Prevalence of cold sensitivity in upper extremity nerve compression syndromes

Wendt, Michael; Novak, Christine B.; Anastakis, Dimitri J.

doi:10.1177/1753193417728426

Cited by 15 publications

(14 citation statements)

References 21 publications

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“…Our results confirm that cold sensitivity is more associated with several other symptoms, as demonstrated by higher symptom scorings for pain, numbness, stiffness and weakness, among cases who scored their cold sensitivity as moderate or severe than among cases who scored their cold sensitivity as mild. One smaller previous study (n = 100) reported cold sensitivity in 52% of patients with CTS or ulnar nerve compression at the elbow 4 . Another study, using the Boston Carpal Tunnel Questionnaire, of the evaluated outcome after OCTR in 102 hands reported cold sensitivity, defined as colour changes or severe pain in the fingers after exposure to cold, in 46/102 (45%) cases.…”

Section: Discussionmentioning

confidence: 94%

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Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

Zimmerman

Nyman

Dahlin

2020

Sci Rep

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Cold sensitivity is common following nerve injuries in the upper extremity, but is less well studied in carpal tunnel syndrome (CTS). We investigated cold sensitivity in CTS and its effects on surgical outcome. A search of the Swedish National Registry for Hand Surgery (HAKIR) for open carpal tunnel releases (OCTR) from 2010-2016 identified 10,746 cases. Symptom severity questionnaires (HQ-8; HAKIR questionnaire 8, eight Likert-scale items scored 0-100, one item on cold sensitivity) and QuickDASH scores before and after surgery were collected. Patient mean age was 56 ± SD 16 years, and 7,150/10,746 (67%) were women. Patients with severe cold sensitivity (defined as cold intolerance symptom severity score > 70; n = 951), scored significantly higher on QuickDASH at all time points compared to those with mild cold sensitivity (cold intolerance symptom severity scores ≤ 30, n = 1,532); preoperatively 64 [50-75] vs. 40 [25-55], at three months 32 [14-52] vs. 18 [9-32] and at 12 months 25 [7-50] vs. 9 [2-23]; all p < 0.0001. Severe cold sensitivity predicted higher postoperative QuickDASH scores at three [12.9 points (95% CI 10.2-15.6; p < 0.0001)] and at 12 months [14.8 points (11.3-18.4; p < 0.0001)] compared to mild cold sensitivity, and adjustment for a concomitant condition in the hand/arm, including ulnar nerve compression, did not influence the results. Cold sensitivity improves after OCTR. A higher preoperative degree of cold sensitivity is associated with more preoperative and postoperative disability and symptoms than a lower degree of cold sensitivity, but with the same improvement in QuickDASH score. Cold sensitivity is a disabling symptom that often presents after hand injuries, particularly those involving peripheral nerves in the upper extremity. It is also common, but often overlooked, in nerve compression syndromes. Cold sensitivity is defined as an abnormal response to cold, with symptoms such as numbness, pain, stiffness, weakness, and sometimes changes in colour 1. Cold sensitivity has also been associated with poorer sensory function following nerve compression 2 , and with reduced quality of life 3. In cases of nerve compression syndromes in the upper extremity, earlier studies have described cold sensitivity as occurring more commonly in patients with diabetes and in women 4. Cold sensitivity largely resolves following open carpal tunnel release (OCTR), but may persist longer in patients with diabetes than in those without 5. The population numbers in previous studies on cold sensitivity in nerve compression syndromes were limited. The impact of cold sensitivity on surgical outcome has not yet been completely clarified 5,6. Hence, our aim was to investigate the occurrence of cold sensitivity in carpal tunnel syndrome (CTS) both pre-and post-operatively, and its effects on the surgical outcome of OCTR.

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Section: Discussionmentioning

confidence: 94%

“…In cases of nerve compression syndromes in the upper extremity, earlier studies have described cold sensitivity as occurring more commonly in patients with diabetes and in women 4 . Cold sensitivity largely resolves following open carpal tunnel release (OCTR), but may persist longer in patients with diabetes than in those without 5 .…”

Section: Introductionmentioning

confidence: 98%

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

Zimmerman

Nyman

Dahlin

2020

Sci Rep

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“…Patients with median and ulnar nerve injuries who have no return of sensory function may have more severe cold intolerance (Irwin et al., 1997; Novak, 2018; Novak and Mackinnon, 2016; Ruijs et al., 2007; Wendt et al., 2018). Severe cold intolerance affects daily life, activity pattern, activity participation, roles, and quality of life (Carlsson et al., 2008; Novak and Mackinnon, 2016; Vaksvik et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of cold intolerance has been found higher in patients with nerve transections than in nerve compression neuropathies (Novak, 2018; Wendt et al., 2018). The aim of the present study is to investigate the relationship between cold intolerance and sensory function after nerve transection or compression neuropathy and to compare the severity of cold intolerance between patients with these two types of injury.…”

Section: Introductionmentioning

confidence: 99%

More severe cold intolerance is associated with worse sensory function after peripheral nerve repair or decompression

Cesim

Öksüz

2019

J Hand Surg Eur Vol

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The aim of the study is to investigate the correlation between cold intolerance and sensory function after repair of nerve transection or decompression of peripheral neuropathy in the upper extremity. We included patients with abnormal cold sensitivity who had a score of 30 or more in the Cold Intolerance Symptom Severity Questionnaire. There were 30 individuals after surgery to repair nerve transection and 30 with compression neuropathy, aged between 18–65 years. We used the Cold Intolerance Symptom Severity Questionnaire to evaluate cold intolerance and the Rosen Score to evaluate sensory function. There was a significant negative correlation between cold intolerance and sensory function in both peripheral nerve transections and compression neuropathies. We conclude that greater cold intolerance is associated with worse sensory function in peripheral nerve injuries. Interventions for sensory function in cold intolerance treatment may reduce the severity of cold intolerance. Level of evidence: III

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“…Cold intolerance, which is the mainstay of CISS questionnaire, is usually seen among the hand-injured patients. This debilitating symptom persists, causing a serious problem as it affects an individual’s daily life and performance at work [16, 19, 21, 26, 27]. The mechanism of cold sensitivity is still under debate, to identify whether it is caused by a thermoregulatory dysfunction or by a neurologic condition that triggers neuropathic pain, which is again applicable to that of HAVS.…”

Section: Discussionmentioning

confidence: 99%

Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study

Kim

et al. 2019

Ann of Occup and Environ Med

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Background The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS. Methods A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value. Results The reliability of the CISS questionnaire was proven to be good, with a total Cronbach’s alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s. Conclusions The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30. Trial registration IRB No. 2018–07–040-001 . Registered on 4 September 2018.

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Prevalence of cold sensitivity in upper extremity nerve compression syndromes

Abstract: IV.

Cited by 15 publications

References 21 publications

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

More severe cold intolerance is associated with worse sensory function after peripheral nerve repair or decompression

Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study

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