Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome

Ana Isabel De La Llave-Rincón, César Fernández-De-Las-Peñas, Josué Fernández-Carnero, Luca Padua, Lars Arendt-Nielsen, Juan A. Pareja

Research output: Contribution to journalArticlepeer-review


The aim of the current study was to evaluate bilaterally warm/cold detection and heat/cold pain thresholds over the hand/wrist in patients with carpal tunnel syndrome (CTS). A total of 25 women with strictly unilateral CTS (mean 42 ± 10 years), and 20 healthy matched women (mean 41 ± 8 years) were recruited. Warm/cold detection and heat/cold pain thresholds were assessed bilaterally over the carpal tunnel and the thenar eminence in a blinded design. Self-reported measures included both clinical pain history (intensity, location and area) and Boston Carpal Tunnel Questionnaire. No significant differences between groups for both warm and cold detection thresholds in either carpal tunnel or thenar eminence (P > 0.5) were found. Further, significant differences between groups, but not between sides, for both heat and cold pain thresholds in both the carpal tunnel and thenar eminence were found (all P <0.001). Heat pain thresholds (P <0.01) were negatively correlated, whereas cold pain thresholds (P <0.001) were positively correlated with hand pain intensity and duration of symptoms. Our findings revealed bilateral thermal hyperalgesia (lower heat pain and reduced cold pain thresholds) but not hypoesthesia (normal warm/cold detection thresholds) in patients with strictly unilateral CTS when compared to controls. We suggest that bilateral heat and cold hyperalgesia may reflect impairments in central nociceptive processing in patients with unilateral CTS. The bilateral thermal hyperalgesia associated with pain intensity and duration of pain history supports a role of generalized sensitization mechanisms in the initiation, maintenance and spread of pain in CTS.

Original languageEnglish
Pages (from-to)455-463
Number of pages9
JournalExperimental Brain Research
Issue number4
Publication statusPublished - Oct 2009


  • Carpal tunnel syndrome
  • Central sensitization
  • Experimental pain
  • Thermal detection
  • Thermal pain threshold

ASJC Scopus subject areas

  • Neuroscience(all)


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