An Association Between Carpal Tunnel Syndrome and Migraine Headaches

National Health Interview Survey, 2010

Huay-Zong Law, MD; Bardia Amirlak, MD; Jonathan Cheng, MD; Douglas M. Sammer, MD

Disclosures

Plast Reconstr Surg Glob Open. 2015;3(3):E333 

In This Article

Abstract and Introduction

Abstract

Background: Migraine headaches have not historically been considered a compression neuropathy. Recent studies suggest that some migraines are successfully treated by targeted peripheral nerve decompression. Other compression neuropathies have previously been associated with one another. The goal of this study is to evaluate whether an association exists between migraines and carpal tunnel syndrome (CTS), the most common compression neuropathy.

Methods: Data from 25,880 respondents of the cross-sectional 2010 National Health Interview Survey were used to calculate nationally representative prevalence estimates and 95% confidence intervals (95% CIs) of CTS and migraine headaches. Logistic regression was used to calculate adjusted odds ratios (aORs) and 95% CI for the degree of association between migraines and CTS after controlling for known demographic and health-related factors.

Results: CTS was associated with older age, female gender, obesity, diabetes, and smoking. CTS was less common in Hispanics and Asians. Migraine was associated with younger age, female gender, obesity, diabetes, and current smoking. Migraine was less common in Asians. Migraine prevalence was 34% in those with CTS compared with 16% in those without CTS (aOR, 2.60; 95% CI, 2.16–3.13). CTS prevalence in patients with migraine headache was 8% compared with 3% in those without migraine headache (aOR, 2.67; 95% CI, 2.22–3.22).

Conclusions: This study is the first to demonstrate an association between CTS and migraine headache. Longitudinal and genetic studies with physician verification of migraine headaches and CTS are needed to further define this association.

Introduction

Carpal tunnel syndrome and migraine headache are common disorders, affecting up to 6%[1–5] and 15%[6–12] of the adult population, respectively. Both result in substantial burden to patients and society. Migraine headaches cause 112 million bedridden days per year[13,14] and generate annual costs totaling up to 17 billion dollars in the United States alone.[14,15] Carpal tunnel syndrome in the United States annually costs society in excess of 2 billion dollars.[16,17] In spite of the high prevalence and socioeconomic burden imposed by carpal tunnel syndrome and migraine headache, the precise etiology of both conditions remains poorly understood.

Carpal tunnel syndrome is the most common disorder in a larger family of compression neuropathies, which includes cubital tunnel syndrome, peroneal neuropathy, tarsal tunnel syndrome, radial tunnel syndrome, pronator syndrome, thoracic outlet syndrome, and others.[18,19] Several studies in the literature support an epidemiologic association between different compression neuropathies such as cubital tunnel syndrome and carpal tunnel syndrome[20,21] and thoracic outlet syndrome and carpal tunnel syndrome.[22–26] The cause of these associations is poorly understood and may be multifactorial.

Migraine headache, on the other hand, has not historically been considered to be a compression neuropathy. Recently, however, there is some evidence that migraine headache may be triggered by nerve compression in the head and neck, with some patients responding to nerve decompression by surgical release.[27–32] In addition, the effects of botulinum toxin, either by direct action on the nerve or by weakening of the overlying muscle, may point further to this theory.[33–38] The purpose of this study is to evaluate the hypothesis that an association exists between carpal tunnel syndrome and migraine headache.

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