spondylosis, compartment syndrome, ischemic stroke, and mononeuritis multiplex
Other neuropathic mimics: multiple sclerosis, forearm median neuropathy, motor neuron disease, diabetic neuropathy, and cervical radiculopathy
Overuse injury, traumatic or radiation-induced brachial plexopathy, and other peripheral neuropathies
Tendonitis, tenosynovitis, and thoracic outlet syndrome

SourceStatPearls "Carpal Tunnel Syndrome" - disease-level clinical article

Presentation findings are traced to the source above.

PREDNISOLONE

1st line

Strength20 mg

Formoral.solid

Adult dose and duration

20 mg once daily in the morning x 2 weeks

Paediatric dose

Specialist paediatric care required

Dose source

Why

Short course oral corticosteroid that reduces tenosynovial flexor swelling around the median nerve, giving temporary symptom relief in carpal tunnel syndrome while definitive treatment such as injection or decompression is arranged.

Cautions

Short course oral steroid reduces tenosynovial flexor edema.
Provides temporary relief lasting up to 8-12 weeks.
Avoid repeated courses; refer for local corticosteroid injection or decompression.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
UNIPRICORT 20MG 20 ORODISPERSIBLE TABS.	EVA PHARMA	45.00 EGP
EPICOPRED 20 MG 20 ORODISPERSIBLE TABS.	EIPICO	104.00 EGP
PREDNISOLONE 20 MG 20 ORODISPERSIBLE TABS.	ARAB DRUG COMPANY (ADCO)	115.00 EGP
DISPRELONE-D 20MG 20 DISPERSABLE TABS.	EPCI > ANDALOUS PHARMA	116.00 EGP
SOLUPRED ORO 20 MG 20 ORODISPERSIBLE TABS.	SANOFI WINTHROP > SANOFI	142.00 EGP
XILONE 20 MG 20 ORODISPERSABLE TABS.	EUROPEAN EGYPTIAN PHARM. IND.	142.00 EGP
DISPRELONE-OD 20 MG 30 ORODISPERSABLE TABS.	ANDALOUS PHARMA	202.50 EGP
ACETASEE 1% EYE DROPS (SUSP.) 5 ML? strength differs? different route - not oral solid	RAMEDA	7.50 EGP
PREDNIS 5MG/5ML SYRUP 100 ML? strength differs? different route - not oral solid	PHAROPHARMA	9.50 EGP

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Carpal Tunnel Syndrome - disease-level clinical article (carpal-tunnel-syndrome-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - Refer for surgical intervention when conservative treatment fails or CTS is severe on electrophysiological testing.

METHYLPREDNISOLONE

2nd line

Forminjection

Adult dose and duration

20 to 40 mg mixed with 1% lidocaine injected into the carpal tunnel

Paediatric dose

No paediatric dose is stated in the sources held for this drug.

Dose source

Carpal Tunnel Syndrome - disease-level clinical article (carpal-tunnel-syndrome-clinical.txt)

Why

Local corticosteroid injection into the carpal tunnel for temporary reduction of tenosynovial flexor swelling and nerve compression.

Cautions

Strict aseptic technique required to prevent septic arthritis.
Limit frequency to max 3-4 intra-articular injections per year into the knee to avoid articular cartilage degeneration.
Contraindicated in systemic infection unless treated; avoid local injection into a previously infected joint.
Avoid intratendinous injection to prevent extensor tendon atrophy or rupture.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
M.P.A 40MG/ML VIAL	AMOUN	8.50 EGP
EPIZOLONE-DEPOT 40MG/ML 1 ML I.M. VIAL	EIPICO	39.00 EGP
SOLU-MEDROL 500MG I.M./I.V.VIAL	PFIZER	180.00 EGP
GLOBISOLONE 500MG I.V./I.M. LYOPHILIZED POWDER VIAL	GLOBAL PHARMACEUTICAL INDUSTRIES	214.00 EGP
SOLU-MEDROL 1GM I.M./I.V.VIAL	PFIZER	360.00 EGP
GLOBISOLONE 1GM I.V./I.M. LYOPHILIZED POWDER VIAL	GLOBAL PHARMACEUTICAL INDUSTRIES	400.00 EGP
METHYLPREDNISOLONE MYLAN 500MG 10 VIALS	MYLAN S.A.S-FRANCE > RAMCO	1225.00 EGP
METHYLPREDNISOLONE MYLAN 1G 10 VIALS	MYLAN S.A.S-FRANCE > RAMCO	2250.00 EGP

IBUPROFEN

add-on - not a substitute

Strength400 mg

Formoral.solid

Adult dose and duration

400 mg 3 times daily with food x 2-4 weeks

Paediatric dose

Extremely rare in children; specialist workup mandatory

Dose source

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Why

Adjunct NSAID added to night splinting for carpal tunnel syndrome; blocks prostaglandin-mediated inflammation to relieve pain, but does not relieve the underlying nerve compression itself.

Cautions

First-line non-pharmacological treatment is neutral wrist splinting at night.
NSAIDs offer short-term symptom relief but do not change nerve compression.
Refer for electrodiagnostic testing or surgery if sensory loss/thenar atrophy occurs.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
DAJUANOFEN 400 MG 20 F.C. TABS.	COPAD PHARMA	5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.	DELTA PHARMA	3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETS	SANOFI	12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.	SEDICO	6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABS	EIPICO	42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.	KAHIRA > ABBOTT LABORATORIES	78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.	EUROPEAN EGYPTIAN PHARM. IND.	31.00 EGP
ANALGIPROF 400 MG 25 SACHETS	EVA PHARMA	37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solid	SANOFI	2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solid	ARAB DRUG COMPANY (ADCO)	4.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.