Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
Developed by David W. Levine, MD and colleagues at Brigham and Women's Hospital, Harvard Medical School, Boston, USA. First published in 1993.
Copyright & Licensing
The Boston Carpal Tunnel Questionnaire was developed by Levine et al. and published in 1993. The instrument is widely used in clinical practice and research. Users should verify current licensing requirements with the original developers or relevant licensing bodies.
Administration Instructions
Please answer all questions based on your symptoms and abilities during the past two weeks. Select the response that best describes your condition.
Scoring Methodology
The BCTQ consists of two subscales: the Symptom Severity Scale (SSS) with 11 items and the Functional Status Scale (FSS) with 8 items. Each item is scored from 1 to 5. The subscale score is calculated as the mean of the item responses. Scores range from 1 (no symptoms/difficulty) to 5 (very severe symptoms/cannot perform). Lower scores indicate better outcomes.
Meaningful Change Threshold
The Minimal Clinically Important Difference (MCID) for the Symptom Severity Scale is approximately 1.0 point. A reduction of 1.0 points or more in the SSS is considered a meaningful improvement from the patient's perspective.
Score Interpretation
Understanding what your score means
minimal
1 - 1.5Minimal symptoms or functional impairment. Patient reports little to no impact from carpal tunnel syndrome.
mild
1.6 - 2.5Mild symptoms or functional impairment. Some symptoms present but manageable without significant impact on daily activities.
moderate
2.6 - 3.5Moderate symptoms or functional impairment. Noticeable impact on daily activities and quality of life.
severe
3.6 - 4.5Severe symptoms or functional impairment. Significant impact on daily activities, work, and quality of life.
very severe
4.6 - 5Very severe symptoms or functional impairment. Major disability with inability to perform many daily activities.
Subscales
This questionnaire measures multiple dimensions
Symptom Severity Scale (SSS) (1-5)
Assesses the severity and frequency of carpal tunnel syndrome symptoms including pain, numbness, tingling, weakness, and nocturnal symptoms.
Functional Status Scale (FSS) (1-5)
Evaluates difficulty performing common daily activities affected by carpal tunnel syndrome such as writing, buttoning clothes, holding objects, and carrying items.
Clinical Limitations & Considerations
The BCTQ is specific to carpal tunnel syndrome and may not capture symptoms from other hand/wrist conditions. Scores may be influenced by comorbidities affecting hand function. The FSS may have ceiling effects in patients with milder symptoms. Some questions reference activities that may not be relevant to all patients (e.g., holding a book, using a telephone). The questionnaire does not assess psychological impact or work-related disability.
Supporting Literature
Key validation and development studies for the Boston Carpal Tunnel Questionnaire
- 1
A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome
Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN
The Journal of Bone and Joint Surgery (American Volume), 1993
- 2
Responsiveness of the Carpal Tunnel Questionnaire after carpal tunnel release
Katz JN, Gelberman RH, Wright EA, Lew RA, Liang MH
The Journal of Hand Surgery, 1994
- 3
Determining the minimal clinically important difference for the Boston Carpal Tunnel Questionnaire
Greenslade JR, Mehta RL, Belward P, Warwick DJ
International Orthopaedics, 2004
- 4
Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome
Mondelli M, Reale F, Sicurelli F, Padua L
Journal of Hand Surgery, 2000
- 5
A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome
Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN
The Journal of Bone and Joint Surgery (American Volume), 1993
- 6
Responsiveness of the Carpal Tunnel Questionnaire after carpal tunnel release
Katz JN, Gelberman RH, Wright EA, Lew RA, Liang MH
The Journal of Hand Surgery, 1994
- 7
Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature
De Kleermaeker FGCM, Boogaarts HD, Meulstee J, Verhagen WIM
Journal of Hand Surgery (European Volume), 2019
- 8
Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome
Mondelli M, Reale F, Sicurelli F, Padua L
Journal of Hand Surgery, 2000
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This questionnaire is provided free of charge. Patient Watch charges only for platform services (data storage, automated reminders, analytics) - not for use of clinical instruments. This non-commercial model supports academic and clinical use. View full licensing disclosure