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Abstract Number: 253

Evaluating Neuropathic Complaints By DN4 and Lanss Scales after Local Corticosteroid Therapy in Carpal Tunnel Syndrome

Taner Dandinoglu1, Murat Karadeniz2, Volkan Yılmaz3, Levent Tekin4 and Ümit Dinçer4, 1Physical Medicine and Rehabilitation, Bursa Military Hospital, Bursa, Turkey, 2Physical Medicine and Rehabilitation, Çorlu Military Hospital, Tekirdağ, Turkey, 3Physical Medicine and Rehabilitation, Mevki Military Hospital, Ankara, Turkey, 4Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Haydarpaşa Training Hospital, İstanbul, Turkey

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Carpal tunnel syndrome, neuropathy, pain management and steroids

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Session Information

Title: Pain: Basic and Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose:

       The purpose of this study was to evaluate the neuropathic symptoms after  local steroid injection in CTS. Since 2001, neuropathic pain scales have been used in the assessment and follow-up of neuropathic pain. DN4 and LANSS pain questionnaires have been applied to groups, mostly consisted of radiculopathy and polyneuropathy cases, before and after various treatments and the results have been compared with the electrophysiologic findings. However to our knowledge there is yet no such study focusing on neuropathic complaints and the relationship between neuropathic pain and electrophysiological findings before and after local corticosteroid injection.

Methods:

       Forty-one patients aged 22-65 years and diagnosed with carpal tunnel syndrome by nerve conduction studies who were also found to have a neuropathic symptoms were included in the study. All patients received local steroid injection into the carpal tunnel while the questionnaires and nerve conduction studies were performed before and 2 months after the injection.  

Results:

       Local steroid injection was found effective on clinical and electrophysiologic parameters as well as on DN4 and LANSS scores in CTS patients (p<0.05) (Table 1). Electrophysiologic severity exhibited no statistically significant relationship with DN4 and LANSS scores, before and after treatment (p>0.05).

Conclusion:

       These findings suggests that the treatment of neuropathic complaints should be planned independently from the electrophysiologic findings and minimally invasive local steroid injection appears to be effective  with regard to clinical and electrophysiologic aspects in CTS patients with neuropathic complaints.

Table 1. DN4 and LANSS Scores Before and After the Treatment

 

Pre-Treatment

Post-Treatment

Difference

P

Mean±SD

Mean±SD

Mean±SD

DN4

6.12±1.50 (6.00)

1.46±1.96 (1.00)

-4.65±1.51

0.001**

LANSS

15.85±2.71 (16.00)

3.22±5.16 (0.00)

-12.63±4.83

0.001**

  Wilcoxon Signed Ranks Test                                 **p<0.01

 DN4: Douleur Neuropathique 4

 LANSS: Leeds Assessment of Neuropathic Symptoms and Signs


Disclosure:

T. Dandinoglu,
None;

M. Karadeniz,
None;

V. Yılmaz,
None;

L. Tekin,
None;

Dinçer,
None.

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