Risk factors for carpal tunnel syndrome in patients attending the primary care center of a tertiary hospital in Riyadh, Saudi Arabia: A case–control study

BACKGROUND: Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital. MATERIALS AND METHODS: A case–control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding. RESULTS: The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls (P < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS. CONCLUSION: Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association.

[1]  G. Castro,et al.  Association Between Diabetes Mellitus and Carpal Tunnel Syndrome: Results From the United States National Ambulatory Medical Care Survey , 2021, Cureus.

[2]  Moath Albusair,et al.  Prevalence of Hypothyroidism Among Carpal Tunnel Syndrome Patients at a Hospital in Saudi Arabia , 2020, Cureus.

[3]  Alia H. Zawawi,et al.  Musculoskeletal manifestations among diabetic patients in Saudi Arabia , 2020, Journal of family medicine and primary care.

[4]  Shih-Yi Lin,et al.  Risk of idiopathic peripheral neuropathy in end‐stage renal disease: A population‐based cohort study , 2020, International journal of clinical practice.

[5]  L. Dahlin,et al.  Diabetes mellitus as a risk factor for compression neuropathy: a longitudinal cohort study from southern Sweden , 2020, BMJ Open Diabetes Research & Care.

[6]  S. Abdullah,et al.  Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia , 2019, Malaysian orthopaedic journal.

[7]  E. Masuadi,et al.  Prevalence of carpal tunnel syndrome symptoms among dentists working in Riyadh , 2019, Annals of Saudi medicine.

[8]  Leilei Wang,et al.  Guiding Treatment for Carpal Tunnel Syndrome. , 2018, Physical medicine and rehabilitation clinics of North America.

[9]  R. Harrison,et al.  Rates of Carpal Tunnel Syndrome in a State Workers’ Compensation Information System, by Industry and Occupation — California, 2007–2014 , 2018, MMWR. Morbidity and mortality weekly report.

[10]  P. Corcia,et al.  Are Carpal Tunnel Syndrome and Regional Degenerative Osteoarthritis Linked? Results of a Case-Control Study. , 2018, The journal of hand surgery Asian-Pacific volume.

[11]  P. Amadio,et al.  Corticosteroid Injections for Carpal Tunnel Syndrome: Long-Term Follow-Up in a Population-Based Cohort , 2017, Plastic and reconstructive surgery.

[12]  Y. Kim,et al.  Does Diabetes Mellitus Influence Carpal Tunnel Syndrome? , 2017, Journal of clinical neurology.

[13]  Lisa D Hobson-Webb,et al.  Carpal tunnel syndrome: clinical features, diagnosis, and management , 2016, The Lancet Neurology.

[14]  L. Kuo,et al.  Medical claims-based case–control study of temporal relationship between clinical visits for hand syndromes and subsequent diabetes diagnosis: implications for identifying patients with undiagnosed type 2 diabetes mellitus , 2016, BMJ Open.

[15]  Shaffi Ahamed S,et al.  Prevalence and associated factors of Carpal Tunnel Syndrome (CTS) among medical laboratory staff at King Saud University Hospitals, KSA , 2015, Pakistan journal of medical sciences.

[16]  S. D. Middleton,et al.  Carpal tunnel syndrome , 2014, BMJ : British Medical Journal.

[17]  H. Bilo,et al.  Type 2 diabetes seems not to be a risk factor for the carpal tunnel syndrome: a case control study , 2014, BMC Musculoskeletal Disorders.

[18]  Ann Marie Dale,et al.  Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. , 2013, Scandinavian journal of work, environment & health.

[19]  Luft A. Abumunaser Carpal Tunnel Syndrome: Associated Co-Morbidities in Saudi Arabia , 2013 .

[20]  F. Sung,et al.  Medical and non‐medical correlates of carpal tunnel syndrome in a Taiwan cohort of one million , 2012, European journal of neurology.

[21]  F. Violante,et al.  Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study , 2009, BMC public health.

[22]  R. E. Pollard,et al.  Management of carpal tunnel syndrome in renal dialysis patients using an extended carpal tunnel release procedure. , 2008, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[23]  M. D. de Rijk,et al.  Does a carpal tunnel syndrome predict an underlying disease? , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[24]  T. Pritsch,et al.  [Carpal tunnel syndrome]. , 2004, Harefuah.

[25]  R. Hubbard,et al.  Risk Factors in Carpal Tunnel Syndrome , 2004, Journal of hand surgery.

[26]  J. Reitsma,et al.  Indications for requesting laboratory tests for concurrent diseases in patients with carpal tunnel syndrome: a systematic review. , 2003, Clinical chemistry.

[27]  S. Mackinnon,et al.  Prevalence of Smoking, Obesity, Diabetes Mellitus, and Thyroid Disease in Patients With Carpal Tunnel Syndrome , 2002, Annals of plastic surgery.

[28]  J. Becton Carpal tunnel syndrome--diagnosis and management. , 1969, Journal of the Medical Association of Georgia.

[29]  N. Jewell,et al.  Case–control matching: effects, misconceptions, and recommendations , 2017, European Journal of Epidemiology.

[30]  Ahmed M Balamash,et al.  Prevalence of trigger finger and carpal tunnel syndrome among diabetic patients and its relationship to hemoglobin A1C. , 2022 .