What is the role of sensitization in carpal tunnel syndrome where pain impacts functional capacity?

Abstract

Aim: Symptoms of Carpal tunnel syndrome (CTS) caused by the entrapped median nerve include pain, paresthesia and numbness. Extra median spread of pain can also be seen as a clinical condition explained by neuroinflammation. Central sensitization (CS) develops a similar mechanism. The purpose of the study is to evaluate the existence of sensitization in patients diagnosed with CTS. Material and Method: In this cross-sectional study, a total number of 152 patients diagnosed with CTS were evaluated, prospectively. Patient data such as gender, age, body mass index (BMI), disease duration, pain severity (NRS), pain DETECT questionnaire, Boston CTS Symptom Severity Scale (SSS) and Functional Status Scale (FSS), CS scale and electroneuromyography results has been collected by the authors. Results: Regarding the age, BMI and rate of CS, there was no statistical difference between the three patient groups (p>0.05). However, a statistically significant difference was found between these groups regarding disease duration, daytime and nighttime NRS, Boston SSS, FSS, and pain DETECT scores (p<0.05). A statistically significant correlation between age, BMI, NRS daytime scores, Boston SSS, FSS, and the presence of CS was not found (p>0.05). However, statistically significant differences were found in a comparison of the patients with and without CS, regarding disease duration, NRS night scores, and Pain DETECT scores (p<0.05). Conclusion: We conclude that the rate of CS is often underestimated in patients with CTS. Central sensitization should be considered in CTS patients with atypical pain and those with pain resistant to conservative treatment.