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


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

In This Article

Materials and Methods

Data from the Adult Core module of the 2010 National Health Interview Survey (NHIS) were used to calculate prevalence estimates for carpal tunnel syndrome and migraine headache.[39] The NHIS is an annual, in-person health survey of the civilian, noninstitutionalized population of the United States. The survey is administrated throughout the year. Analyses were restricted to adults that provided complete information for carpal tunnel syndrome status, migraine headache status, and covariates as listed below. Race/ethnicity groups were excluded if unable to be included in the logistic regression analysis due to too few respondents. All estimates were calculated using provided final sample weights to produce nationally representative estimates that adjust for the stratified sampling design of the survey.

A case of carpal tunnel syndrome was defined as a respondent who answered "yes" to both questions, "Have you ever been told by a doctor or other health professional that you have a condition affecting the wrist and hand called carpal tunnel syndrome?" and "During the past 12 months have you had carpal tunnel syndrome?" A case of migraine headache was defined as a respondent who answered "yes" to the question, "During the past 3 months, did you have severe headache or migraine?" Demographic covariates included age (18–34, 35–49, 50–64, and ≥65 years); gender; and race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and Asian). Health status and behavior covariates included body mass index (BMI) (≤24.99 = healthy or underweight, 25.00–29.99 = overweight, and ≥30.00 = obese); diabetes status (yes/no); and smoking status (current, former, and never). These covariates have all previously been associated with these conditions and were available in this database. These age groups were selected to provide similar ranges of age (15- to 17-year range in youngest 3 groups) and to ensure sufficient responses in each group to allow for reliable reporting of statistics. The BMI categories are based on categories defined by the Centers for Disease Control and Prevention.[40]

Statistical Analysis

All analyses were performed with SAS software, version 9.3 (SAS Institute, Cary, N.C.). All respondents—including those with missing data—remained in the analysis universe to maintain accurate variance estimates, with domain analyses performed for those records with and without missing variable data. Given the stratified sampling design, the SURVEYFREQ function was used to determine weighted distribution and prevalence rates with 95% confidence intervals (CIs) by each covariate for both carpal tunnel syndrome and migraine headache. Chi-square analyses were used to determine statistically significant differences among subgroups. All covariates were found to be significant (P < 0.05) in bivariate analyses and were included in the multivariate regression models. The multivariate logistic regression models were used to control for confounding by covariates. Given the sampling design, the SURVEYLOGISTIC function was used to calculate weighted adjusted odds ratios (aORs) with 95% CI for having carpal tunnel syndrome and for having migraine headache. Collinearity was evaluated by calculating variance inflation factors (VIFs) for each covariate. All VIFs were less than 2, below the common convention criterion of VIF < 10.[41]