Presence of Carpal Tunnel Syndrome and Its Impact on Clinical and Ultrasonographic Evaluations in Patients with Fibromyalgia

Abstract

Background/Aims: Carpal tunnel syndrome (CTS) may be overlooked in patients with fibromyalgia (FM) due to the high prevalence of paresthesia and hand pain. This study aimed to determine the presence of CTS in patients with FM compared to healthy controls and to identify potential associations between clinical parameters and ultrasound (US).

Materials and Methods: This study included 40 patients with FM (80 wrists) and 36 healthy controls (72 wrists). The presence of paresthesia, sensory/motor deficits, and Tinel/Phalen test results was recorded. All participants underwent US to assess the median nerve cross-sectional area (CSA), distal/proximal ratio, and intraneural power Doppler signal (PDS). Electrodiagnostic studies were conducted in the presence of any CTS-related symptom. The Boston Carpal Tunnel Syndrome Questionnaire symptom severity (BCTQs) and functional status (BCTQf) scale, and the Fibromyalgia Impact Questionnaire (FIQ) were recorded for all FM patients.

Results: Carpal tunnel syndrome was identified in 18 wrists (22.5%) of 14 patients (35%) in the FM group, whereas it was present in only 2 wrists (2.8%) of a single participant (2.8%) in the control group (P < .001). No statistically significant differences were observed in the median nerve CSA, distal/proximal ratio, and PDS between the groups (P = .727, P = .270, and P = .058, respectively). Median nerve CSA was moderately correlated with BCTQs, BCTQf, and FIQ (r = 0.557, r = 0.599, r = 0.553; all P < .001) in patients with FM. Median nerve CSA was greater in moderate (1.31 [1.30-1.47]) than mild CTS (1.13 [1.00-1.20]) (P < .001).

Conclusion: Carpal tunnel syndrome appears to be a common clinical manifestation of FM. Ultrasonographic evaluation demonstrated significant correlations with clinical scales, highlighting its value as a complementary tool in evaluating CTS in FM.

Cite this article as: Akkaya S, Saglam Akkaya G, Alisar K, Cetinkaya Alisar D, Karakullukcu S. Presence of carpal tunnel syndrome and its impact on clinical and ultrasonographic evaluations in patıents with fibromyalgia. ArchRheumatol. 2026;41(1):64-71.