Pain Phenotyping in Carpal Tunnel Syndrome Based on IASP Criteria: A Cross-Sectional Study
Clinical Journal of Pain, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/ajp.0000000000001411
- Dergi Adı: Clinical Journal of Pain
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Psycinfo
- Anahtar Kelimeler: Carpal tunnel syndrome, central sensitization, mixed pain phenotype, nociplastic pain, pain phenotype
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: – The primary aim of this study is to determine the pain phenotype in carpal tunnel sydrome (CTS) using an algorithm to support clinical reasoning processes. A secondary aim entails examining whether symptom severity, functional status, health related quality of life (HRQoL) and electrodiagnostic findings differs between the pain phenotypes in CTS. Methods: – This cross-sectional study included 113 patients with CTS. Following the electrodiagnostic assessments, participants completed the Margolis pain diagram, Numeric Pain Rating Scale, Boston Carpal Tunnel Questionnaire, and Short Form-36 (SF-36). Clinical sensory examinations were performed, and pain phenotypes were classified using an IASP-aligned clinical phenotyping approach. Between-group differences were analyzed using covariate-adjusted multivariate models (MANCOVA), controlling for age, sex, pain intensity, and symptom duration. Results: – Of the participants, 53 (46.9%) were classified as having a neuropathic pain phenotype and 60 (53.1%) as having a mixed pain phenotype. Significant differences were observed between groups in symptom severity (P=0.035), functional status (P=0.0001), selected SF-36 domains (P=0.043–0.002), and electrodiagnostic parameters, including motor latency (P<0.001), motor amplitude (P=0.019), sensory amplitude (P<0.001) and sensory conduction velocity (P=0.001). The neuropathic pain group demonstrated more favorable electrophysiological findings, as well as better symptom severity, functional status and HRQoL scores. Discussion: – In this study, approximately half of the patients were classified as neuropathic pain phenotype and the other half as mixed pain phenotype. Patients with a mixed pain phenotype exhibited worse clinical, functional, and electrodiagnostic profiles compared to those with neuropathic pain. Pain phenotyping may support improved clinical characterization and patient stratification in CTS.