Evaluating the Association Between Educational Status and Carpal Tunnel Syndrome Presentations and Severity

Abstract

Introduction: Carpal tunnel syndrome (CTS), a painful prevalent orthopedic hand condition causing pain and paresthesia, is typically diagnosed clinically. Initial management involves analgesia trials, steroid injections, and night splints, with surgery as an option for failed conservative treatment. While prior research has explored the relationship between patients' educational status and various orthopedic conditions, no studies have investigated its association with clinical presentation and symptom severity in CTS. Therefore, our study aims to investigate this important link. Methods: Our study utilized a retrospective study design, which included 681 patients undergoing carpal tunnel release surgery at a prominent teaching hospital. The aim was to investigate the association between four distinct educational levels and the clinical presentation and severity of the disease. Disease severity was evaluated using the Boston Carpal Tunnel Questionnaire (BCTQ). Results: The study included individuals with a mean age of 52.0 years and diverse educational backgrounds: 20.0% high school, 34.9% diploma, 28.5% bachelor's degree, and 6.6% higher education qualifications. Subjective grip strength decline was more pronounced in high school and diploma categories (83.1% and 82.4%, respectively) compared to bachelor's and higher education categories (71.0% and 68.8%, respectively; p=0.005). Additionally, high school patients had higher Gabapentin usage for analgesia (32.4%) compared to other groups (p=0.014). Conclusion: In patients with CTS, there is a correlation between lower education and symptoms of subjective weakened grip strength, increased analgesic use, and higher Gabapentin utilization. Conversely, higher education is associated with greater utilization of night splints. Moreover, postoperative improvements were observed across all educational groups with no significant differences. Level of Evidence: Level III, Retrospective Study.

Keywords: Boston Carpal Tunnel Questionnaire; carpal tunnel syndrome; educational status; hand pain.

Figure 1

Boston Carpal Tunnel Questionnaire [24].

Figure 2

Flowchart summary of the study methodology.