Higher preoperative pain catastrophizing was independently associated with higher postoperative pain intensity after carpal tunnel release, suggesting this factor may be useful as part of preoperative screening to identify patients at higher risk for more severe postoperative pain.
Key Findings
Results
Pain catastrophizing was the only factor independently associated with higher worst postoperative pain intensity in multivariable analysis.
In univariable analyses, poorer sleep quality, more pain catastrophizing, more PRWHE hand pain and disability, and higher preoperative pain were all associated with more severe postoperative pain.
In the multivariable analysis, only higher level of pain catastrophizing remained independently associated with more severe postoperative pain.
Study included 83 patients aged 18–79 years undergoing primary outpatient open carpal tunnel release.
Linear regression analyses were used to estimate associations between age, sex, education, comorbidity, pain catastrophizing, and sleep quality and worst postoperative pain intensity.
Results
A substantial proportion of patients experienced moderate to severe acute pain following carpal tunnel release.
47% of patients experienced moderate pain during the first three postoperative days.
32.5% of patients reported severe pain during the first three postoperative days.
The primary outcome was worst pain intensity during the first three postoperative days, measured on a 0–10 scale.
Mean worst pain intensity during the first three postoperative days was 5.3 out of 10.
Results
Patients' mean worst preoperative pain was lower than their mean worst postoperative pain.
Patients rated their worst preoperative pain at 4.5 on a scale from 0 to 10.
Worst pain intensity during the first three postoperative days was 5.3 on a scale from 0 to 10.
This represents an increase in worst pain intensity from pre- to postoperative period.
Methods
The study sample was predominantly female with a mean age of 60 years.
83 patients were included in the prospective observational study.
64% of patients were women.
Mean patient age was 60 years.
Patients underwent primary outpatient open carpal tunnel release.
Patients completed questionnaires assessing demographics, comorbidities, pain and function (PRWHE), sleep quality, and pain catastrophizing preoperatively.
Conclusions
Preoperative screening for pain catastrophizing may help identify patients at higher risk for severe acute postoperative pain after carpal tunnel release.
Authors suggest pain catastrophizing 'may be useful as part of preoperative screening to identify patients at higher risk for more severe postoperative pain.'
Pain catastrophizing was assessed preoperatively as part of the study questionnaire.
The finding held after controlling for age, sex, education, comorbidity, and sleep quality in multivariable analysis.
What This Means
This research suggests that how much a person tends to catastrophize about pain before surgery — meaning they ruminate on it, feel helpless about it, or magnify how bad it might be — is the strongest predictor of how much pain they will experience in the first few days after carpal tunnel release surgery. The study followed 83 patients and found that while several factors (including poor sleep, hand disability, and higher preoperative pain) were linked to worse postoperative pain when examined individually, only pain catastrophizing remained a significant predictor when all factors were considered together.
The results also highlight that acute post-surgical pain after carpal tunnel release is common and often significant: nearly half of patients reported moderate pain and about one-third reported severe pain in the first three days after the procedure, with average worst pain scores actually higher after surgery than before. This suggests that pain management after this commonly performed outpatient surgery deserves more attention than it may currently receive.
This research suggests that routinely measuring pain catastrophizing before carpal tunnel surgery could help healthcare providers identify which patients are most likely to struggle with acute pain afterward, potentially allowing for more targeted pain management strategies or psychological support to be put in place before the operation.
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Sletten R, Olsen U, Aamodt A, Lindberg M. (2026). Pain catastrophizing is associated with higher pain intensity following carpal tunnel release: a prospective observational study.. Scandinavian journal of pain. https://doi.org/10.1515/sjpain-2026-0011