Carpal tunnel syndrome: correlation of the severity of the clinical picture and electrophysiological studies

Abstract

Purpose: This study aimed to correlate the severity of carpal tunnel syndrome (CTS) in terms of the clinical picture with electrophysiological studies to determine whether the severity could be predicted through one measure based on correlations with another.Methods: This cross-sectional correlational study enrolled 96 patients (139 hands) whose nerve conduction studies (NCS) confirmed the diagnosis of CTS, and to whom the Boston Carpal Tunnel Questionnaire (BCTQ) was administered to determine the subjective and clinical CTS severity. The severity of both measures was correlated. Results: The patients’ mean age was 49.84±12.23 years. Most (67.7%) were female. The NCS severity grades were as follows: mild, 46%; moderate, 32.4; severe, 9.4%; and very severe, 12.2%. The sensory and motor NCS parameters were significantly correlated with the BCTQ severity. The patients’ overall mean scores for symptom severity had substantive predictive accuracy for the patients’ CTS severity measured with the NCS. Similarly, most of the functional severity score items had significant predictive accuracy for the patients’ NCS-based carpal tunnel severity score.Conclusion: The clinical severity of CTS was strongly correlated with the severity based on nerve conduction. This correlation was more notable for symptom severity scores than for functional status scores. Night pain and numbness demonstrated the strongest associations of all BCTQ items with the NCS. Although clinical severity (based on the BCTQ) predicts the nerve conduction severity, we still recommend performing NCS for patients with a clinical diagnosis of CTS as a confirmatory objective measure and for medico-legal reasons.

Impact of Occupations and Hobbies on the Severity of Carpal Tunnel Syndrome

“…The authors are well aware of the never-ending debate about the presence versus lack of correlation between clinical grade and EDX grade of severity of CTS. The most recent article is by Almigdad et al, 24 which finds a good correlation between the Boston Carpal Tunnel Questionnaire and EDX severity. The subjective scores based on patient’s symptoms are not considered sufficient to do a CTR by most surgeons.…”

“…There were significant differences between the severity groups in duration of occupation (moderate/moderately severe = 20 years [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], severe = 25 years [7-30], P = 0.052), age (moderate/ moderately severe = 51.7 years (12.3), severe = 60.3 years (13.3), P < 0.001), and having hobbies (moderate/moderately severe = 37/ 564 (6.6%), severe = 11/49 (22.4%), P < 0.001) (Table 5). Patients who had been employed a longer duration in their occupation, were older, and had hobbies were more likely to have severe CTS by NCS.…”

Neuromodulation of the median nerve in carpal tunnel syndrome, a single-blind, randomized controlled study

“…BCTQ assesses symptom severity and functionality and is easy to apply. The correlation between these two tests has been previously studied, and in the literature, three studies found no correlation between ENMG and BCTQ, one study found a weak correlation, and one study found a significant correlation [22][23][24][25][26].…”

Serum levels of Interleukin-6 in patients with Idiopathic Carpal Tunnel Syndrome: A case control study in Najaf Province

“…The total score of the SSS was classified into asymptomatic (11 points), mild (12-22 points), moderate (23-33 points), severe (34-44 points), and very severe (45-55 points). The total score of FSS was categorized into no difficulty (8 points), little difficulty (9-16 points), moderate difficulty (17-24 points), severe difficulty (25-32 points), and very severe (33-40 points) (11) . The control group was composed of seventy healthy participants (10 males and 60 females); they had no clinical or electrophysiological manifestations of CTS, and their age, gender, BMI, and geographical distribution were similar to the patients.…”