Psychological Status Is Associated With Symptom Severity in Patients With Carpal Tunnel Syndrome

Shin, Y. H.; Yoon, Jun O; Kim, You Keun; Kim, Jae Kwang

doi:10.1016/j.jhsa.2017.10.031

Cited by 48 publications

(40 citation statements)

References 24 publications

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“…There is also increasing evidence supporting a role of psychological factors in CTS . In fact, psychological factors, particularly depression, are more strongly correlated with symptoms than electrophysiological findings in CTS patients .…”

Section: Introductionmentioning

confidence: 99%

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Fernández‐de‐las‐Peñas

de-la-Llave-Rincón

Cescon

et al. 2019

Pain Practice

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Objective To assess the influence of clinical, psychological, and psychophysical variables on long‐term clinical outcomes after the application of either physical therapy or surgery in women presenting with carpal tunnel syndrome (CTS). Methods A secondary analysis of a randomized trial investigating the efficacy of manual therapy including desensitization maneuvers of the central nervous system against surgery in 120 women with CTS was performed. Clinical outcomes including pain intensity, function, or symptom severity were assessed at 6 and 12 months post‐intervention. Participants completed at baseline several clinical (pain intensity, function, and symptom severity), psychological (depression), and psychophysical (pressure pain thresholds and pain extent) variables, which were included as predictors. Multiple regression analyses were conducted to assess the relationship between baseline variables and clinical outcomes at 6 and 12 months post‐intervention. Results The regression models indicated that higher scores of each clinical outcome (ie, intensity of pain or symptom severity) at baseline predicted better outcomes at 6 and 12 months post‐intervention (from 15% to 65% of variance) in both groups. Lower pressure pain thresholds over the carpal tunnel at baseline predicted poorer clinical outcomes at 6 and 12 months post‐intervention (from 5% to 20% of variance) in the physical therapy group, whereas higher depressive symptoms at baseline contributed to poorer outcomes at 6 and 12 months post‐intervention (from 5% to 15% of the variance) within the surgery group. Conclusion This study found that baseline localized pressure pain sensitivity and depression were predictive of long‐term clinical outcomes in women with CTS following physical therapy or surgery, respectively.

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Section: Introductionmentioning

confidence: 99%

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Fernández‐de‐las‐Peñas

de-la-Llave-Rincón

Cescon

et al. 2019

Pain Practice

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“…In many studies conducted with CTS patients, it has been demonstrated that the severity of symptoms indicated by the patient was related to his/her depression and anxiety levels [22][23][24] . The results of these studies suggested that psychological disorders contribute significantly to the clinical presentation of CTS.…”

Section: Discussionmentioning

confidence: 99%

Elektromyografisi normal karpal tünel sendromlu bireylerde anksiyete, sağlık anksiyetesi ve somatosensoryal amplifikasyon düzeyleri

Demir

Akaltun²,

Altindag³

et al. 2021

Cukurova Medical Journal

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The aim of this study was to investigate the levels of anxiety, health anxiety and somatosensory amplification in patients who presented with the clinical manifestation of Carpal Tunnel Syndrome (CTS) without electromyography findings. Materials and Methods: Patients who applied to the Physical Therapy and Rehabilitation outpatient clinic, respectively, and were diagnosed with CTS with clinical findings were included in the study. The patients who were determined to have no evidence of conduction loss in EMG were evaluated by using Short Health Anxiety Inventory (HAI-18), SomatoSensory Amplification Scale (SSAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ). Results: A total of 111 participants were included in the study, of whom 56 were patients and 55 were healthy control subjects. There was no significant difference between the patient and control groups in terms of age, gender, and body mass index (BMI). A statistically significant relationship was observed between these scales and the VAS, BCTQ symptom-severity and BCTQ function status in the positive direction. Conclusion:In our study, it was shown that the patient group showed higher anxiety, health anxiety and somatosensory amplification characteristics, and these features were associated with the severity of the CTS clinical scales. Studies with large-scale samples are needed to be carried out to confirm the results of this study. Amaç: Bu çalışmada Karpal Tunel Sendromu (KTS) klinik tablosu ile başvuran ve Elektromyografi (EMG) sonucunda sinir iletimi normal tespit edilen hastalarda anksiyete, sağlık anksiyesi ve somatosensoryel amplifikasyon düzeylerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Fizik Tedavi ve Rehabilitasyon polikliniğine sırasıyla başvurmuş klinik bulgular ile KTS tanısı konulan hastalar alındı. EMG'de iletim kaybı bulgusu olmayan hastalara Sağlık Anksiyetesi Ölçeği-18 (HAI-18), Bedensel Belirtileri Abartma Ölçeği (BBAÖ), Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği (BAÖ), Görsel Ağrı Skalası (VAS) ve Boston Karpal Tünel Sorgulama Anketi (BKTSA) uygulandı. Bulgular: Çalışmamız 56 hasta, 55 kontrol olmak üzere 111 vakadan oluştu. 42 erkek olmak üzere, 69 vaka kadın cinsiyetteydi. Hasta ve kontrol grubu arasında yaş, cinsiyet, beden kitle indeksi (BKİ) açısından anlamlı bir farklılık yoktu. Uygulanan ölçekler ile VAS, BKTSA semptom şiddeti ve BKTSA fonksiyonel durum arasında pozitif yönde anlamlı ilişki gözlendi. Sonuç: Çalışmamız ile bu hasta grubunun yüksek anksiyete, sağlık anksiyetesi ve somatosensoryal amplifikasyon özellikleri gösterdiği ve bu özelliklerin KTS klinik ölçeklerinin şiddeti ile ilişkili olduğu gösterilmiştir. Mevcut sonuçlarımızı doğrulamak için daha geniş örneklemlerde çalışmalara ihitiyaç vardır.

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“…The association between neuropathic pain and psychological symptoms is well recognized (34,35); however, the precipitating pathology between these symptoms remains unclear. Tekeoglu et al (10) found that the majority of patients in the CTS group had higher symptoms of depression and anxiety, compared with the control group, which significantly improved at 3 months after carpal tunnel release (36).…”

Section: Discussionmentioning

confidence: 99%

Carpel tunnel syndrome: A link with vitamin D and calcium

Abdul‐Razzak

Kofahi

2020

biom rep

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Carpal tunnel syndrome (CTS) and vitamin D deficiency are two conditions that cause chronic pain and are thus associated with psychological issues as well. The aim of the present study was to evaluate vitamin D levels, daily calcium intake, musculoskeletal pain and psychological symptoms in patients with CTS. The study included 48 patients with CTS and age-sex matched controls. Serum vitamin D levels were measured, and psychological symptoms were assessed using a Hospital Anxiety and Depression Scale. A Pain DETECT questionnaire was used to assess musculoskeletal pain (MSP) sites and severity. The results showed that vitamin D deficiency was considerably more prevalent in patients with CTS (95.8%) compared with controls (22.9%). Clinical anxiety (35.4 vs. 6.3%) and clinical depression (29.2 vs. 4.2%) were also more common in patients with CTS compared with controls. All the patients with CTS exhibited MSP, whereas none of the controls reported any MSP. Anxiety was significantly and inversely associated with vitamin D levels (r 2 =-0.482; P<0.01), total daily calcium intake (r 2 =-0.294: P<0.05), and positively associated with body mass index (BMI; r 2 =0.200; P≤0.05) and depression (r 2 =0.587; P<0.01). Depression was significantly and inversely associated with vitamin D levels (r 2 =-0.269; P<0.01) and total daily calcium intake (r 2 =-0.236; P<0.05). Logistic regression analysis showed that with every unit increase in serum vitamin D levels, the odds of CTS were decreased 1.22x. While a one-unit increase in anxiety total score was associated with a 14% increase in the odds of having CTS after adjusting for different confounders. In conclusion, vitamin D deficiency, MSP and psychological symptoms are common in patients with CTS. Serum vitamin D levels and anxiety were significant independent predictors of CTS. Based on the results of the present study, it was shown that housewives had an equivalent chance of suffering from CTS morbidity as other high-risk professions. Further studies are required to confirm if vitamin D supplementation could prevent the onset of CTS.

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Psychological Status Is Associated With Symptom Severity in Patients With Carpal Tunnel Syndrome

Cited by 48 publications

References 24 publications

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Elektromyografisi normal karpal tünel sendromlu bireylerde anksiyete, sağlık anksiyetesi ve somatosensoryal amplifikasyon düzeyleri

Carpel tunnel syndrome: A link with vitamin D and calcium

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