Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
Clin J Pain. 2011 Nov-Dec;27(9):747-54. doi: 10.1097/AJP.0b013e31821c29d3.
To determine the differences in widespread pressure pain and thermal hypersensitivity in women with minimal, moderate, and severe carpal tunnel syndrome (CTS) and healthy controls.
A total of 72 women with CTS (19 with minimal, 18 with moderate, and 35 with severe) and 19 healthy age-matched women participated. Pressure pain thresholds were bilaterally assessed over the median, ulnar, and radial nerves, the C5 to C6 zygapophyseal joint, the carpal tunnel, and the tibialis anterior muscle. In addition, warm and cold detection thresholds and heat and cold pain thresholds were bilaterally assessed over the carpal tunnel and the thenar eminence. All outcome parameters were assessed by an assessor blinded to the participant's condition.
No significant differences in pain parameters among patients with minimal, moderate, and severe CTS were found. The results showed that PPT were significantly decreased bilaterally over the median, ulnar, and radial nerve trunks, the carpal tunnel, C5 to C6 zygapophyseal joint, and the tibialis anterior muscle in patients with minimal, moderate, or severe CTS as compared with healthy controls (all, P<0.001). In addition, patients with CTS also showed lower heat pain threshold and reduced cold pain threshold compared with controls (P<0.001). No significant sensory differences between minimal, moderate, or severe CTS were found.
The similar widespread pressure and thermal hypersensitivity in patients with minimal, moderate, or severe CTS and pain intensity suggests that increased pain sensitivity is not related to electrodiagnostic findings.
确定轻度、中度和重度腕管综合征(CTS)女性与健康对照组之间广泛压痛和热敏感差异。
共有 72 名 CTS 女性(轻度 19 名,中度 18 名,重度 35 名)和 19 名年龄匹配的健康女性参加。双侧评估正中神经、尺神经、桡神经、C5 到 C6 关节突关节、腕管和胫骨前肌的压力疼痛阈值。此外,双侧评估腕管和大鱼际的温觉和冷觉阈值以及热痛和冷痛阈值。所有结果参数均由对参与者状况不知情的评估员评估。
轻度、中度和重度 CTS 患者之间的疼痛参数无显著差异。结果显示,与健康对照组相比,轻度、中度或重度 CTS 患者双侧正中神经、尺神经、桡神经干、腕管、C5 到 C6 关节突关节和胫骨前肌的 PPT 均显著降低(均 P<0.001)。此外,CTS 患者的热痛阈值也较低,冷痛阈值也降低(均 P<0.001)。轻度、中度或重度 CTS 之间没有明显的感觉差异。
轻度、中度和重度 CTS 患者广泛的压痛和热敏感以及疼痛强度相似,表明疼痛敏感性增加与电诊断结果无关。