Evaluating the Association Between Obesity and Development of Trigger Finger and Carpal Tunnel Syndrome

Abstract

Purpose: Obesity is known to cause a low-grade inflammatory environment that can influence the development of musculoskeletal disorders. We hypothesized that patients with high body mass index (BMI), defined as ≥30, would develop carpal tunnel syndrome (CTS) or stenosing tenosynovitis (TF) earlier than patients with a normal BMI. Methods: A retrospective chart review was performed for adults diagnosed with CTS or TF between January 2016 and December 2020 at a tertiary center. The primary outcome was age at diagnosis of CTS or TF. A high BMI was considered ≥ 30, whereas a normal BMI was 18.5–24.9. A stepwise multivariate linear regression model compared the association of BMI with age of CTS or TF diagnosis after adjusting for accelerating covariates. Results: In total, 259 patients met the inclusion criteria. Our analysis revealed that patients with a BMI above 30 were diagnosed with CTS or TF an average of 6.4 years earlier than those with a normal BMI, at 67.5 and 61.1 years, respectively (P = .0053). Furthermore, covariate analysis showed that a BMI above 30 was associated with the onset of CTS or TF 6.2 years sooner than patients with normal BMI (P < .05). Current smokers developed CTS or TF 12.5 years sooner than never smokers (P < .05). Patients with type 1 diabetes developed CTS or TF, on average, 18.8 years sooner than nondiabetic patients (P < .05). Patients with hypertension developed CTS or TF on average 6.0 years later than those without hypertension (P < 0.05). Conclusions: Patients with a high BMI above 30 were diagnosed with CTS or TF at a younger age than normal BMI after covariate adjustment. Obesity is associated with accelerated development of CTS and TF after adjusting for comorbidities such as smoking and type 1 diabetes. Clinical relevance: This study sheds light on the earlier development of CTS and trigger finger in patients with a BMI greater than 30, contributing to a relatively underexplored area of upper-extremity musculoskeletal pathology research and enabling clinicians with more thorough data for preventative talks with patients.

Keywords

• Carpal tunnel syndrome
• Compression injury of nerve
• Hand orthopedic surgery
• Obesity