Correlation of Pain in Carpal Tunnel Syndrome with Electrophysiological Findings

Year 2022, Volume: 17 Issue: 1, 182 - 185, 21.03.2022

Ayşe Çağlar Sarılar , Büşra Sümeyye Arıca Polat

https://doi.org/10.17517/ksutfd.1025318

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common mononeuropathy characterized by numbness, paresthesia, pain and weakness in the fingers, depending on the functions of the median nerve. The aim of this study is to investigate the relationship between the pain and electrophysiological findings in patients diagnosed with idiopathic CTS.
Materials and Methods: 106 patients diagnosed with idiopathic CTS were included in this cross-sectional observational study. Demographic data of the patients were recorded. Motor and sensory conduction velocities, amplitudes and latency of the median and ulnar nerves were evaluated. According to electrophysiological findings, staging of CTS was made as "Mild CTS", "Moderate CTS" and "Severe CTS". Visual Analogue Scale (VAS) was used for pain severity.
Results: 106 patients (90 females (84.9%), 16 males (15.1%), mean age 45.97 years ± 5.28 years) diagnosed with CTS were included in this study. Bilateral CTS symptoms were present in 63.2% of the patients. According to VAS, the mean pain intensity of the patients was 5.88 ± 2.29. The mean VAS score of the patients in the mild CTS group was 4.03±1.66, 6.85±1.67 in the moderate CTS group, and 8.83±1.60 in the severe CTS group (p=0.01 and p=0.02). While the mean VAS was 4.46±2.22 in those with unilateral CTS, it was 6.23±2.08 in those with bilateral CTS (p=0.01). Moderate CTS was detected in 61.2% of the patients with bilateral clinical findings (p=0.01). In addition, the VAS scores of those with both unilateral and bilateral CTS were found to be significantly higher in those with moderate than mild CTS (p= 0.01/ p=0.01).
Discussion: In this study, it was determined that the pain was more severe in patients with electrophysiologically more severe CTS and that pain was more in those with bilateral CTS. The increase in the severity of the pain that determined with VAS which can be applied easily and quickly in daily practice. and the increase in the stage of the disease may contribute to the early and effective initiation of the patient's treatment.

Keywords

Pain, carpal tunnel syndrome, electrophsiology

Karpal Tünel Sendromundaki Ağrının Elektrofizyolojik Bulgularla Korelasyonu

Abstract

Giriş: Karpal tünel sendromu (KTS) median sinirin işlevlerine bağlı olarak parmaklarda uyuşma, parestezi, ağrı ve güçsüzlükle karakterize en sık görülen mononöropatidir. Bu çalışmanın amacı idiyopatik KTS tanısı alan hastalarda hissedilen ağrı ile elektrofizyolojik bulgular arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Bu kesitsel gözlemsel çalışmaya idiyopatik KTS tanısı alan 106 hasta alındı. Hastaların demografik verileri kaydedildi. Median ve ulnar sinirin motor ve duyu olarak iletim hızları, amplitüdleri, latansları değerlendirildi. Elektrofizyolojik bulgulara göre KTS evrelemesi ‘’Hafif KTS’’, ‘’Orta KTS’’ ve ‘’Şiddetli KTS’’ olarak yapıldı. Ağrı şiddeti için Görsel Analog Ölçeği (GAÖ) kullanıldı.
Bulgular: Bu çalışmaya KTS tanısı alan 106 hasta (90 kadın (%84,9), 16 erkek (%15,1), ortalama yaş 45,97 yıl ± 5,28) dahil edildi. Hastaların %63,2’sinde bilateral KTS semptomları vardı. GAÖ’ye göre, hastaların ortalama ağrı şiddeti 5,88 ± 2,29 idi. Hafif KTS grubunda olan hastaların ortalama GAÖ puanı 4,03±1,66, orta KTS grubundakilerin 6,85±1,67, şiddetli KTS grubundakilerin ise 8,83±1,60 idi (p=0,01 ve p=0,02). Tek taraflı KTS’si olanlarda VAS ortalaması 4,46±2,22 iken bilateral KTS’si olanlarda VAS ortalaması 6,23±2,08’di (p=0.01). Bilateral klinik bulgusu olan hastaların %61,2’sinde orta derecede KTS saptandı (p=0,01). Ayrıca hem unilateral hem de bilateral KTS’si olanlarda VAS puanları hafife göre orta evre KTS’si olanlarda anlamlı olarak yüksek bulunmuştur (p= 0,01/ p=0,01).
Tartışma: Bu çalışmada elektrofizyolojik olarak daha ağır olan KTS’de ağrının daha şiddetli olduğu ve bilateral KTS’si olanlarda da ağrının daha fazla olduğu saptanmıştır. Ağrının şiddetinin artması ile hastalığın evresinin artması, günlük pratikte kolay ve çabuk uygulanacak GAÖ’nün hastanın tedavisinin erken ve etkili bir şekilde başlatılabilmesine katkı sağlayabilir.

Keywords

Ağrı, Elektrofizyoloji, karpal tünel sendromu

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