Turkish Journal of Physical Medicine and Rehabilitation 2005 , Vol 51 , Num 4

Pain Frequency at Night Reflects Median Nerve Injury in Carpal Tunnel Syndrome

Abdulkadir Koçer 1 ,Ülkü Türk Börü 2
1 Bezmialem Vakıf Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye
2 Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Nöroloji Kliniği, İstanbul

Objective: Assessment of pain is useful in evaluating the median nerve entrapment in wrist. We aimed to examine the relationships between characteristics of pain and clinical severity of carpal tunnel syndrome (CTS).

Materials and Methods: In this prospective study, the characteristics (severity, frequency, occurrence during day life or night) of pain were evaluated by using modified self-administered Symptom Severity Questionnaire with idiopathic carpal tunnel syndrome. The diagnosis of CTS was made clinically and electrophysiologically. We assessed the relationship between electrophysiological findings and pain in 41 patients (32 female and 9 male) with idiopathic CTS.

Results: Sixty-three hands (38 left hands, 25 right hands) with CTS were included in this study. The mean age was 43.9±12.1 (Range: 23-78) years. Although a previous study reported a strong relationship between clinical and neurophysiologic findings, we found a significant correlation only between nocturnal pain frequency and median nerve compound muscle action potential amplitudes (p=0.03). This significant correlation was independent from gender, age, side of entrapment, other parameters of nerve conduction studies, and other characteristics of pain. We did not find any correlation between pain scores and other median nerve conduction study parameters.

Conclusion: Based on these findings, we suggest that nocturnal pain frequency has biological significance and better reflect median nerve injury. 

Keywords : Nocturnal pain, symptom severity scale, carpal tunnel syndrome, nerve conduction studies