Outcome of endoscopic carpal tunnel release in patients with chronic nonhand pain compared with those without chronic pain.

PURPOSE

This prospective observational study compared the outcomes of single-port endoscopic carpal tunnel release in patients taking narcotic pain medication chronically for back, neck, leg, or other bodily pain for more than 3 months, with patients not taking chronic narcotic pain medication (control group).

METHODS

Patients undergoing endoscopic carpal tunnel release completed the Levine-Katz carpal tunnel questionnaire (primary outcome) and the Disabilities of the Arm, Shoulder, and Hand questionnaire preoperatively, at 2, 4, 6, and 12 weeks, and at 1 year after surgery. We measured subjective satisfaction with surgery at each postoperative time point as well.

RESULTS

There were 14 patients in the chronic narcotic pain group and 68 in the control group. Both groups showed significant improvement in the Levine-Katz symptom and functional scores and in the Disabilities of the Arm, Shoulder, and Hand score (compared with preoperative) at nearly all times. The control group showed better scores at the early time points, but by 6 weeks, there was no difference between groups. Patient satisfaction was excellent in both groups.

CONCLUSIONS

Patients who had carpal tunnel syndrome and who were receiving narcotic pain medication chronically for nonhand pain benefited from endoscopic carpal tunnel release. These patients experienced a longer recovery period but ultimately achieved the same outcomes as patients without chronic pain, as measured by the Levine-Katz scores and the DASH score.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic I.