Determinants of remission in medically treated carpal tunnel syndrome: Study from Central India

• Main Authors: Ajoy Sodani, Raunak Dani, Mukesh Dube, Dinesh Choukesey, Sunil Athale
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Annals of Indian Academy of Neurology
• Subjects: Carpal tunnel syndrome; grading scale; nerve conduction; prognostic factors; outcome
• Online Access: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2018;volume=21;issue=1;spage=29;epage=34;aulast=Sodani

Background: The factors associated with the spontaneous remission (SR) of symptoms in carpal tunnel syndrome (CTS) are not well known. Objectives: To look for determinants of SR in medically treated, electrophysiologically proven patients of CTS. Methods: We revisited the medical records and nerve conduction study data of 130 hands with CTS and divided them into two groups as per the absence or persistence of the symptoms when contacted after a median time lapse of 3 years following the diagnosis. Results: SR occurred in 46.1% of the hands. Higher odds of SR were linked with female gender, symptoms restriction to lateral fingers, symptom duration <10 months, mildly delayed median motor and sensory distal latencies, and median sensory amplitude >20 μV. We developed a seven-point scale, on which a score of ≥4 had a strong association (odds ratio 4.31) with SR. Discussion and Conclusion: No single risk factor, standalone, can predict SR in patients with CTS, which could lead to an invasive treatment (Surgery or local injection) to them. We propose that patients scoring ≥4 on our 7 point scale should be treated medically for the initial 10 months after the symptom onset.