Determinants of pain in patients with carpal tunnel syndrome

Clin Orthop Relat Res. 2010 Dec;468(12):3328-32. doi: 10.1007/s11999-010-1551-x. Epub 2010 Sep 1.

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.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Boston
  • Carpal Tunnel Syndrome / complications*
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / physiopathology
  • Carpal Tunnel Syndrome / psychology
  • Catastrophization / complications
  • Depression / complications
  • Electrodiagnosis
  • Female
  • Humans
  • Illness Behavior*
  • Linear Models
  • Male
  • Middle Aged
  • Neural Conduction
  • Pain / diagnosis
  • Pain / etiology*
  • Pain / physiopathology
  • Pain / psychology
  • Pain Measurement
  • Prospective Studies
  • Reaction Time
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires