Cold Intolerance after Brachial Plexus Nerve Injury

Abstract

Background The purpose of this study was to evaluate cold intolerance symptoms in patients with brachial plexus nerve injury. We hypothesized that higher levels of cold intolerance would be associated with more pain, greater disability, and unemployment. Methods Following research ethics board approval and patient consent, we included English-speaking adults more than 6 months following brachial plexus nerve injury. Patient questionnaires included Cold Intolerance Severity Scale (CISS), McGill Pain Questionnaire, SF-36, DASH, pain catastrophizing scale, and Post-traumatic Stress Disorder Checklist. Statistical analyses evaluated the relationships among the questionnaires and the independent variables. Multivariable linear regression evaluated the factors associated with the CISS. Results There were 61 patients, 20 women and 41 men (mean age 40±17 years). The mean questionnaire scores indicated high scores in the CISS, DASH, and pain intensity. The CISS was significantly higher in women. The final regression model with CISS as the dependent variable included the following independent variables: McGill pain rating index, DASH score, and time since injury. Neither pain catastrophizing nor post-traumatic stress scores were retained in the final model. Conclusions Patients with brachial plexus nerve injury reported substantial cold intolerance which was associated with the McGill pain rating index, upper extremity disability, and time since injury.

Raynaud’s phenomenon in Northern Sweden: a population-based nested case–control study

“…A number of these diseases and injuries have previously been reported in conjunction to CS alone, such as vascular disease [24], nerve injury [10], cold injury [25] and HAV syndrome [12]. Thus, it seems that CS and secondary RP share several common denominators, which suggest that CS is an acquired condition primarily arising as a result of peripheral neural or vascular injury.…”

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

“…The pathophysiological mechanisms are not fully elucidated, but seem to involve a multifactorial etiology, including neural (Irwin et al 1997 ), vascular (Hope et al 2014 ), as well as humoral (Koman et al 1998 ) aspects. Cold sensitivity has previously been studied as a sequela to upper extremity injuries, such as digital and hand amputation (Lithell et al 1997 ; Tark et al 1989 ), hand fracture (Nijhuis et al 2010 ), peripheral nerve and brachial plexus injury (Novak et al 2012 ; Ruijs et al 2007 ), upper extremity arterial injury (Klocker et al 2012 ), flexor tendon repair (Riaz et al 1999 ), corrective surgery for Dupuytren’s disease (McKirdy 2007 ), carpal tunnel syndrome (Thomsen et al 2009 ), freezing cold injury (Carlsson et al 2014 ), and hand–arm vibration (HAV) syndrome (Carlsson et al 2010c ; Necking et al 2002 ). Injuries aside, cold sensitivity has also been described in relation to diabetes mellitus (Thomsen et al 2009 ), and rheumatic diseases (Merkel et al 2002 ).…”

Evaluation of Cold Sensitivity, Pain, and Quality of Life After Upper Extremity Nerve Injury

“…Neuropathic pain following traumatic injury and coldinduced pain have been associated with increased upper extremity disability. 14,15 The purpose of this study was to evaluate the relationship between self-reported cold sensitivity, pain, and impact on QoL after upper extremity nerve injury. We hypothesized that in patients with long-standing nerve injury, (1) higher levels of cold sensitivity and pain would be associated with a higher impact on QoL, and (2) patients who selected a single descriptor of "coldness" would have more severe pain, higher cold sensitivity scores, and higher impact on QoL.…”