, Volume 468, Issue 12, pp 3328-3332
Date: 01 Sep 2010

Determinants of Pain in Patients with Carpal Tunnel Syndrome

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Abstract

Background

Carpal tunnel syndrome causes numbness, weakness, and atrophy. Pain without numbness is not characteristic of this disease.

Questions/purposes

We tested the hypothesis that among patients with carpal tunnel syndrome confirmed by electrophysiologic testing, pain catastrophizing and/or depression would be good predictors of pain intensity at the time of diagnosis, whereas nerve conduction velocity would not.

Patients and Methods

Fifty-four patients completed a measure of tendency to misinterpret pain, a measure of depressive symptoms, anxiety about pain, self-efficacy in response to pain, and a five-point Likert measure of pain intensity. One-tailed Spearman correlation was performed to find a correlation between pain and continuous variables. One-way ANOVA was performed to assess differences between categorical variables. For each group, all variables with significant correlations with pain intensity were included in a multiple linear regression analysis.

Results

Sex, age, and electrophysiologic measures did not correlate with pain intensity. All measures of illness behavior correlated with pain intensity and were entered in a multiple linear regression model; only misinterpretation of nociception and depression were significantly associated and accounted for 39% of the variation in pain intensity.

Conclusions

Illness behavior (specifically depression and misinterpretation of nociception) predicts pain intensity in patients with carpal tunnel syndrome.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

One or more of the authors (DR) received an unrestricted fund from the American Orthopedics Foundation.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.