Obesity and Carpal Tunnel Syndrome: Is There a Causal Relationship?

Abstract

Objectives: Obesity is defined as a risk factor for carpal tunnel syndrome (CTS). In this study, the presence or absence of recovery in median nerve conduction velocities after weight loss in obese patients was assessed in order to determine whether excess weight or other factors influence the higher prevalence of CTS in obese patients. Methods: Patients with body mass indexes (BMIs) ≧30 were included in the study. CTS symptoms, age, gender, height, body weight, and concomitant diseases were evaluated. Nerve conduction studies (NCS) were obtained on one upper extremity. All patients were included in dietetic programs. Three months later, NCS were repeated and compared with the first NCS. Results: BMIs were statistically significantly lower on the second visits 3 months later (p = 0.0001). No statistically significant difference was observed in the second NCS of electromyographically diagnosed cases with CTS (p > 0.05). Conclusion: We expected a recovery in median nerve conduction velocities in patients with CTS after weight loss. In the literature, even in untreated cases with CTS, spontaneous improvements in second NCS have been reported. This finding suggests that factors other than excess body weight may be influential in the higher prevalence of CTS in obese patients. A more detailed, genetic-factor-targeted investigation may prove more beneficial to clarify this issue.

Ultrasound evaluation on carpal tunnel syndrome before and after bariatric surgery

“…In the second hypothesis, the CTS symptoms would not respond to weight loss, as was found at present. Corroborating these findings, Kurt et al 11 studied CTS in 92 obese patients, who underwent a three-month dietary program for weight loss, and found no changes in nerve conduction studies, signs or symptoms after that intervention. Also, Shiri et al 13 demonstrated an association of CTS with dyslipidemia, hypertension and cardiac arrhythmia in individuals between 30 and 34 years of age, and with coronary artery disease, valvular heart disease and carotid intimal thickness in subjects aged 60 years or more.…”

“…It can therefore be concluded that obesity is associated with CTS, but weight loss in bariatric surgery is not sufficient to improve its repercussions in daily life. The higher prevalence of CTS in obese individuals is already well known in the literature [6][7][8][9][10][11][12][13] . Similarly, Moghtaderi et al 8 conducted a case-control study examining risk factors for CTS and demonstrated that BMI, age and anthropometric data of the wrist were higher in patients with CTS than in controls.…”

“…The most widely accepted theories for CTS ethiopathology are the mechanical and the microvascular nerve damage 2 . Many authors considered obesity as a predisposing factor [6][7][8][9][10][11][12][13] , as it may be associated to the mechanical theory when the fat tissue causes nerve root compression and raises local hydrostatic pressure 10,12 . However, microvascular insufficiency secondary to atherosclerosis, which is more common in the obese population 13 , may also play a role.…”

The diagnostic efficacy of clinical findings and electrophysiological studies in carpal tunnel syndrome

“…In patients with right CTS right hand was dominant but there was no correlation like this for the left side. If we look up the literature investigating the relation between obesity and CTS, it is mentioned that obesity is a risk factor for CTS in most of the studies [3,4,5]. De Azevedo et al [6] investigated the profile of patients on sick leave with CTS and reported obesity with a ratio of 44% among these patients [6].…”

Relations between entrapment neuropathies of the lower extremities and Body Mass Index

“…Numerous studies have investigated and determined a relation of obesity especially with CTS, which is one of the upper extremity entrapment neuropathies [7][8][9][10][11]. Likewise, a triggering effect of obesity on the cubital tunnel syndrome was reported [12,13].…”