Pain syndrome in patients with ulnar nerve neuropathy

Introduction. Limb compression-ischemic neuropathies are typically characterized by pain and sensory loss. However, in cubital tunnel syndrome (CuTS), pain syndrome is relatively uncommon and develops at later stages of the disease, warranting further investigation.

Aim. To determine the frequency and causes of pain syndrome in patients with CuTS before and after surgical decompression, depending on sex, age, and comorbid disorders.

Materials and methods. The study included patients with compression-ischemic neuropathy of the ulnar nerve (CuTS, n = 42), of whom a subset (n = 15) had pain syndrome. Clinical and neurophysiological examinations were performed, utilizing diagnostic scales and questionnaires before decompressive surgery and at 12–24 months postoperatively.

Results. All patients showed positive dynamics in the recovery of lost functions after surgical treatment, both in the group with pain syndrome and the group without pain (according to the Symptom Severity Scale, p = 0.002 and p = 0.013, respectively, and the Functional Status Scale of the Boston Questionnaire, p < 0.001 and p = 0.013, respectively). A correlation was established between the severity of pain syndrome (assessed by the Numerical Rating Scale), the presence of comorbid emotional disorders (p < 0.001), and sleep disturbances (p < 0.001) in CuTS. A significant decrease in quality of life was demonstrated in patients with pain syndrome (p < 0.001). A negative impact of increased anxiety, depression, and sleep disturbances on the development, severity, and duration of neuropathic pain syndrome was identified.

Conclusion. Increased anxiety, depression, and sleep disorders are associated with the presence of pain in CuTS. Therefore, they require timely diagnosis and adequate correction, which holds significant medical and social importance for the rehabilitation of this patient category.

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