The Frequency of Fibromyalgia in Patients Presenting with Symptoms of Carpal Tunnel Syndrome

Abstract

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It is characterized by complaints such as pain, numbness and weakness in the hands. Fibromyalgia (FM) is a chronic musculoskeletal disease accompanied by widespread pain. In a wide range of symp-toms, complaints of paresthesia are common and can be confused with CTS. There are few studies investigating the frequency of CTS in patients with FM, and the results have been contradictory. The aim of this study is to investigate whether there is a difference in terms of FM between the electrophysiologically confirmed and not confirmed CTS patients. Female patients who admitted to the Physical Medicine and Rehabilitation Outpatient Clinic and were referred to the electrophysiology laboratory with a preliminary diagnosis of CTS were included in the study. FM 2016 ACR diagnostic criteria were applied to all patients and the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), Fibromyalgia Severity Score (FSS) were recorded.As a result of the nerve conduction study, 30 CTS positive and 25 CTS negative patients were included in the study. There was no difference between the two groups according to age and body mass index. FM was diag-nosed according to ACR 2016 criteria in 26.7% of those with CTS, and 24% of those without and there was no statistically significant differ-ence between the two groups. No statistical difference was found between the groups according to WPI, SSS and FSS. On the other hand, when the two groups with and without FM were compared, the median nerve conduction velocities were significantly slower in the group without FM. As a result, the prevalence of FM is high in CTS patients. Since there are significant differences in the median nerve conduction velocities of CTS patients with and without FM, electrophysiological confirmation may be recommended for CTS diagnosis in FM patients.

Keywords

• Fibromyalgia
• Carpal tunnel syndrome
• Nerve conduction study

Karpal Tünel Sendromu Semptomları ile Başvuran Hastalarda Fibromiyalji Sıklığı

Abstract

Karpal tünel sendromu (KTS), en sık görülen tuzak nöropatisidir. Ellerde ağrı, uyuşma ve kuvvetsizlik gibi yakınmalarla karakterizedir. Fibromiyalji (FM) ise yaygın ağrının eşlik ettiği kronik kas iskelet sistemi hastalığıdır. Geniş semptom yelpazesi içinde parestezi yakınması sık görülmekte olup KTS ile karışabilmektedir. FM’li hastalarda KTS sıklığını araştıran az sayıda çalışma olup sonuçlar çelişkili bulunmuş-tur. Bu çalışmada amaç, klinik olarak KTS ile uyumlu yakınmaları olup sinir ileti çalışmalarında KTS saptanan ve saptanmayan iki grup arasında FM açısından farlılık olup olmadığını araştırmaktır. Fiziksel Tıp ve Rehabilitasyon Polikliniği’ne başvuran ve KTS ön tanısı ile elektrofizyoloji laboratuvarına yönlendirilen kadın hastalar çalışmaya dahil edilmiştir. Tüm hastalara FM 2016 ACR tanı kriterleri uygulan-mış ve Yaygın Ağrı İndeksi (YAİ), Semptom Şiddet Skalası (SSS), Fibromiyalji Şiddet Skoru (FŞS) kaydedilmiştir. Hastalar elektrofizyolo-jik olarak KTS saptanan ve saptanmayan iki gruba ayrılarak sonuçlar karşılaştırılmıştır. Çalışmaya ellerde uyuşma yakınması olan ve sinir ileti çalışması sonucunda 30 KTS pozitif, 25 KTS negatif hasta alındı. İki grup arasında yaşa ve beden kitle indeksine göre farklılık saptan-madı. KTS saptananların %26,7’sinde, saptanmayanların %24’ünde ACR 2016 kriterlerine göre FM saptanmış olup, iki grup arasında istatis-tiksel olarak anlamlı fark bulunmamıştır. YAİ, SSS ve FŞS incelendiğinde de gruplar arasında istatistiksel fark saptanmamıştır. Diğer yandan FM saptanan ve saptanmayan iki grup karşılaştırıldığında FM saptanmayan grupta median sinir ileti hızları anlamlı olarak daha yavaş bulun-du. Sonuç olarak, KTS hastalarında FM prevalansı yüksek bulunmuştur. FM olan ve olmayan KTS hastalarının median sinir iletim hızların-da anlamlı farklılıklar olduğundan, FM hastalarında KTS tanısı için elektrofizyolojik doğrulama önerilebilir.

Keywords

• fibromiyalji
• , karpal tünel sendromu
• sinir ileti çalışması

Thanks

Dr.Cemre Güler, Dr.Burcu Sezer ve Dr.Gökhan Ocakoğlu'na veri toplama ve istatistiksel analizler konusundaki desteklerinden dolayı teşekkür ederim.

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