Glucocorticoid, Ozone and 5% Dextrose Local Injection for Pain Relief in Carpal Tunnel Syndrome

Inclusion Criteria: * Adults aged 18-65 years with a clinical diagnosis of mild to moderate Carpal Tunnel Syndrome . * Clinical diagnosis of mild to moderate Carpal Tunnel Syndrome , as classified by Bland neurophysiological classification scale: Mild Carpal Tunnel Syndrome : Slow Distal Sensory Latency(≥3.6 ms), Normal Distal Motor Latency(\< 4.5 ms) * Moderate Carpal Tunnel Syndrome : Slow Distal Sensory Latency (≥ 3.6 ms), Slow Distal Motor Latency (4.5 - 6.4 ms) * Failure to respond to conservative treatments (e.g., splinting, activity modification, or oral medications) for at least 6 weeks. Exclusion Criteria: * Patient refusal. * Severe Carpal Tunnel Syndrome requiring surgical intervention, as defined by the Bland neurophysiological classification scale: Severe Carpal Tunnel Syndrome: Absent Distal Sensory Latency and Slow Distal Motor Latency (4.5 - 6.4 ms) * Previous corticosteroid injection for Carpal Tunnel Syndrome within the last 6 months. * History of wrist trauma, surgery or anatomical abnormalities. * Systemic conditions such as diabetes mellitus, thyroid dysfunction or rheumatoid arthritis. * Pregnancy or lactation. * Contraindications to any of the study interventions (e.g., allergy to glucocorticoids or ozone). * Infection at wrist.