The Relationship Between Electrodiagnostic Findings and Patient Symptoms and Function in Carpal Tunnel Syndrome
Abstract
Chan L, Turner JA, Comstock BA, Levenson LM, Hollingworth W, Heagerty PJ, Kliot M, Jarvik JG. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome.
Objective
To examine whether, in patients with carpal tunnel syndrome (CTS), electrodiagnostic study findings were associated with patient symptom severity and functional limitations after controlling for potentially confounding variables including depression, somatization, and pain-related catastrophizing.
Design
Cross-sectional design including data from 2 ongoing CTS studies.
Setting
Patients enrolled from hospitals and clinics in Washington State between October 2002 and February 2006.
Participants
Adults with CTS (N=215) (based on symptoms and abnormal electrodiagnostic findings) were analyzed. Exclusion criteria were any mass, tumor, severe trauma, or deformity in the hand or wrist, radiculopathy, polyneuropathy, pregnancy, lactation, or severe CTS.
Interventions
Not applicable.
Main Outcome Measures
The Carpal Tunnel Syndrome Assessment Questionnaire (CTSAQ) functional status scale assessed the ability to perform 9 common hand-related tasks. The CTSAQ symptom severity scale included 11 items that assess pain, numbness, and weakness. Patients also rated their average hand and wrist pain in the last month.
Results
With and without controlling for patient characteristics, including age, sex, body mass index, symptom duration, depression, somatization, and pain-related catastrophizing, there were no statistically significant relationships between the electrodiagnostic findings and patient functional status and symptom severity.
Conclusions
Electrodiagnostic findings and patient CTS-related symptoms and function appear to be independent measures. Clinicians and researchers interested in CTS outcomes need to assess both.
aDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA
bDepartment of Medicine, University of Washington, Seattle, WA
cDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
dDepartment of Biostatistics, University of Washington, Seattle, WA
eDepartment of Neurosurgery, University of Washington, Seattle, WA
fDepartment of Health Services, University of Washington, Seattle, WA
gDepartment of Radiology, University of Washington, Seattle, WA.
Correspondence to Leighton Chan, MD, MPH, Dept of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA 98195-6490.
Supported by the Multidisciplinary Clinical Research Center and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant no. P60 AR48093).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. The views expressed here are those of the authors and not necessarily those of the University of Washington.
ABSTRACT