Background & Aims

Widespread pain may be related to psychosocial aspects in several musculoskeletal conditions, but specific information regarding carpal tunnel syndrome (CTS) remains limited. This study aimed to explore the association between the extent of pain and psychological factors, including catastrophizing, kinesiophobia, anxiety symptoms, and depression, in people with CTS. A secondary objective was to analyze the relationship between these psychological factors and other pain characteristics, such as the number of unconnected objects, intensity and entropy.

Methods

A cross-sectional study was carried out on patients diagnosed with carpal tunnel syndrome (CTS), who were recruited from two public hospitals in Chile: Hospital Clínico La Florida and Hospital Provincia Cordillera. The independent variables examined included pain intensity , disability (assessed through the QuickDASH), duration of symptoms, symptoms of anxiety and depression, catastrophizing and kinesiophobia. The main outcome measured was the extent of pain (% of total area and categories “pain within the median nerve-innervated territory” versus “extra-median nerve pain”). For the correlation analysis, Spearman’s correlation coefficient was used. In addition, a linear regression model and a binary logistic regression, both with forward selection, were implemented to determine the main predictors of the extent of pain.

Results

Forty-eight participants, with an average age of 51.6 ± 9.8 years, were included in the study. A moderate positive correlation was observed between catastrophizing (r=0.455; p=0.024) and disability (r=0.448; p=0.024) with total pain extent area. No significant correlations were observed for the other correlations (p>0.05). Regression analyses revealed that catastrophizing explained 22% of the variance in pain extent (?=0.003; 95% CI: 0.002-0.005), while kinesiophobia was the variable that best explained the distribution of pain in the extra-median territory (R2 Nagelkerke=0.182). Null or weak correlations were identified for the remaining associations.

Conclusions

Catastrophizing and kinesiophobia emerge as the main indicators for the extent of pain, both in terms of the percentage of the affected area and the distribution of pain within the extra-median nerve territory. It is recommended that clinicians employ specific questionnaires to assess the presence of catastrophizing and kinesiophobia, particularly in cases of wider pain extension. This approach can facilitate targeted interventions that address these psychological factors, potentially mitigating the impact of pain.

References

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Shin YH, Yoon JO, Kim YK, et al. Psychological Status Is Associated With Symptom Severity in Patients With Carpal Tunnel Syndrome. J Hand Surg Am 2018; 43: 484.e1–484.e8.
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Presenting Author

Giselle Horment-Lara

Poster Authors

Giselle Horment

MSc

University of Chile

Lead Author

E-mail

Jose Carrasco-Plaza

MSc

Lead Author

E-mail

Joaquín Salazar-Méndez

PT

Universidad Santo Tomás

Lead Author

E-mail

Serghio Torreblanca-Vargas

MSc

Lead Author

E-mail

Sofía Pérez-Alenda

PhD

Lead Author

E-mail

Joaquín Calatayud

PhD

University of Valencia

Lead Author

E-mail

Enrique Lluch

PT

University of Valencia

Lead Author

E-mail

Carlos Cruz-Montecinos

PT

University of Chile

Lead Author

E-mail

Mauricio Cerda

PhD

Lead Author

E-mail

Rodrigo Núñez-Cortés

PhD

University of Chile

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Neuropathic Pain - Peripheral