Predictors of Central Sensitization and Pain Quantification in Patients with Carpal Tunnel Syndrome

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Background: Carpal tunnel syndrome (CTS) occurs following compression of the median nerve within the carpal tunnel leading to paresthesia and pain in the median nerve distribution, numbness, and falling of objects out of the patient’s hand. It affects 2.7% of the general population. The prevalence of CTS in Upper Egypt and the other types of peripheral neuropathies is about 1686/100,000 with a female-to-male ratio of 10 /1. Aim: to evaluate the predictors of central sensitization and pain quantification in patients with unilateral, mild to moderate CTS. Methods: This study was conducted on 84 patients recruited at the electrodiagnosis Clinic at the Suez Canal University Hospital after fulfilling the eligibility criteria. Patients were evaluated by history, clinical examination, nerve conduction studies, and outcome measures by VAS for pain, Boston carpal tunnel questionnaire, central sensitization inventory, sensory threshold, pain threshold, and pressure pain threshold. Results: In this study, pain was evaluated by VAS score which was 9 ±1.23. Results for the symptoms severity scale were evaluated by the Boston CTS questionnaire which was 3.92 ± 0.83. The functional status scale was 3.75 ± 1.08. Central sensitization inventory (CSI) was 50.83 ±10.57. Regarding sensory and pain thresholds for electrical stimulation, there were significantly lower sensory and pain thresholds in CTS patients in comparison to healthy subjects. Concerning pressure pain threshold, patients with CTS had lower thresholds over the median, ulnar, radial, and C5-6 zygapophyseal joints compared to healthy individuals. Conclusion: CTS can be associated with central sensitization which is manifested by augmented response to pain.

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