Disability Related to Carpal Tunnel Syndrome May Be Greater Than Related Chronic Hand Conditions

This study used a novel patient disability assessment, the Mississippi Qualitative Hand Pain Questionnaire (MQHPQ), to compare carpal tunnel syndrome (CTS) with other hand pain diagnoses (non-CTS) and then to the levels of impairment in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (ie, AMA Guides).

One hundred prospective patients with a chief complaint of hand pain were administered the MQHPQ. Patients were grouped into CTS and non-CTS groups based on diagnosis at the time of their initial visit. Patient-reported disability was then compared with the percentage of total body impairment assigned by the AMA Guides.

Patients with CTS (n=47) versus non-CTS (n=53) experienced increased severity (0.64 vs. 0.52, P=0.024) and greater levels of disability in all questioned activities of daily living. According to the AMA Guides, CTS can cause a range of 0% to 9% total body impairment (median 4.5%). Other participant hand pain diagnoses demonstrated total body disability ranging from 0% to 22% (average of medians 4.57%).

Although the AMA Guides demonstrates similar percentages of impairment for the CTS group and the non-CTS group, patients with CTS who completed the MQHPQ experienced significantly increased disability in all tested activities of daily living and pain severity.