Houston Methodist. Leading Medicine

Hand FAQ

Question:

I am in a study for patients with carpal tunnel syndrome who have surgery. I've already had the operation. Each time I go in for a check-up, they have me fill out the same two questionnaires about my pain. I don't really think I'm getting better but the researcher collecting the data says I am. Really, wouldn't I know better how I'm doing than this pip-squeak?

Answer:

You may be experiencing a phenomenon called the response shift theory. Your measurements before and after treatment show a significant difference. But you are experiencing the change more slowly. As your symptoms improve, your internal measuring unit for change shifts. Your judgment may have been clouded by your perception -- you may have actually experienced measurable improvement in symptoms. But you got used to the gradual change. When change occured, you may not have recognized just how much improvement there was. In other words, you did not register the full amount of pain decrease no matter what amount of recovery had really been experienced. This is not an uncommon shift in response to treatment. That's why physicians, surgeons, and therapists use different tools to measure outcomes of treatment. Each tool has its own function and importance. Isam Atroshi, MD, PhD, et al. The Six-Item CTS Symptoms Scale and Palmar Pain Scale in Carpal Tunnel Syndrome. In The Journal of Hand Surgery. May 2011. Vol. 36A. No. 5. Pp. 788-794.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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