Carpal tunnel syndrome and pain

Núñez-Cortés, Rodrigo; Cruz-Montecinos, Carlos; Tapia, Claudio; Pino Pommer, Paula; Pérez-Alenda, Sofía

Keywords: pain, disability evaluation, physical therapy, Carpal tunnel syndrome, Median Neuropathy, Carpal tunnel release, Catastrophization, Anxiety, Depression, Patient-reported outcome measures


Carpal tunnel syndrome (CTS) is a compressive peripheral neuropathy characterized by pain, tingling sensation, and paresthesia in the region of the median nerve. The patient’s medical history, the presence of risk factors, and the characteristics of the symptoms are key aspects for establishing a suitable differential diagnosis. Conservative or surgical treatment of CTS may be indicated depending on both the severity and temporality of the condition. The conservative treatment of mild and moderate CTS includes, among the most common treatments in physiotherapy and occupational therapy, the use of orthoses, physical agents, manual therapy, therapeutic exercises, education, ergonomic interventions, and multimodal intervention. Surgery is indicated in patients for whom conservative treatment has failed and also when presenting severe conditions. In terms of psychosocial factors, catastrophic thinking has proven to be one of the most important predictors of upper extremity disability and is associated with wider areas of pain. Depression and anxiety are highly associated with the postoperative satisfaction of patients and with the severity of symptoms before and after surgery. In short, it is essential to consider psychosocial variables prior to decision-making in CTS management, since they can predict the results of interventions in highly relevant areas for patient satisfaction, such as pain intensity, functional recovery, and returning to work.

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Editorial: Academic Press
Fecha de publicación: 2022
Idioma: Inglés