The prevalence of hand pain in Ibadan – implications for the carpal tunnel syndrome

Hand pain or brachialgia paraesthetica nocturna (BPN) is a series of symptoms described as “waking up at night due to unpleasant sensation in the fingers” (Dekrom et al, 1992). Usually, these symptoms form the first rungs up the ladder leading up to the carpal tunnel syndrome (CTS) (Skandalakis et al 1992), and thus are used as part of the diagnostic criteria for the disorder. We described the result of a questionnaire survey of 422 patients attending two major hospitals in Ibadan, Nigeria for complaints unrelated to hand pathology. Questions related to the bio-data (including type of occupation), general health status, past medical and or surgical history, and finally hand symptoms for the patients. For a patient to be positive for BPN, the hand symptoms had to correspond to the cutaneous distribution of the median nerve. Positive cases formed 12.75% of all interviews in one hospital and 19.59% of respondents in the other, with females forming the bulk of those affected. This figure is somewhat higher than the ones previously reported. From earlier work on the predictive value of BPN for the carpal tunnel syndrome we conservatively estimate that between 20% to 30% of individuals in our study group will suffer from CTS. The relationship of heavy hand use to BPN was a negative one as most sufferers of BPN were light hand-users. However individual occupations requiring highly repetitive flexion-extension wrist movements recorded many BPN cases. No BPN case confirmed when the patients presented in hospital, indicating that more awareness of symptoms and signs of this disorder need to be created among doctors and the general public. Also we believe that more investigations, particularly among the general population, are needed to be able to define the prevalence of this condition more accurately. Résumé La douleur à la main ou brachialgie para-esthétique nocturne (BPN) est des series de symptoms décrit comme <> (DeKrom et al, 1992). Habituellement, ces symt mes constituent les critères important pourrant conduire au syndrome du tunnel carpelle (CTS) (Skandalakis et al, 1992), et par consequent font pardi des critères diagnostiques du mal. Nous décrivons le résultat d'une enquête meree sur 422 patients visitant deux h pitaux majeurs à la pathologie des mains. Des questions liées aux données biographiques, état general de santé, l'historique médicale et chirurgicale et finalement symptoms de mains du patient. Pour qu'un patient soit positif pour la BPN, les symptoms de la main doivent correspondent à la distribution cutanées des nerfs medians. Les cas positives constituent les 12.75% de tous les personne interviewees dans un h pital et 19.59% des respondants dans l'autre, avec les femelles constituant le lot des affectes. Cette figure est encaque sorte plus élevée que celle obtenues precedement. Des travaux precedents sur la valeur predictive du BPN pour la CTS nous conservativement estimons qu'entre 20% et 38% des individus dans notre group d'étude so