Association of Psychological Factors with Limb Disability in Patients with Cervical Radiculopathy: Comparison with Carpal Tunnel Syndrome

Background: Regarding musculoskeletal conditions, patient’s psychological distress, are shown to be associated with higher disability. This study aims to investigate the association of validated scores for depression, anxiety, and pain catastrophizing, with measures of upper limb patient-reported and performance-based disability, in patients with cervical radiculopathy (CR), and compare the obtained results with our similar study on carpal tunnel syndrome (CTS). Methods: : In a cross-sectional study, we recruited 92 patients with CR, and investigated their disability level using patient-reported questionnaires (Quick Disabilities of the Arm, Shoulder and Hand (DASH) and pain Likert Scale) and by measuring grip and pinch strength. We also assessed their psychological status with Hospital Anxiety and Depression Scale questionnaire for depression (HADS-D) and anxiety (HADS-A) and also Pain Catastrophizing Scale (PCS) tools. We performed correlational coefficient analysis between disability and psychological scores and regression analysis of dependent variables (Pain, DASH, grip and pinch scores) and independent (psychological) variables. Finally, Z observed value was calculated to compare correlational coefficients between two diseases of CTS and CR. Results: : The results of the correlational coefficient analysis indicate that all three HADS-A, HADS-D and PCS scores correlated with DASH score (r = 0.49, 0.37, 0.38 for HADS-A, HADS-D and PCS, respectively; p < 0.001 for all three). HADS-A also significantly correlated with VAS pain score (r = 0.41, P <0.001) and grip strength (r = -0.25, P = 0.016). Linear regression analysis revealed that anxiety has a notable predicting value for DASH and VAS pain scores as well as grip strength. Fisher’s r correlation coefficient to z transformation, revealed that there was no difference between two diseases of CTS and CR in terms of the resulted r coefficients from correlational coefficient analysis between disability and psychological distress. Conclusion: It is concluded that psychological disorders are associated with disability in CR patients, with anxiety also correlating with objective disability parameter of grip strength. Finally, both CTS and CR patients’ disabilities relate to psychological conditions in a similar manner. Level of Evidence: Level IV (cross-sectional study)