Frequency of carpal tunnel syndrome and its related risk factors in patients upper extremity pain

The prototypical injury of the median nerve at the wrist is either an acute or chronic compressive lesion referred to as carpal tunnel syndrome (CTS). The present study was conducted to determine the individual risk factors for carpal tunnel syndrome (CTS) in subjects referred to Department of Physical Medicine and Rehabilitation of Shoha-Tajrish Hospital.

A cross sectional study was performed on 1000 patients with upper limbs pain, among whom 250 cases (34 men and 216 women) aged 18-69 years were diagnosed to have CTS on basis of clinical history and electrodiagnostic criteria. Following factors were compared between CTS patients and controls: body mass index (BMI), wrist A-P/M-L diameter, occupation, average daily hours of computer use, history of steroid use, family history, diabetes mellitus, thyroid disease, chronic heart failure, renal failure, history of wrist and distal radius fracture, smoking, alcohol drinking, use of OCP, history of hysterectomy, pregnancy, menopause, radiculopathy, associated rheumatologic disease and other soft tissue rheumatism.

The frequency of CTS among the studied subjects was 25%. Mean BMI was higher in patients with CTS in both genders (p<0.000), but increasing of BMI excess 30, didn’t raise the risk of CTS (NS). Wrist (A-P/M-L) dimension was found to be higher in CTS group (p<0.05). Steroid use was 2% in control group and 8% in CTS group (p<0.05). Colleś fracture was only reported among 2.4% of CTS subjects (p<0.05). Diabetes mellitus was 4% in controls versus 11.2% in CTS group (p<0.05). Severe CTS was associated with the following factors: BMI≥25, WD>0.7 and duration>6 month, female gender, and diabetes mellitus and Colleś fracture, in both genders.

The prevalence of syndrome was quite high, therefore, supplementary investigation should be performed. The wrist A-P/M-L dimension was higher in both genders of CTS group, thus we suggest wrist A-P/M-L dimension as a risk factor for CTS, however it could be explained as a consequence of CTS pathology.