Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?

Schmid, Annina B., Soon, Benjamin T. C., Wasner, Gunnar and Coppieters, Michel W. (2012) Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?. European Journal of Pain, 16 2: 217-228. doi:10.1016/j.ejpain.2011.06.003

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Author Schmid, Annina B.
Soon, Benjamin T. C.
Wasner, Gunnar
Coppieters, Michel W.
Total Author Count Override 4
Title Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?
Journal name European Journal of Pain   Check publisher's open access policy
ISSN 1090-3801
1532-2149
Publication date 2012-02
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.ejpain.2011.06.003
Volume 16
Issue 2
Start page 217
End page 228
Total pages 12
Place of publication Oxford, U.K.
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Recent studies demonstrated that patients with carpal tunnel syndrome (CTS) have signs of thermal and mechanical hyperalgesia in extra-median territories suggesting an involvement of central pain mechanisms. As previous studies included patients with shoulder/arm symptoms or neck pain, a potential influence of these coexisting disorders cannot be excluded. This study therefore evaluated whether widespread sensory changes (hypoesthesia or hyperalgesia) are present in patients with unilateral CTS in the absence of coexisting disorders. Twenty-six patients with unilateral CTS with symptoms localised to their hand and 26 healthy controls participated in the study. A comprehensive quantitative sensory testing (QST) protocol including thermal and mechanical detection and pain thresholds was performed over the hands (median, ulnar and radial innervation area), lateral elbows, neck and tibialis anterior muscle. Patients with CTS demonstrated thermal and mechanical hypoesthesia in the hand but not at distant sites. Thermal or mechanical hyperalgesia was not identified at any location with traditional QST threshold testing. However, patients with CTS rated the pain during thermal pain testing significantly higher than healthy participants. This was especially apparent for heat pain ratings which were elevated not only in the affected hand but also in the neck and tibialis anterior muscle. In conclusion, CTS alone in the absence of coexisting neck and arm pain does not account for sensory changes outside the affected hand as determined by traditional QST threshold testing. Elevated pain ratings may however be an early indication of central pain mechanisms.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 25 June 2011. Authors prepress title: "Can widespread hypersensitivity in unilateral carpal tunnel syndrome be substantiated if neck and arm pain are absent?" Article first published online: 6 January 2012. Source, EJP via DOI

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Mon, 20 Feb 2012, 13:16:21 EST by Ms Annina Barbara Schmid on behalf of Physiotherapy