Prevalence and Correlation of Myofascial Pain Syndrome in Patient with Possible Carpal Tunnel Syndrome

Abstract

Patients with carpal tunnel syndrome (CTS), often complain of pain and paresthesia of fingers and hands. Some may even progress to arms and shoulders. These symptoms can also be found in patients with myofascial pain syndrome (MPS). This study aims to evaluate the prevalence and correlation of myofascial pain syndrome in patients with possibly carpal tunnel syndrome.A total of 125 hands with suspected CTS were performed electrodiagnosis study on, between February-August 2018. Demographic data, chief complaint, pain score, paresthesia score, and presence of myofascial pain syndrome were collected and recorded, then electrodiagnosis studies were performed on. The studied variables were analyzed with a computer program using Chi-square and spearman’s rank correlation. 112 hands (89.6%) were diagnosed with CTS by electrodiagnosis and 56 hands (44.8%) were diagnosed with myofascial pain syndrome. Symptoms within the median nerve distribution were found in only 43 hands (34.4 %). MPS can be found in the group that symptoms spread beyond median nerve distribution more than the group that symptoms were within the median nerve distribution (p = 0.046). If the chief complain was pain, MPS can be found more than that within the paresthesia group (P < 0.001). We also found correlation between pain score and MPS (r2 = 0.596, p < 0.001). When analyzed with the ROC curve, MPS can be found with 76.7% sensitivity and 72.5% specificity (area .840, p < 0.001) when pain score is 5. We conclude that 44.8% of patients with clinical suspicion of CTS have MPS and clinicians should search for MPS if pain is the prominent symptom; if pain or paresthesia is spread beyond median nerve distribution; and if pain score is ≥ 5.