# Carpal Tunnel Syndrome - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - Prednisolone — 20 mg — oral.solid - Referral & safety-netting (no drug therapy) - Methylprednisolone — injection - Ibuprofen — 400 mg — oral.solid ## Complete treatment card ```text CARPAL TUNNEL SYNDROME 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) Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "Carpal Tunnel Syndrome" - disease-level clinical article Status traced to the source above 1. PREDNISOLONE [1st line] Adult 20 mg once daily in the morning x 2 weeks Peds Specialist paediatric care required Source 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. 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. Caution 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. Egypt 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 RAMEDA 7.50 EGP -> ? strength differs, ? different route - not oral solid PREDNIS 5MG/5ML SYRUP 100 ML PHAROPHARMA 9.50 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution RED FLAG - Refer for surgical intervention when conservative treatment fails or CTS is severe on electrophysiological testing. 3. METHYLPREDNISOLONE [2nd line] Adult 20 to 40 mg mixed with 1% lidocaine injected into the carpal tunnel Peds No paediatric dose is stated in the sources held for this drug. 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. Caution 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. Egypt 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 PHARMACEUTICA... 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 ... 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 4. IBUPROFEN [add-on - not a substitute] Adult 400 mg 3 times daily with food x 2-4 weeks Peds Extremely rare in children; specialist workup mandatory 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. Caution 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. Egypt 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 > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)