Carpal Tunnel Syndrome: Neuropathic Pain Associated or Not with a Nociplastic Condition

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MARC

Fernandez-de-las-Penas, C. (author)

Carpal Tunnel Syndrome: Neuropathic Pain Associated or Not with a Nociplastic Condition

Article/chapterEnglish2023

Publisher, publication year, extent ...

2023

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LIBRIS-ID:oai:gup.ub.gu.se/327826
https://gup.ub.gu.se/publication/327826URI
https://doi.org/10.3390/biomedicines11061744DOI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

Carpal tunnel syndrome (CTS) has been traditionally classified as primarily a neuropathic condition with or without pain. Precision medicine refers to an evidence-based method of grouping patients based on their susceptibility to biology, prognosis of a particular disease, or in their response to a specific treatment, and tailoring specific treatments accordingly. In 2021, the International Association for the Study of Pain (IASP) proposed a grading system for classifying patients into nociceptive, neuropathic, or nociplastic phenotypes. This position paper presents data supporting the possibility of subgrouping individuals with specific CTS related-pain into nociceptive, neuropathic, nociplastic or mixed-type phenotypes. Carpal tunnel syndrome is a neuropathic condition but can also be comorbid with a nociplastic pain condition. The presence of extra-median symptoms and the development of facilitated pain processing seem to be signs suggesting that specific CTS cases can be classified as the nociplastic pain phenotype. The clinical responses of therapeutic approaches for the management of CTS are inconclusive. Accordingly, the ability to identify the predominant pain phenotype in patients with CTS could likely be problematic for producing efficient treatment outcomes. In fact, the presence of a nociplastic or mixed-type pain phenotype would explain the lack of clinical effect of treatment interventions targeting the carpal tunnel area selectively. We propose a clinical decision tree by using the 2021 IASP classification criteria for identifying the predominant pain phenotype in people with CTS-related pain, albeit CTS being a priori a neuropathic pain condition. The identification of a nociplastic-associated condition requires a more nuanced multimodal treatment approach to achieve better treatment outcomes.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Farmakologi och toxikologi hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Pharmacology and Toxicology hsv//eng
carpal tunnel syndrome
median nerve
nociceptive
neuropathic
nociplastic pain
precision medicine
peripheral drive
central
sensitization
sensitivity
symptoms
neuroplasticity
definition
prevalence
deficits
therapy
surgery
system
Biochemistry & Molecular Biology
Research & Experimental Medicine
Pharmacology & Pharmacy

Added entries (persons, corporate bodies, meetings, titles ...)

Fuensalida-Novo, S. (author)
Nijs, JoGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering,Institute of Neuroscience and Physiology, Department of Health and Rehabilitation (author)
Basson, A. (author)
Plaza-Manzano, G. (author)
Valera-Calero, J. A. (author)
Arendt-Nielsen, L. (author)
de-la-Llave-Rincon, A. I. (author)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering (creator_code:org_t)

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In:Biomedicines11:62227-9059

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Pharmacology and ...

Articles in the publication: Biomedicines

By the university: University of Gothenburg

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