Neuropathic Pain in Carpal Tunnel Syndrome: Association with Electrophysiological Findings and Functional Status


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AĞADAYI S., ESER F., AGADAYI E., BODUR H.

Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, cilt.26, sa.1, ss.87-93, 2023 (Hakemli Dergi) identifier

Özet

Aims of the present study are to determine the presence of neuropathic pain according to The Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) in patients with electrophysiologically confirmed carpal tunnel syndrome (CTS) and investigate the association of neuropathic pain with clinical and electrophysiological findings and hand functionality. Material and Methods: One hundred and seventy five patients (234 hands) whose electrophysiological test results were compatible with CTS were included. Standard electrophysiological tests, LANSS and Quick Disability of the Arm, Shoulder, and Hand (Q-DASH) were applied to each patient. Patients with LANSS score 12 formed Group 1 and <12 formed Group 2. Results: Of patients, 58.11% (136 hands) had a LANSS score ≥12 (Group 1) and 41.89% (98 hands) had a LANSS score <12 (Group 2). Female sex, symptom duration, sensory loss detected in the hand innervated by the median nerve, abductor pollicis muscle strength, thenar atrophy, phalen sign positivity and Q-DASH scores were higher in Group 1 (p<0.05). Electrophysiological severity was found to be higher in Group 1 (p<0.005). Median nerve motor distal latency and median nerve 2nd digit-wrist sensory distal latency were longer (p<0.05) in Group 1. Median nerve 2nd digit-wrist sensory amplitude and median nerve 2nd digit-wrist sensory velocity were found to be significantly lower in Group 1 (p<0.05). Conclusion: It has been shown that median nerve motor distal latency and sensory nerve conduction studies can be used to determine the presence of neuropathic pain in patients with CTS. Knowing the presence and mechanism of neuropathic pain in patients with CTS will guide the clinician in determining the appropriate treatment strategy.