Are Migraine and Carpal Tunnel Syndrome Linked?

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A new study suggests that there may be a link between carpal tunnel syndrome (CTS) and migraine. The results of this study were recently published online in the journal Plastic and Reconstructive Surgery.

The Study:

Study 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."

Study Methods:

  • Data from the cross-sectional 2010 National Health Interview Survey (NHIS) was used to identify participants with both CTS and migraine.
  • If a respondent in the study answered, "yes," to two questions, they were identified as a case of CTS. The questions were:
    • "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?”
    • “During the past 12 months have you had carpal tunnel syndrome?"
  • If a respondent in the study answered, "yes," to one question, “During the past 3 months, did you have severe headache or migraine?” they were identified as a case of "migraine headache."

Study Results:

"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)."

Study 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."

Summary and Comments:

It's worthy of noting that this study was conducted by researchers in the field of plastic surgery, not researchers in the field of migraine and other headache disorders. I have several concerns about what they consider to be the background for the study and the methods by which the study was conducted:

  • The authors refer to migraines as "migraine headaches," leaving me wondering if they paid any attention to migraine symptoms other than head pain. If they took into account only the one symptom in their background, that's one major flaw before they even began the study.
  • Reference is made to peripheral nerve decompression surgery, surgery for which there are inadequate properly controlled trials from which to draw any reasonable conclusion that the surgery is indeed helpful and appropriate.
  • The way by which they identified CTS patients and especially migraine patients is so inadequate that I can place no value on the study results or conclusions. "Severe headache" doesn't necessarily mean migraine, and relying only on study participants saying they've had a migraine means little to nothing without appropriate diagnosis.
  • Approaching migraine as a compression neuropathy when the vast majority of health care professionals who diagnose and know it to be a neurological disease of the brain inspires no faith in how the study was conducted, its results, or its conclusions.

Whether there is a connection between carpal tunnel syndrome and migraine is an interesting question, but the flaws in this study lead me to not take it very seriously. Studies with better considered background and better study methods are necessary to answer the question.

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Sources:

Law, Huay-Zong, MD; Amirlak, Bardia, MD; Cheng, Jonathan, MD; Sammer, Douglas M., MD. "An Association between Carpal Tunnel Syndrome and Migraine Headaches - National Health Interview Survey, 2010." Plastic and Reconstructive Surgery. Volume 3, Issue 3. March, 2015.

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