Self-reported cold sensitivity in patients with traumatic hand injuries or hand-arm vibration syndrome - an eight year follow up

Abstract

BackgroundCold sensitivity is a common complaint following hand injuries. Our aim was to investigate long-term self-reported cold sensitivity, and its predictors and the importance of sense of coherence (SOC), 8 years after a hand injury as well as in patients treated for Hand Arm Vibration Syndrome (HAVS) during the same time period.MethodsResponses to the Cold Intolerance Symptom Severity (CISS) questionnaire and the Sense of Coherence (SOC) questionnaire were investigated in hand injured patients (n = 64) and in patients with HAVS (n = 26). The Mann–Whitney U-Test was used to identify significant differences between subgroups. When analysing predictors for cold sensitivity severity, the Spearman rank correlation (rS coefficient) were used for quantitative predictive variables, Mann–Whitney U-Test for dichotomous variables and Kruskal-Wallis Test for multiple categorical data. The Wilcoxon´s signed rank test was used to investigate longitudinal changes in outcome.ResultsThere was a significant change in total CISS score for patients with traumatic hand injury, indicating fewer problems with cold sensitivity over time. Symptoms, such as stiffness, weakness and skin colour change on cold exposure, caused fewer problems, but perceived pain/aching and numbness remained unchanged as well as time needed for relief of symptoms on return to a warm environment. The negative impact of cold sensitivity on daily activities and at work was reduced, but problems when engaged in hobbies or when being exposed to cold wintry weather remained unchanged. None of the investigated predictors related to the hand injury were significantly associated with a change in cold sensitivity at the 8-year follow up. In contrast, no significant change in cold sensitivity was noted in the patients with HAVS for any of the situations included in the CISS questionnaire. A lower sense of coherence score correlated significantly with worse cold sensitivity (CISS score) in both patient groups.ConclusionsThe negative impact of cold sensitivity on daily life was reduced for patients with traumatic hand injury, but did not change over time in patients with HAVS. A low SOC is associated with worse cold sensitivity in such groups of patients. Information about relieving strategies should be provided for patients with cold sensitivity.

Neurosensory and vascular function after 14 months of military training comprising cold winter conditions

“…The most frequently reported and severe neurosensory symptom was "pain/discomfort when exposed to cold". This is also the symptom most in line with the definition of cold sensitivity, commonly reported among cold injury and persons suffering from hand injuries (6,7,(25)(26)(27)(28). The mechanisms of cold sensitivity are still not fully revealed.…”

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

“…These conditions limit the generalizability of the results and increase the uncertainty in risk estimates. There are several possible reporting biases; firstly, there is a possibility that symptomatic subjects might be more prone to respond to questionnaires of this kind, and this might lead to an overestimation of both exposure and symptoms; secondly, there is a risk that a selection effect diminishes the cold exposure estimates in cold sensitive cases, since one would expect that such individuals leave cold-exposed occupations, and are deterred from leisure-time cold exposure as well, as was the case in previous studies (Carlsson and Dahlin 2014 ). The number of retired respondents was high, which might weaken any possible associations with occupational factors.…”

“…Upper extremity nerve injuries were particularly common, and this is in line with previous research (Engkvist et al 1985 ; Nylander et al 1987 ). Some authors have argued that nerve injury should be considered the main determinant of cold sensitivity (Ruijs et al 2007 ), while others have argued that in traumatic hand injury, both vascular, neural, humoral, and bony components can been associated with cold sensitivity (Carlsson and Dahlin 2014 ). The presence of vascular disease showed a relationship with cold sensitivity in our study, which would support the theory of a vascular mechanism.…”

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

“…Nerve injury, including amputation, in the upper extremity is associated with Raynaud's phenomenon and cold sensitivity 16 . Patients with a previous hand trauma reported that cold sensitivity negatively impacted their daily life 17 , but it improved over time 18 . We cannot, on the basis of the present results, shed detailed light on the pathophysiology of cold sensitivity in CTS and after OCTR.…”