title: Outcome of endoscopic carpal tunnel release in patients with chronic nonhand pain compared with those without chronic pain.
abstract: OBJECTIVE
  This prospective observational study compared the outcomes of single-port endoscopic carpal tunnel release in patients taking narcotic pain medication chronically for back, neck, leg, or other bodily pain for more than 3 months, with patients not taking chronic narcotic pain medication (control group).
  
  
  METHODS
  Patients undergoing endoscopic carpal tunnel release completed the Levine-Katz carpal tunnel questionnaire (primary outcome) and the Disabilities of the Arm, Shoulder, and Hand questionnaire preoperatively, at 2, 4, 6, and 12 weeks, and at 1 year after surgery. We measured subjective satisfaction with surgery at each postoperative time point as well.
  
  
  RESULTS
  There were 14 patients in the chronic narcotic pain group and 68 in the control group. Both groups showed significant improvement in the Levine-Katz symptom and functional scores and in the Disabilities of the Arm, Shoulder, and Hand score (compared with preoperative) at nearly all times. The control group showed better scores at the early time points, but by 6 weeks, there was no difference between groups. Patient satisfaction was excellent in both groups.
  
  
  CONCLUSIONS
  Patients who had carpal tunnel syndrome and who were receiving narcotic pain medication chronically for nonhand pain benefited from endoscopic carpal tunnel release. These patients experienced a longer recovery period but ultimately achieved the same outcomes as patients without chronic pain, as measured by the Levine-Katz scores and the DASH score.
  
  
  METHODS
  Prognostic I.
authors: Department of Plastic and Reconstructive Surgery, The Johns Hopkins University, Baltimore, MD, USA.
authors: Keith E
authors: KE
authors: Follmar
authors: Monica D
authors: MD
authors: Chetelat
authors: Scott D
authors: SD
authors: Lifchez
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology*; D004185:Disability Evaluation; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D009294:Narcotics