Impact of Pain and Somatosensory Phenotype on Carpal Tunnel Surgery
Carpal Tunnel Syndrome: An investigation of the impact of neuropathic Pain and Somatosensory phenotype on post-operative outcome (CAPS)
Imperial College London and ICNHT
14HH2173, Imperial College London AHSC JRCO
Carpal Tunnel Syndrome (CTS) results from entrapment of the median nerve at the wrist. It is common and causes pain and numbness of the hand, interferes with sleep and makes everyday tasks difficult. Surgery for CTS is the most common procedure in the hand however between 15% and 25% of patients report themselves as unimproved or worse following surgery. While it is estimated that prior to surgery, 50% of patients with CTS have neuropathic pain, the effect of neuropathic pain on surgical outcome has not been investigated.
Patients with neuropathic pain present with various associated signs, symptoms and pain qualities. Our hypothesis is that failure to improve, or worsening of symptoms following carpal tunnel surgery may be predicted, not simply by the preoperative presence/absence of neuropathic pain, but by a composite of traits, characteristics, signs and symptoms which reflects inter-individual variation.
This non-interventional observational study will use validated tests and questionnaires prior to surgery and at 3 and 6 months post-surgery to investigate how neuropathic pain affects outcome following carpal tunnel surgery. This National Institute for Health Research/ Higher Education England funded study will be conducted over 4 years at Chelsea and Westminster Hospital and ICHNT. Patients who have been scheduled for carpal tunnel surgery and have no confounding medical conditions including a recent steroid injection or trauma of the surgery hand may be eligible to participate. The study will not impact the Trusts’ customary care for patients with carpal tunnel syndrome. The study will investigate the influence of median nerve function, pain parameters, psychosocial factors, personality traits and quality of life on surgical outcome. We will then develop a screening tool to identify CTS patients at risk of poor outcome with the aim of developing new care pathways and improving surgical outcome.
London - Camberwell St Giles Research Ethics Committee
Date of REC Opinion
29 Aug 2014