Misdiagnosis may occur when pain results from certain activities
Carpal tunnel syndrome (CTS) is a common condition that affects the wrist and is characterized by a “tingling” sensation or numbness. Pain is not considered a classical symptom of CTS, except for in rare cases when numbness is so intense that it can be described by some as painful. Despite this, pain associated with certain activities, especially regular computer work, is often misdiagnosed as CTS. As a result, this can lead to patients having the wrong impression of the source of their pain, which can negatively affect outlooks when symptoms remain. Therefore, a study was conducted to determine which factors are associated with pain in patients with CTS.
Large group of patients assessed using two questionnaires
The study focused on 275 patients diagnosed and treated for CTS. Demographic data including age, sex, dominant hand, occupation and smoking status were gathered for each patient, and the severity of their CTS was established through a combination of clinical assessment and nerve conduction studies (NCS). Patients then completed two questionnaires, the Short Form–McGill pain questionnaire (SF-MPQ) and the Quick Disabilities of the Arm, Shoulder, and Hand (DASH) to assess pain and disability one year after intervention.
Pain is not associated with a CTS diagnosis
Results from the analysis of the questionnaires showed that the only variables associated with pain were smoking and bilateral (on both sides) disease. Pain alone was not found to be correlated with a CTS diagnosis, and researchers therefore believe it should not be listed as a common or primary symptom of CTS. Furthermore, they stress the importance of proper diagnosis before any treatment can be prescribed, and this can be accomplished by separating pain from numbness at all times and using the NCS methods that were used in this study. By following these suggestions, researchers hope fewer cases of pain are misdiagnosed and patients are treated properly for their condition, CTS or otherwise. Physical therapists can help in this process by accurately diagnosing wrist numbness, tingling or pain using results of NCS, and prescribing an appropriate management strategy to treat it.
-As reported in the August ’13 issue of the Journal of Hand Surgery