Expected and actual improvement of symptoms with carpal tunnel release.
OBJECTIVE
This study tested the null hypothesis that there is no difference between expected improvement and actual improvement of symptoms with carpal tunnel release (CTR). Secondary analyses addressed factors associated with both expected relief and actual relief of symptoms with carpal tunnel syndrome surgical release, predictors of arm-specific disability, and satisfaction with surgery.


METHODS
Sixty-six employed, English-speaking adult patients requesting limited-incision open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Before surgery, patients completed a survey regarding demographic data, expected improvement of symptoms with surgery, expected return to work after surgery, and validated questionnaires assessing arm-specific disability, job burnout, depressive symptoms, catastrophic thinking, and pain anxiety. An average of 6 ± 5 months (range, 40 d to 19 mo) after surgery, participants completed questionnaires regarding actual improvement of symptoms with surgery, actual return to work, satisfaction with surgery, and arm-specific disability.


RESULTS
Patients' actual and expected improvements with CTR were similar, with the exception of sleep disturbance, which was an average 0.3 points better than patients expected on a 5-point Likert scale. Lower postoperative disability was associated with men, less catastrophic thinking, and greater actual improvement of weakness with CTR. Fifty-three percent of the variation in satisfaction with treatment was associated with single status, more education, and relief of pain, sleep disturbance, and tingling.


CONCLUSIONS
Actual relief of symptoms with CTR matched patients' expectations in an employed population. Satisfaction with treatment correlated with relief of symptoms.
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA 02114, USA.
Stéphanie J E
SJ
Becker
Heeren S
HS
Makanji
David
D
Ring
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome