Association of psychological factors with limb disability in patients with cervical radiculopathy: comparison with carpal tunnel syndrome

Abstract

Background Regarding musculoskeletal conditions, patient’s psychological distress, are shown to be associated with higher disability. Cervical radiculopathy (CR) and carpal tunnel syndrome (CTS), are two conditions caused by entrapment of cervical nerve roots and carpal median nerve, respectively. This study aims to investigate the association of psychological factors including depression, anxiety, and pain catastrophizing, with measures of upper limb patient-reported and performance-based disability, in patients with CR, and compare the obtained results with our similar study on CTS. Methods In a cross-sectional study, we recruited 92 patients with CR, and investigated their disability level using patient-reported questionnaires (Quick Disabilities of the Arm, Shoulder and Hand (DASH) and pain Likert Scale) and by measuring grip and pinch strength. We also assessed their psychological status with Hospital Anxiety and Depression Scale questionnaire for depression (HADS-D) and anxiety (HADS-A) and also Pain Catastrophizing Scale (PCS) tools. We performed correlational coefficient analysis between disability and psychological scores and regression analysis of dependent variables (Pain, DASH, grip and pinch scores) and independent (psychological) variables. Finally, Z observed value was calculated to compare correlational coefficients between two diseases of CTS and CR. Results The results of the correlational coefficient analysis indicate that all three HADS-A, HADS-D and PCS scores correlated with DASH score (r = 0.49, 0.37, 0.38 for HADS-A, HADS-D and PCS, respectively; p < 0.001 for all three). HADS-A also significantly correlated with VAS pain score (r = 0.41, P < 0.001) and grip strength (r = − 0.25, P = 0.016). Linear regression analysis revealed that anxiety has a notable value for DASH and VAS pain scores as well as grip strength. Fisher’s r correlation coefficient to z transformation, revealed that there was no difference between two diseases of CTS and CR in terms of the resulted r coefficients from correlational coefficient analysis between disability and psychological distress. Conclusion It is concluded that psychological disorders are associated with disability in CR patients, with anxiety also correlating with objective disability parameter of grip strength. Finally, both CTS and CR patients’ disabilities associate with anxiety, depression, and catastrophysing thinking in a similar manner. Level of evidence Level IV (cross-sectional study).

Perceived stress, coping strategies, symptoms severity and function status among carpal tunnel syndrome patients: a nurse-led correlational Study

“…Our finding concerning this relationship is the case in the studies of Núñez-Cortés et al (2023); Moro-López-Menchero et al (2023); Daliri et al (2022); Sun et al (2019); Alsharif et al (2022); and Kurtul & Mazican (2023) [ 4 , 6 , 10 , 12 , 18 , 56 ]. There is a consensus in these studies that adaptive coping of patients with disease and the resultant stress could decrease pain perception among CTS patients, which further increases the pain threshold and decreases pain intensity among patients.…”

“…In addition, Daliri et al (2022) compared the correlation of depression, pain intensity, and anxiety with limb disability in patients with CTS. Their results revealed that anxiety was a significant predictor of disability and pain in both groups, which suggested that psychological factors are important determinants of self-reported symptoms severity and functional status in patients with CTS [ 18 ]. Furthermore, Harris-Adamson et al (2022) found that personal, psychosocial, biomechanical, and job factors prophesied CTS-related disability.…”

Integrating jigsaw puzzle thinking into practice: the assessment of cervical spine radiculopathy

“…Psychological factors are associated with the development and pain presentations 32▪▪–34 . Painful conditions such as osteoarthritis 35 and low back pain 36 are associated with anxiety and depressive symptoms.…”

Pairwise association of upper extremity musculoskeletal conditions: large population investigation from PERSIAN cohort study

“…Shared local [ 15 ], psychosocial [ 16 , 17 ], biomechanical (occupational) [ 12 , 18 ], metabolic [ 19 ], and genetic [ 14 , 20 ] factors, as well as a previous history of upper extremity injury, are hypothesized underlying contributors to the concomitant UEMSCs. By estimating the likelihood that two UEMSCs would develop concurrently, we may focus on high-risk individuals and use physical examinations for early detection and secondary prevention (screening).…”