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NOR Flare

Distance follow-up of patients with rheumatoid arthritis

Project managers
Post doc


Carpal tunnel syndrome causes numbness and pain in the hand and forearm. It is the most common non-traumatic hand disorder in Norway, and is a significant cause of absenteeism and disability. As of today, approximately 4% of the population has carpal tunnel syndrome. In Norway, around 7,500 people were operated on because of this in 2017, which gives an adjusted incidence of 140 surgical interventions per 100,000 inhabitants. It is well documented that patients with severe carpal tunnel syndrome should be treated operatively. But treatment of the patient group with mild to moderate symptoms is debated, and this is one of the conditions where the health authorities have called for increased use of non-surgical treatment. As of today, there is a limited knowledge base for this area. In Norway today, both treatment strategies are in use, but the vast majority of patients are operated on without having tried a cortisone injection beforehand.

NOR-CACTUS is a clinical randomized controlled multicentre study that runs over two years. The main aim of the study is to investigate whether a treatment strategy in which the patient receives injection treatment, followed by surgery in case of suboptimal effect gives non-inferior results to a treatment strategy in which the patient is operated on directly.


Patients with carpal tunnel syndrome.

Recruitment in the study is ongoing.


In one study arm, the study participants will first receive an ultrasound-guided cortisone injection, and then be monitored for the need for a further cortisone injection or surgery. In the second arm of the study, the participants will be operated on directly and then followed up. In addition to a clinical examination, the study participants will be examined with ultrasound, patient-reported outcome measures and neurography. We will assess the effect both at individual level and from a socio-economic perspective. We will assess the effect and safety of the treatment strategies, prognostic factors and societal consequences (e.g. sick leave, costs related to treatment).