Electrodiagnostic severity distribution of carpal tunnel syndrome and its clinical correlates
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261207Keywords:
CTS, NCS, Hand, NumbnessAbstract
Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. Nerve conduction studies are used to confirm the diagnosis and classify severity. Understanding the distribution of electrodiagnostic severity and its clinical correlates is important for patient management and healthcare planning.
Methods: This descriptive cross-sectional study included 100 consecutive adult patients with confirmed CTS and completed nerve conduction studies at Jordan University Hospital. Electrodiagnostic severity was classified as mild, moderate, or severe. Demographic characteristics, symptom duration, and comorbidities were analyzed using descriptive statistics. Cross-tabulation was used to examine severity in relation to selected variables.
Results: Severe CTS was the most common category, accounting for 67% of cases. Moderate CTS was observed in 21%, and mild CTS in 12%. Females represented 80% of the study population. Severe disease was proportionally more frequent among females. Patients with moderate and severe CTS were older than those with mild disease. Mean symptom duration increased slightly with greater severity. Hypertension and diabetes mellitus were common in moderate and severe groups. Other comorbidities were less frequent.
Conclusions: Severe electrodiagnostic CTS was predominant in this cohort. Female sex, older age, and certain systemic comorbidities were frequently observed in moderate and severe cases. These findings highlight the importance of early evaluation to reduce progression to advanced disease.
References
Ibrahim I, Khan W, Goddard N, Smitham P. Carpal tunnel syndrome: a review of the recent literature. Open Orthop J. 2012;6(1):69.
Chammas M. Carpal tunnel syndrome. Chir Main. 2014;33(2):75-94.
Singjam A, Charoentanyarak K, Saengsuwan J. Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: a retrospective study. PLoS One. 2021;16(12):e0260578.
Ozdag Y, Hu Y, Hayes DS, Manzar S, Akoon A, Klena JC, et al. Sensitivity and specificity of examination maneuvers for carpal tunnel syndrome: a meta-analysis. Cureus. 2023;15(7):e42383.
Pourmokhtari M, Mazrooyi M, Vosoughi AR. Conservative or surgical treatment of carpal tunnel syndrome based on the severity and patient risk factors. Musculoskelet Surg. 2021;105(3):315-9.
Latinovic R, Gulliford MC, Hughes RAC. Incidence of common compressive neuropathies in primary care. J Neurol Neurosurg Psychiatry. 2006;77(2):263-5.
Thomas M, Hinton A, Heywood A, Shirley R, Chan JKK. Peripheral nerve decompression in the upper limb in spinal cord injury: experiences at the National Spinal Injuries Centre, UK. Spinal Cord Ser Cases. 2021;7(1):1-7.
Lam N, Thurston A. Association of obesity, gender, age and occupation with carpal tunnel syndrome. Aust N Z J Surg. 1998;68(3):190-3.
Karpitskaya Y, Novak CB, Mackinnon SE. Prevalence of smoking, obesity, diabetes mellitus, and thyroid disease in patients with carpal tunnel syndrome. Ann Plast Surg. 2002;48(3):269-73.
Burton CL, Chesterton LS, Chen Y, van der Windt DA. Clinical course and prognostic factors in conservatively managed carpal tunnel syndrome: a systematic review. Arch Phys Med Rehabil. 2016;97(5):836-52.
Conzen C, Conzen M, Rübsamen N, Mikolajczyk R. Predictors of the patient-centered outcomes of surgical carpal tunnel release: a prospective cohort study. BMC Musculoskelet Disord. 2016;17(1):1-9.
Hooper RC, Tong Y, Sanders HM, Wang L, Chung KC. An analysis of treatment choices among White and African American Medicaid patients with carpal tunnel syndrome. Plast Reconstr Surg. 2024;153(3):649-55.
Lakshminarayanan K, Shah R, Li ZM. Sex-related differences in carpal arch morphology. PLoS One. 2019;14(5):e0217425.
Al-Rousan T, Sparks JA, Pettinger M, Chlebowski R, Manson JE, Kauntiz AM, et al. Menopausal hormone therapy and the incidence of carpal tunnel syndrome in postmenopausal women: findings from the Women’s Health Initiative. PLoS One. 2018;13(12):e0207509.
Taams NE, Drenthen J, Hanewinckel R, Ikram MA, van Doorn PA. Age-related changes in neurologic examination and sensory nerve amplitude in the general population. Neurology. 2023;101(13):1351-8.
Duncan SFM, Bhate O, Mustaly H. Pathophysiology of carpal tunnel syndrome. Neurosciences. 2015;20(1):4.
Ozkul Y, Sabuncu T, Kocabey Y, Nazligul Y. Outcomes of carpal tunnel release in diabetic and non-diabetic patients. Acta Neurol Scand. 2002;106(3):168-72.
Zimmerman M, Gottsäter A, Dahlin LB. Carpal tunnel syndrome and diabetes: a comprehensive review. J Clin Med. 2022;11(6):1674.
Sharief F, Kanmani J, Kumar S. Risk factors, symptom severity and functional status among patients with carpal tunnel syndrome. Neurol India. 2018;66(3):743-6.
Smerilli G, Di Matteo A, Cipolletta E, Carloni S, Incorvaia A, Di Carlo M, et al. Ultrasound assessment of carpal tunnel in rheumatoid arthritis and idiopathic carpal tunnel syndrome. Clin Rheumatol. 2021;40(3):1085-92.