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Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome

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Abstract

The aim of the current study was to evaluate bilaterally warm/cold detection and heat/cold pain thresholds over the hand/wrist in patients with carpal tunnel syndrome (CTS). A total of 25 women with strictly unilateral CTS (mean 42 ± 10 years), and 20 healthy matched women (mean 41 ± 8 years) were recruited. Warm/cold detection and heat/cold pain thresholds were assessed bilaterally over the carpal tunnel and the thenar eminence in a blinded design. Self-reported measures included both clinical pain history (intensity, location and area) and Boston Carpal Tunnel Questionnaire. No significant differences between groups for both warm and cold detection thresholds in either carpal tunnel or thenar eminence (P > 0.5) were found. Further, significant differences between groups, but not between sides, for both heat and cold pain thresholds in both the carpal tunnel and thenar eminence were found (all P < 0.001). Heat pain thresholds (P < 0.01) were negatively correlated, whereas cold pain thresholds (P < 0.001) were positively correlated with hand pain intensity and duration of symptoms. Our findings revealed bilateral thermal hyperalgesia (lower heat pain and reduced cold pain thresholds) but not hypoesthesia (normal warm/cold detection thresholds) in patients with strictly unilateral CTS when compared to controls. We suggest that bilateral heat and cold hyperalgesia may reflect impairments in central nociceptive processing in patients with unilateral CTS. The bilateral thermal hyperalgesia associated with pain intensity and duration of pain history supports a role of generalized sensitization mechanisms in the initiation, maintenance and spread of pain in CTS.

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Acknowledgments

This study received funds from a grand conceded by the Universidad Rey Juan Carlos and Comunidad de Madrid (reference CCG08-URJC/BIO-3469).

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Authors and Affiliations

  1. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922, Alcorcón, Madrid, Spain

    Ana Isabel de la Llave-Rincón, César Fernández-de-las-Peñas & Josué Fernández-Carnero

  2. Esthesiology Laboratory, Universidad Rey Juan Carlos, Alcorcón, Spain

    Ana Isabel de la Llave-Rincón, César Fernández-de-las-Peñas, Josué Fernández-Carnero & Juan A. Pareja

  3. Department of Health Science and Technology, Centre for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark

    César Fernández-de-las-Peñas & Lars Arendt-Nielsen

  4. Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy

    Luca Padua

  5. Fondazione Don Carlo Gnocchi, Rome, Italy

    Luca Padua

  6. Department of Neurology, Fundación Hospital Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain

    Juan A. Pareja

Authors
  1. Ana Isabel de la Llave-Rincón
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  2. César Fernández-de-las-Peñas
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  3. Josué Fernández-Carnero
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  4. Luca Padua
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  5. Lars Arendt-Nielsen
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  6. Juan A. Pareja
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Correspondence to César Fernández-de-las-Peñas.

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de la Llave-Rincón, A.I., Fernández-de-las-Peñas, C., Fernández-Carnero, J. et al. Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome. Exp Brain Res 198, 455–463 (2009). https://doi.org/10.1007/s00221-009-1941-z

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  • DOI: https://doi.org/10.1007/s00221-009-1941-z

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