Factor analysis of carpal tunnel syndrome questionnaire in relation to nerve conduction studies.

OBJECTIVE: This study aims to assess the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) structure and its relation to nerve conduction studies (NCS). METHODS: A total of 403 patients with clinical and/or electrophysiological definition of CTS were evaluated with the instrument. The structure of the questionnaire was assessed by means of factor analysis. Factors obtained were compared with NCS. RESULTS: Factor analysis showed that three factors represented nearly 60% of the variance of the instrument. Factor one is related to all the function domain questions and to the weakness and difficulty in grasping questions of the symptom domain; factor two to questions that assess numbness and tingling, and to the pain-awakening question of the symptom domain; and factor three, to pain questions of the symptom domain. Factor two had a stronger correlation with latencies of NCS and with the neurophysiological scale than the other two factors. CONCLUSIONS: BCTQ assesses function and symptoms in patients with CTS by means of questions related to numbness and tingling sensation, pain and functional status. Questions related to numbness and tingling (factor two) better reflected the pathophysiology of the median nerve. SIGNIFICANCE: Factor-2 sensory-related questions of BCTQ may be more useful in diagnosis, follow-up and assessing therapeutic outcome in CTS.

Natural evolution of carpal tunnel syndrome in untreated patients.

OBJECTIVE: To describe the clinical and electrophysiological evolution of a group of patients diagnosed with carpal tunnel syndrome (CTS) who have not undergone any type of treatment (injections, braces or surgery). METHODS: Clinical and electrophysiological monitoring was done consecutively in a series of patients who were admitted with a diagnosis of CTS. The average time for follow-up was 2 years. The Historic and objective Classification scale (HiOb) was used to establish the severity of the disease in the test group, and neuro conductions were done to determine the electrophysiological classification. RESULTS: A total of 132 patients were monitored. In 31 patients (23.4% of the cases), the HiOb classification deteriorated, 28.8% remained stable, and 47.6% showed recovery. In the nerve conduction studies, 10 cases (7.6%) exhibited electrophysiological deterioration, 67.4% remained constant and 25% improved. CONCLUSIONS: A significant percentage of patients with carpal tunnel syndrome had no change in their clinical and electrophysiological condition, while some improved spontaneously without treatment. SIGNIFICANCE: Given that most patients diagnosed with CTS remain stable or even improve over time, a conservative treatment may be all that is needed in a selection of patients with this disorder.