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Evaluation of Cold Sensitivity in Patients With Upper Extremity Nerve Compression Syndromes: A Scoping Review

  • Moaath M. Saggaf
    Correspondence
    Corresponding author: Moaath M. Saggaf, MBBS, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Room 508, Toronto, Ontario, M5T 1P5, Canada.
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto Western Hospital Hand Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

    Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada

    Division of Plastic and Reconstructive Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
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  • Jeunice Vianca Evangelista
    Affiliations
    Toronto Western Hospital Hand Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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  • Christine B. Novak
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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  • Dimitri J. Anastakis
    Affiliations
    Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto Western Hospital Hand Program, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

    Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada

    Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
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Published:September 20, 2021DOI:https://doi.org/10.1016/j.jhsa.2021.06.025

      Purpose

      The aim of this study was to review the literature to determine the prevalence of cold sensitivity in upper extremity nerve compression syndromes and the impact of treating nerve compression syndromes on cold sensitivity.

      Methods

      Following a standardized scoping review protocol, this study included interventional and observational study designs assessing patients with cold sensitivity and upper extremity nerve compression syndromes. Review articles, case reports, and small case series (n < 5) were excluded. The abstracts and eligible full texts were screened by 2 independent reviewers. Data were extracted and reported according to PRISMA extension for scoping reviews statement.

      Results

      Three databases were searched (Ovid MEDLINE, Ovid EMBASE, and CINAHL on EBSCO); 274 references were reviewed. Fifteen studies from the database search and 8 studies from the reference search were eligible for this review (n = 23). Two interventional and 21 observational studies were identified. The most common method for assessing cold sensitivity was cold pain threshold testing (n = 12), followed by subjective patient reporting (n = 4). The Cold Intolerance Symptom Severity questionnaire was the most common validated patient-reported outcome questionnaire used in the studies (n = 3). Cold sensitivity was most commonly reported in carpal tunnel syndrome (96% of the studies). The prevalence of cold sensitivity in nerve compression syndromes ranged from 20% to 69%. Nerve decompression improved the severity of cold sensitivity in 5 of 6 studies where cold sensitivity was studied.

      Conclusions

      There is heterogenicity in the studies assessing cold sensitivity in nerve compression syndromes. Despite moderate prevalence in patients with carpal tunnel syndrome, cold sensitivity is understudied. Within the limitations of eligible studies reviewed, surgical decompression improved the severity of cold sensitivity in some studies.

      Type of study/level of evidence

      Therapeutic IV.

      Key words

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      References

        • Novak C.B.
        • Mackinnon S.E.
        Evaluation of cold sensitivity, pain, and quality of life after upper extremity nerve injury.
        Hand (N Y). 2016; 11: 173-176
        • Novak C.B.
        • Anastakis D.J.
        • Beaton D.E.
        • Mackinnon S.E.
        • Katz J.
        Biomedical and psychosocial factors associated with disability after peripheral nerve injury.
        J Bone Joint Surg Am. 2011; 93: 929-936
        • Irwin M.S.
        • Gilbert S.E.
        • Terenghi G.
        • Smith R.W.
        • Green C.J.
        Cold intolerance following peripheral nerve injury. Natural history and factors predicting severity of symptoms.
        J Hand Surg Br. 1997; 22: 308-316
        • Novak C.B.
        • McCabe S.J.
        Prevalence of cold sensitivity in patients with hand pathology.
        Hand (N Y). 2015; 10: 173-176
        • Novak C.B.
        Cold intolerance after nerve injury.
        J Hand Ther. 2018; 31: 195-200
        • Verdugo R.J.
        • Salinas R.A.
        • Castillo J.L.
        • Cea J.G.
        Surgical versus non-surgical treatment for carpal tunnel syndrome.
        Cochrane Database Syst Rev. 2008; CD001552
        • Lawrence R.C.
        • Felson D.T.
        • Helmick C.G.
        • et al.
        Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II.
        Arthritis Rheum. 2008; 58: 26-35
        • Graham B.
        • Schofield M.
        Self-reported symptoms of cold intolerance in workers with injuries of the hand.
        Hand (N Y). 2008; 3: 203-209
        • Ruijs A.C.
        • Jaquet J.B.
        • Daanen H.A.
        • Hovius S.E.
        Cold intolerance of the hand measured by the CISS questionnaire in a normative study population.
        J Hand Surg Br. 2006; 31: 533-536
        • Wendt M.
        • Novak C.B.
        • Anastakis D.J.
        Prevalence of cold sensitivity in upper extremity nerve compression syndromes.
        J Hand Surg Eur Vol. 2018; 43: 282-285
        • Thomsen N.O.
        • Cederlund R.
        • Rosén I.
        • Björk J.
        • Dahlin L.B.
        Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls.
        J Hand Surg Am. 2009; 34: 1177-1187
        • Thomsen N.O.
        • Cederlund R.I.
        • Andersson G.S.
        • Rosén I.
        • Björk J.
        • Dahlin L.B.
        Carpal tunnel release in patients with diabetes: a 5-year follow-up with matched controls.
        J Hand Surg Am. 2014; 39: 713-720
        • Osborne N.R.
        • Anastakis D.J.
        • Davis K.D.
        Peripheral nerve injuries, pain, and neuroplasticity.
        J Hand Ther. 2018; 31: 184-194
      1. The Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual 2015-Methodology for JBI Scoping Reviews. Accessed June 1, 2020. https://synthesismanual.jbi.global

        • Tricco A.C.
        • Lillie E.
        • Zarin W.
        • et al.
        PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation.
        Ann Intern Med. 2018; 169: 467-473
        • Cesim ÖB
        Öksüz Ç. More severe cold intolerance is associated with worse sensory function after peripheral nerve repair or decompression.
        J Hand Surg Eur Vol. 2020; 45: 231-236
        • Tampin B.
        • Vollert J.
        • Schmid A.B.
        Sensory profiles are comparable in patients with distal and proximal entrapment neuropathies, while the pain experience differs.
        Curr Med Res Opin. 2018; 34: 1899-1906
        • Baselgia L.T.
        • Bennett D.L.
        • Silbiger R.M.
        • Schmid A.B.
        Negative neurodynamic tests do not exclude neural dysfunction in patients with entrapment neuropathies.
        Arch Phys Med Rehabil. 2017; 98: 480-486
        • Fernández-Muñoz J.J.
        • Palacios-Ceña M.
        • Cigarán-Méndez M.
        • et al.
        Pain is associated to clinical, psychological, physical, and neurophysiological variables in women with carpal tunnel syndrome.
        Clin J Pain. 2016; 32: 122-129
        • Fernández-de-Las-Peñas C.
        • Fernández-Muñoz J.J.
        • Navarro-Pardo E.
        • da-Silva-Pocinho R.F.
        • Ambite-Quesada S.
        • Pareja J.A.
        Identification of subgroups of women with carpal tunnel syndrome with central sensitization.
        Pain Med. 2016; 17: 1749-1756
        • Schmid A.B.
        • Bland J.D.
        • Bhat M.A.
        • Bennett D.L.
        The relationship of nerve fibre pathology to sensory function in entrapment neuropathy.
        Brain. 2014; 137: 3186-3199
        • Schmid A.B.
        • Soon B.T.
        • Wasner G.
        • Coppieters M.W.
        Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?.
        Eur J Pain. 2012; 16: 217-228
        • Isoardo G.
        • Stella M.
        • Cocito D.
        • et al.
        Neuropathic pain in post-burn hypertrophic scars: a psychophysical and neurophysiological study.
        Muscle Nerve. 2012; 45: 883-890
        • Constand M.K.
        • MacDermid J.C.
        Analysis of red blood cell concentration in the digits of the hand of controls and participants with carpal tunnel syndrome: a response to cold temperature.
        Crit Rev Phys Rehabil. 2012; 24: 159-168
        • de la Llave-Rincón A.I.
        • Fernández-de-las-Peñas C.
        • Laguarta-Val S.
        • et al.
        Increased pain sensitivity is not associated with electrodiagnostic findings in women with carpal tunnel syndrome.
        Clin J Pain. 2011; 27: 747-754
        • Zanette G.
        • Cacciatori C.
        • Tamburin S.
        Central sensitization in carpal tunnel syndrome with extraterritorial spread of sensory symptoms.
        Pain. 2010; 148: 227-236
        • Fernández-de-Las-Peñas C.
        • Cleland J.A.
        • Ortega-Santiago R.
        • de-la-Llave-Rincon A.I.
        • Martínez-Perez A.
        • Pareja J.A.
        Central sensitization does not identify patients with carpal tunnel syndrome who are likely to achieve short-term success with physical therapy.
        Exp Brain Res. 2010; 207: 85-94
        • de la Llave-Rincón A.I.
        • Fernández-de-las-Peñas C.
        • Fernández-Carnero J.
        • Padua L.
        • Arendt-Nielsen L.
        • Pareja J.A.
        Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome.
        Exp Brain Res. 2009; 198: 455-463
        • Tucker A.T.
        • White P.D.
        • Kosek E.
        • et al.
        Comparison of vibration perception thresholds in individuals with diffuse upper limb pain and carpal tunnel syndrome.
        Pain. 2007; 127: 263-269
        • Novak C.B.
        • Mackinnon S.E.
        • Stuebe A.M.
        Patient self-reported outcome after ulnar nerve transposition.
        Ann Plast Surg. 2002; 48: 274-280
        • Dahlin L.B.
        • Lekholm C.
        • Kardum P.
        • Holmberg J.
        Coverage of the median nerve with free and pedicled flaps for the treatment of recurrent severe carpal tunnel syndrome.
        Scand J Plast Reconstr Surg Hand Surg. 2002; 36: 172-176
        • Strasberg S.R.
        • Novak C.B.
        • Mackinnon S.E.
        • Murray J.F.
        Subjective and employment outcome following secondary carpal tunnel surgery.
        Ann Plast Surg. 1994; 32: 485-489
        • Gong H.S.
        • Oh J.H.
        • Bin S.W.
        • Kim W.S.
        • Chung M.S.
        • Baek G.H.
        Clinical features influencing the patient-based outcome after carpal tunnel release.
        J Hand Surg Am. 2008; 33: 1512-1517
        • Placzek J.D.
        • Boyer M.I.
        • Gelberman R.H.
        • Sopp B.
        • Goldfarb C.A.
        Nerve decompression for complex regional pain syndrome type II following upper extremity surgery.
        J Hand Surg Am. 2005; 30: 69-74
        • Zhu G.C.
        • Böttger K.
        • Slater H.
        • et al.
        Concurrent validity of a low-cost and time-efficient clinical sensory test battery to evaluate somatosensory dysfunction.
        Eur J Pain. 2019; 23: 1826-1838
        • Borg K.
        • Lindblom U.
        Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome.
        Acta Neurol Scand. 1988; 78: 537-541
        • Levine D.W.
        • Simmons B.P.
        • Koris M.J.
        • et al.
        A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome.
        J Bone Joint Surg Am. 1993; 75: 1585-1592
        • Zanette G.
        • Marani S.
        • Tamburin S.
        Extra-median spread of sensory symptoms in carpal tunnel syndrome suggests the presence of pain-related mechanisms.
        Pain. 2006; 122: 264-270
        • Clarke C.
        • Christensen C.
        • Curran M.W.T.
        • Chan K.M.
        Assessment of small sensory fiber function across the spectrum of severity in carpal tunnel syndrome patients.
        Muscle Nerve. 2017; 56: 814-816
        • Kambiz S.
        • Duraku L.S.
        • Holstege J.C.
        • Hovius S.E.
        • Ruigrok T.J.
        • Walbeehm E.T.
        Thermo-sensitive TRP channels in peripheral nerve injury: a review of their role in cold intolerance.
        J Plast Reconstr Aesthet Surg. 2014; 67: 591-599
        • Goswami R.
        • Anastakis D.J.
        • Katz J.
        • Davis K.D.
        A longitudinal study of pain, personality, and brain plasticity following peripheral nerve injury.
        Pain. 2016; 157: 729-739
        • McCabe S.J.
        • Mizgala C.
        • Glickman L.
        The measurement of cold sensitivity of the hand.
        J Hand Surg Am. 1991; 16: 1037-1040
        • Carlsson I.K.
        • Nilsson J.A.
        • Dahlin L.B.
        Cut-off value for self-reported abnormal cold sensitivity and predictors for abnormality and severity in hand injuries.
        J Hand Surg Eur Vol. 2010; 35: 409-416
        • Yarnitsky D.
        Quantitative sensory testing.
        Muscle Nerve. 1997; 20: 198-204
        • Treede R.D.
        The role of quantitative sensory testing in the prediction of chronic pain.
        Pain. 2019; 160: S66-S69
        • Rolke R.
        • Baron R.
        • Maier C.
        • et al.
        Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values.
        Pain. 2006; 123: 231-243
        • Yekta S.S.
        • Smeets R.
        • Stein J.M.
        • Ellrich J.
        Assessment of trigeminal nerve functions by quantitative sensory testing in patients and healthy volunteers.
        J Oral Maxillofac Surg. 2010; 68: 2437-2451
        • Maier C.
        • Baron R.
        • Tölle T.R.
        • et al.
        Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes.
        Pain. 2010; 150: 439-450
        • Traynor R.
        • MacDermid J.C.
        Immersion in Cold-Water Evaluation (ICE) and self-reported cold intolerance are reliable but unrelated measures.
        Hand (N Y). 2008; 3: 212-219