Bariatric surgery is associated with lower incidence of carpal tunnel syndrome

Obesity is related with increased risk for carpal tunnel syndrome (CTS). The effect of bariatric surgery (BS) on the incidence of nerve entrapments is undetermined. We aimed to evaluate the incidence of CTS following BS in a large cohort study.

A retrospective cohort study of patients with obesity who underwent BS was conducted. The incidence of CTS in the 5-years pre- and post BS was compared. Patients who developed CTS following BS were compared to those who did not.

Six-thousand, one-hundred and twenty-four patients met the inclusion criteria. The average age was 41.2 (SD 12.9) years, most were female (68.6%). The average pre-operative BMI was 42.9 (SD 5.4). Most patients underwent restrictive surgery. The incidence of CTS at the 5-years prior to the BS was significantly higher than the post BS incidence, 8.4% versus 5.1% respectively (p < 0.001) despite the aging of the cohort. Patients who developed CTS following the BS were older and had a higher prevalence of hypertension and diabetes mellitus prior to the BS. They had a higher BMI and excess body weight at every time point measured and a lower BMI reduction. Weight regain was not associated with increased incidence of CTS. Finally, a direct correlation between excess weight loss to greater reduction in the incidence of CTS was noted.

BS was found to be associated with reduced incidence of developing CTS. There is a dose-response association where greater weight loss following BS is protective of developing CTS.