RT Journal Article
T1 Carpal Tunnel Syndrome: Neuropathic Pain Associated or Not with a Nociplastic Condition
A1 Fernández-de-las-Peñas, César
A1 Fuensalida-Novo, Stella
A1 Nijs, Jo
A1 Basson, Annalie
A1 Plaza Manzano, Gustavo
A1 Valera Calero, Juan Antonio
A1 Arendt-Nielsen, Lars
A1 de-la-Llave-Rincón, Ana I.
AB Carpal tunnel syndrome (CTS) has been traditionally classified as primarily a neuropathic condition with or without pain. Precision medicine refers to an evidence-based method of grouping patients based on their susceptibility to biology, prognosis of a particular disease, or in their response to a specific treatment, and tailoring specific treatments accordingly. In 2021, the International Association for the Study of Pain (IASP) proposed a grading system for classifying patients into nociceptive, neuropathic, or nociplastic phenotypes. This position paper presents data supporting the possibility of subgrouping individuals with specific CTS related-pain into nociceptive, neuropathic, nociplastic or mixed-type phenotypes. Carpal tunnel syndrome is a neuropathic condition but can also be comorbid with a nociplastic pain condition. The presence of extra-median symptoms and the development of facilitated pain processing seem to be signs suggesting that specific CTS cases can be classified as the nociplastic pain phenotype. The clinical responses of therapeutic approaches for the management of CTS are inconclusive. Accordingly, the ability to identify the predominant pain phenotype in patients with CTS could likely be problematic for producing efficient treatment outcomes. In fact, the presence of a nociplastic or mixed-type pain phenotype would explain the lack of clinical effect of treatment interventions targeting the carpal tunnel area selectively. We propose a clinical decision tree by using the 2021 IASP classification criteria for identifying the predominant pain phenotype in people with CTS-related pain, albeit CTS being a priori a neuropathic pain condition. The identification of a nociplastic-associated condition requires a more nuanced multimodal treatment approach to achieve better treatment outcomes.
PB Multidisciplinary Digital Publishing Institute (MDPI)
SN 2227-9059
YR 2023
FD 2023-06-17
LK https://hdl.handle.net/20.500.14352/121404
UL https://hdl.handle.net/20.500.14352/121404
LA eng
NO Fernández-de-las-Peñas C, Fuensalida-Novo S, Nijs J, Basson A, Plaza-Manzano G, Valera-Calero JA, et al. Carpal Tunnel Syndrome: Neuropathic Pain Associated or Not with a Nociplastic Condition. Biomedicines. 2023;11(6).
DS Docta Complutense
RD 23 dic 2025