ArticleBMJ open2017
Association of psychological distress, quality of life and costs with carpal tunnel syndrome severity: a cross-sectional analysis of the PALMS cohort.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Psychology of nerve injury, repair, and recovery: a systematic review.Frontiers in rehabilitation sciences · 2024Pooled it
- Does Societal Cost Information Affect Patient Decision-Making in Carpal Tunnel Syndrome? A Randomized Controlled Trial.Hand (New York, N.Y.) · 2021Trial
- Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome: A prospective randomized, single-blind trial.International journal of medical sciences · 2021Trial
- Palmitoylethanolamide: A Multifunctional Molecule for Neuroprotection, Chronic Pain, and Immune Modulation.Biomedicines · 2025Article
- Ultrasound Characteristics of Carpal Tunnel Syndrome in the Spanish Population.Journal of clinical ultrasound : JCU · 2025Observational
- Factors Associated with Preoperative Anxiety in Patients Undergoing Ambulatory Hand Surgery: A Cross-Sectional Observational Study.Journal of clinical medicine · 2024Article
- External wrist ratio is not a proxy for internal carpal tunnel shape: Implications for evaluating carpal tunnel syndrome risk.Clinical anatomy (New York, N.Y.) · 2024Article
- Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication.Journal of clinical medicine · 2022Article
- Article
- Radiographs and Corticosteroid Injections at a New Patient Visit for Care of Carpal Tunnel Syndrome and Ulnar Neuropathy at the Elbow.Journal of hand and microsurgery · 2022Article
- Is psychological distress associated with carpal tunnel syndrome symptoms and nerve conduction study findings? A case-control study from Syria.Brain and behavior · 2022Article
- Beyond the Knife-Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions.Journal of personalized medicine · 2021Review
- Article
- Predicting outcomes of conservative treatment for patients with carpal tunnel syndrome: Group- and individual-based rehabilitation.Hong Kong journal of occupational therapy : HKJOT · 2021Article
- Palmitoylethanolamide: A Natural Compound for Health Management.International journal of molecular sciences · 2021Review
- Quantitative Models for Prediction of Cumulative Trauma Disorders Applied to the Maquiladora Industry.International journal of environmental research and public health · 2021Article
- Is There a Role of Cupping Therapy in the Treatment of Carpal Tunnel Syndrome in Primary Care Setting?Cureus · 2021Review
- Carpel tunnel syndrome: A link with vitamin D and calcium.Biomedical reports · 2020Article
- Acupuncture plus night splint for quality of life and disability in patients with carpal tunnel syndrome: a randomized controlled trial.Integrative medicine research · 2019Article
- Characteristics of Traditional Chinese Medicine Use for Carpal Tunnel Syndrome.International journal of environmental research and public health · 2019Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesThe Prediciting factors for response to treatment in carpal tunnel syndrome (PALMS) study is designed to identify prognostic factors for outcome from corticosteroid injection and surgical decompression for carpal tunnel syndrome (CTS) and predictors of cost over 2 years. The aim of this paper is to explore the cross-sectional association of baseline patient-reported and clinical severity with anxiety, depression, health-related quality of life and costs of CTS in patients referred to secondary care.
methodsProspective, multicentre cohort study initiated in 2013. We collected baseline data on patient-reported symptom severity (CTS-6), psychological status (Hospital Anxiety and Depression Scale), hand function (Michigan Hand Questionnaire) comorbidities, EQ-5D-3L (3-level version of EuroQol-5 dimension) and sociodemographic variables. Nerve conduction tests classified patients into five severity grades (mild to very severe). Data were analysed using a general linear model.
results753 patients with CTS provided complete baseline data. Multivariable linear regression adjusting for age, sex, ethnicity, duration of CTS, smoking status, alcohol consumption, employment status, body mass index and comorbidities showed a highly statistically significant relationship between CTS-6 and anxiety, depression and the EQ-5D (p<0.0001 in each case). Likewise, a significant relationship was observed between electrodiagnostic severity and anxiety (p=0.027) but not with depression (p=0.986) or the EQ-5D (p=0.257). National Health Service (NHS) and societal costs in the 3 months prior to enrolment were significantly associated with self-reported severity (p<0.0001) but not with electrodiagnostic severity.
conclusionsPatient-reported symptom severity in CTS is significantly and positively associated with anxiety, depression, health-related quality of life, and NHS and societal costs even when adjusting for age, gender, body mass index, comorbidities, smoking, drinking and occupational status. In contrast, there is little or no evidence of any relationship with objectively derived CTS severity. Future research is needed to understand the impact of approaches and treatments that address psychosocial stressors as well as biomedical factors on relief of symptoms from carpal tunnel syndrome.
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