Investigation of the Relationship Between Pain Sensitization and Diagnostic Parameters in Carpal Tunnel Syndrome
- Conditions
- Central SensitisationCarpal Tunnel Syndrome
- Interventions
- Diagnostic Test: Nerve ultrasoundDiagnostic Test: Nerve conduction studiesDiagnostic Test: Pressure pain threshold
- Registration Number
- NCT06043141
- Lead Sponsor
- Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
- Brief Summary
The aim of this observational, cross-sectional study is to investigate the relationship between pain sensitization and ultrasonographic and nerve conduction studies in patients diagnosed with carpal tunnel syndrome (CTS).
The main questions it aims to answer are:
* Can threshold values be determined ultrasonographically and electrodiagnostically in patients who develop pain sensitization?
* Are pressure pain threshold values and central sensitization inventory scores correlated with ultrasonographic and nerve conduction studies of the median nerve?
- Detailed Description
Carpal tunnel syndrome (CTS) is the most common nerve entrapment and the main mechanism is compression of the median nerve under the transverse ligament at the wrist level. Its incidence varies between 6.3-11.7% in the general population. In CTS, neuropathic complaints such as numbness, burning and tingling in the palmar face of the first two fingers, which are the innervation area of the median nerve, and fatigue in the hand are the most common symptoms. However, it has been reported that these complaints in most patients are not limited to the innervation area of the median nerve but also spread to other neighboring areas. This has been found to be associated with the development of central sensitization in CTS patients, and extra-median symptoms are suggested to be a clinical marker of pain sensitization. The term central sensitization is explained as an increase in pain sensitivity due to the amplification of neuron-derived signals in the central nervous system.Research shows that ongoing damage to the median nerve stimulates neurons located in the central nervous system, advancing the central sensitization process. Although the diagnosis of CTS is made electrodiagnostically with typical clinical findings, in recent years ultrasound has been frequently used in the diagnosis of CTS because it is non-invasive, fast and reliable. Cross-sectional area and echogenicity of the median nerve are the most frequently evaluated parameters at the carpal tunnel with ultrasound. Studies focus on the clinical relationship of central sensitization in CTS, but its relationship with ultrasonographic and electrodiagnostic data is not yet known.Based on this, this study aimed to investigate the relationship between pain sensitization and electrodiagnostic and ultrasonographic parameters in patients diagnosed with CTS.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
- Being diagnosed with carpal tunnel syndrome based on clinical and electrodiagnostic findings
- Agreeing to participate in the study
- Concomitant history of diabetes, systemic inflammatory disease, active infection and malignancy
- Having a disease with neuropathic pain such as polyneuropathy, radiculopathy,multiple sclerosis
- Not agreeing to participate in the study
- History of surgery due to CTS
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Patients with carpal tunnel syndrome Pressure pain threshold Patients with carpal tunnel syndrome Patients with carpal tunnel syndrome Nerve ultrasound Patients with carpal tunnel syndrome Patients with carpal tunnel syndrome Nerve conduction studies Patients with carpal tunnel syndrome
- Primary Outcome Measures
Name Time Method Pressure pian threshold 3 months Pain pressure threshold (PPT) is used to measure deep muscular tissue sensitivity. Algometer is used in the measurement and low values are interpreted in favor of increased sensitivity.
- Secondary Outcome Measures
Name Time Method Short form-12 3 months The 12-item Short Form Questionnaire (SF-12) is used for objective measurement of quality of life. Low scores are associated with poor in quality of life.
Self Leeds Assessment of Neuropathic Symptoms and Sign (S-LANSS) 3 months S-LANSS is a 7-question scale used to define pain of neuropathic origin and a score of 12 points or more is in favor of the presence of neuropathic pain.
Central sensitization inventory (CSI) 3 months Clinical instrument used in the diagnosis of central sensitization. A CSI part-A score of 40 and above is significant in the diagnosis.
Upper extremity nerve conduction studies 3 months Latency, conduction velocity and amplitude values obtained in bilateral median-ulnar motor and sensory nerve conduction studies.
Visual analog scale 3 months The visual analog scale (VAS) is a validated subjective measure for pain, scored in the 0-10 range (0:no pain; 10: worst pain).
hand grip strength 3 months Grip strength is a measure of muscle strength or the maximum force/tension produced by one's forearm muscles and is measured with a hand dynamometer.
Boston Carpal Tunnel Questionnaire (BCTQ) 3 months The Boston Carpal Tunnel Score is a patient-reported questionnaire that examines symptom severity and overall functional status of patients with carpal tunnel syndrome. Two subscores are calculated: Symptom Severity Scale (SSS) and Functional Status Scale (FSS); higher scores indicate worse symptoms or function.
median nerve ultrasound 3 months Median nerve cross-sectional area and echogenicity measurement
Trial Locations
- Locations (1)
Sultan Abdülhamid Han Training and Research Hospital
🇹🇷Istanbul, Uskudar, Turkey