The pillar pain in the carpal tunnel's surgery. Neurogenic inflammation? A new therapeutic approach with local anaesthetic.
OBJECTIVE
After the surgical decompression of the transverse carpal ligament as treatment of the tunnel carpal syndrome, pillar pain manifestation is possible. This is a painful and temporary invaliding syndrome with unknown aetiology. Aim of the study is to demonstrate that pillar pain is based on autonomic irritation that disappears with simple infiltration of local anaesthetic (LA), or rather by neuromodulation.


METHODS
Eighty-four patients were enrolled for this study and underwent an open release technique surgery. They were then asked for regular postoperative follow-ups.


RESULTS
Thirty-two out of 84 patients (38%) developed pillar pain. Accordingly, injection of LA as pain treatment has since been studied and results compared with the conventional protocol for this painful syndrome.


CONCLUSIONS
Even if the number of the patients considered is not great, there is evidence of a decrement of pillar pain by means of LA injections. Excellent functional outcomes and satisfaction were achieved using LA infiltrations for pillar pain after carpal tunnel decompression. The minimally invasive technique offers a quick, easy, effective, and inexpensive method useful to minimize and cure in a few days the pillar pain.
Monacelli
G
G
Neuromed, IRCCS, Pozzilli, Isernia, Italy.
Rizzo
M I
MI
Spagnoli
A M
AM
Pardi
M
M
Irace
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002349:Carpal Tunnel Syndrome / Q000601:surgery; D002921:Cicatrix / Q000188:drug therapy / Q000628:therapy; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006225:Hand / Q000473:pathology; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000627:therapeutic use*; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000628:therapy*; D020078:Neurogenic Inflammation / Q000209:etiology / Q000628:therapy*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D026741:Physical Therapy Modalities
D000779:Anesthetics, Local; D008619:Mepivacaine