nach oben

Journal of Occupational Rehabilitation

Erschienen in:

01.06.2006 | Original paper

Evaluation of Work-Related Carpal Tunnel Syndrome

verfasst von: Robert A. Werner

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 2/2006

Einloggen, um Zugang zu erhalten

Abstract

Objectives: Carpal tunnel syndrome (CTS) is common in the industrial setting but there are still some advocates who argue that CTS is not a work related problem. There are also controversies about the proper way to establish the diagnosis and whether screening for CTS in the industrial setting is warranted. Methods: A comprehensive literature review. Results: The literature does demonstrate that the prevalence of CTS in the industrial setting is significantly higher than in the general population. Numerous epidemiologic studies have identified independent risk factors, which include repetitiveness of work, forceful exertions, mechanical stress, posture, and vibration as well as several personal co-factors. The strength of these associations are discussed. The diagnostic criteria for establishing work-related CTS are discussed as well as the effectiveness of various screening methods that are commonly used in the workplace. The sensitivity and specificity of nerve conduction studies to establish or confirm the diagnosis of CTS is presented along with normative data for the industrial worker. Conclusions: CTS has both work-related and personal risk factors. The diagnosis is best established using a combination of history, symptom distribution and confirmation using the relative latency of median sensory testing using normative data. Screening for CTS in the industrial setting has questionable benefit.

Ramazzini B. Treatise on disease of workers. Wright WC, translator. New York: Hafner Publishing Co, 1964.

Bureau of Labor Statistics, http://stats.bls.gov/iif/oshwc/osh/os/osch0024.pdf, accessed 4-19-05.

Feuerstein M, Miller VL, Burrell LM, Berger R. Occupational upper extremity disorders in the federal workforce: prevalence, health care expenditures and patterns of work disability. JOEM 1998;40:546–55.CrossRef

Bureau of Labor Statistics. http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm, accessed 2-25-2005.

Cummings K, Maizlish N, Rudolph L, Dervin K, Ervin A. Occupational disease surveillance: carpal tunnel syndome. MMWR 1989;38:485–9.

Armstrong TJ, Castelli W, Evans F, Diaz-Perez R. Some histological changes in carpal tunnel contents and their biomechanical implications. J Occup Med 1984;26:197–201.PubMed

Phalen G. The carpal tunnel syndrome. J Bone Joint Surg 1966;48:211–28.PubMed

Phalen G. The carpal tunnel syndrome: clinical evaluation of 598 hands. Clin Orthop Relat Res 1972;83:29–40.PubMedCrossRef

Stevens JC, Sun S, Beard CM, O’Fallon WM, Kurland LT. Carpal tunnel syndrome in Rochester, Minnesota, 1961–1980. Neurology 1988;38:134–8.PubMed

10.

Franklin GM, Haug J, Heyer N, Checkoway H, Peck N. Occupational carpal tunnel syndrome in Washington state, 1984–1988. Am J Public Health 1991;81:741–6.PubMed

11.

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282:153–8.PubMedCrossRef

12.

deKrom MC, Kester AD, Knipschild PG, Spaans F. Risk factors for carpal tunnel syndrome. Am J Epidemiol 1990;132:1102–10.

13.

Franzblau A, Werner RA, Valle J, Johnston E. Workplace surveillance for carpal tunnel syndrome: a comparison of methods. J Occup Rehabil 1993;3:1–14.CrossRef

14.

Homan MM, Franzblau A, Werner RA, Albers JW, Armstrong TJ, Bromberg MB. Agreement between symptom surveys, physical examination procedures and electrodiagnostic findings for carpal tunnel syndrome. Scand J Work Environ Health 1999;25:115–24.PubMed

15.

Matte TD, Baker EL, Honchar PA. The selection and definition of target work-related conditions for surveillance under SENSOR. Am J Public Health 1989;79:S21–5.

16.

Rempel D, Evanoff B, Amadio PC, de Krom M, Franklin G, Franzblau A, Gray R, Gerr F, Hagberg M, Hales T, Katz JN, Pransky G. Consensus criteria for classification of carpal tunnel syndrome in epidemiologic studies. Am J Pub Health 1998;88:1447–51.PubMed

17.

Katz JN, Larson MG, Fossel AH, Liang MH. Validation of a surveillance case definition of carpal tunnel syndrome. Am J Public Health 1991;81:189–93.PubMed

18.

Salerno DF, Franzblau A, Werner RA, Chung KC, Schultz JS, Becker MP, Armstrong TJ. Reliability of physical examination of the upper extremity among keyboard operators. Am J Ind Med 2000;37:423–30.PubMedCrossRef

19.

Bingham RC, Rosecrance JC, Cook TM. Prevalence of abnormal nerve conduction in applicants for industrial jobs. Am J Ind Med 1996;30:355–61.PubMedCrossRef

20.

Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 1993;16:1392–414.PubMedCrossRef

21.

American Academy of Neurology, American Association of Electrodiagnostic Medicine, American Academy of Physical Medicine and Rehabilitation. Summary statement for electrodiagnostic studies in carpal tunnel syndrome. Muscle Nerve 2002;25:918–22.CrossRef

22.

Andary MT, Fankhauser MJ, Spiegel N, Zaneteas P, Ritson JL, Hulce VD, Yosef M, Stanton DF. Comparison of four techniques in the diagnosis of mild carpal tunnel syndrome, abstract. Muscle Nerve 1992;15:1174.

23.

Salerno DF, Franzblau A, Werner RA, Bromberg MB, Armstrong TJ, Albers JW. Median and ulnar nerve conduction studies among workers: normative values. Muscle Nerve 1998;21:999–1005.PubMedCrossRef

24.

Stetson DS, Albers JW, Silverstein BA, Wolfe RA. Effects of age, sex, and anthropometric factors on nerve conduction measures. Muscle Nerve 1992;15:1095–104.PubMedCrossRef

25.

Kimura J. Electrodiagnosis in diseases of nerve and muscle: principles and practices. Philadelphia: FA Davis; 1983. p. 106–11.

26.

Robinson LR, Temkin NR, Fujimoto WY, Stolov W. Effect of statisical methodology on normal limits in nerve conduction studies. Muscle Nerve 1991;14:1084–90.PubMedCrossRef

27.

Robinson LR, Micklesen P, Wang L. Strategies for analyzing nerve conduction data: superiority of a summary index over single tests. Muscle Nerve 1998;21:1166–71.PubMedCrossRef

28.

Stetson DS, Silverstein BA, Keyserling W, Wolfe RA, Albers JW. Median sensory distal amplitude and latency: comparisons between non-exposed managerial/professional employees and industrial workers. Am J Ind Med 1993;24:175–89.PubMedCrossRef

29.

Kearns J, Gresch EE, Weichel CY, Eby P, Pallapothu SR. Pre- and post-employment median nerve latency in pork processing employees. J Occup Environ Med 2000;42:96–100.PubMedCrossRef

30.

Bernard BP, editor. Musculoskeletal disorders and workplace factors: a critical review of epidemiological evidence for work-related musculoskeletal disorders of the neck, upper extremity and low back. NIOSH Publication 97–141. Washington, DC: National Institute for Occupational Safety and Health, 1997.

31.

Silverstein BA, Fine LJ, Armstrong TJ. Occupational factors and carpal tunnel syndrome. Am J Ind Med 1987;11:343–58.PubMedCrossRef

32.

Nathan PA, Keniston RC, Myers LD, Meadows KD. Obesity as a risk factor for slowing of sensory conduction of the median nerve in industry: A cross-sectional and longitudinal study involving 429 workers. J Occup Med 1992;34:379–83.PubMedCrossRef

33.

Stock SR. Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: a meta-analysis. Am J Ind Med 1991;19:87–107.PubMedCrossRef

34.

Cannon LJ, Bernacki EJ, Walter SD. Personal and occupational factors associated with carpal tunnel syndrome. J Occup Med 1982;23:255–8.

35.

Latko W, Armstrong T, Franzblau A, Ulin S, Werner R, Albers JW. A cross-sectional study of the relationaship between repetitive work and the prevalence of upper limb musculoskeletal disorders. Am J Ind Med 1999;36:248–59.PubMedCrossRef

36.

Armstrong TJ, Foulke JA, Joseph BS, Goldstein SA. Investigation of cumulative trauma disorders in a poultry processing plant. Am Ind Hyg Assoc J 1982;43:103–16.PubMed

37.

2002 Threshold Limit Values for Chemical Substances and Physical Agents in the Work Environment. ACGIH Worldwide, 2002.

38.

Werner RA, Armstrong TJ. Carpal tunnel syndrome: ergonomic risk factors and intracarpal canal pressure. In: Johnson E, editor, Carpal tunnel syndrome. Phys Med Rehabil Clin N Am 1997;8:555–69.

39.

Armstrong T, Chaffin D. Carpal tunnel syndrome and selected personal attributes. J Occup Med 1979;21:481–6.PubMed

40.

Armstrong TJ. Upper-extremity posture: definition measurement and control. In: Corlett N, Wilson J, Manenica I, editors, The ergonomics of working postures: proceedings of the first international occupational ergonomics symposium, Zadar, Yugoslavia. London: Taylor and Francis; 1985.

41.

Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH. The carpal tunnel syndrome. A study of carpal canal pressures. J Bone Joint Surg 1981;63:380–3.PubMed

42.

Tanzer R. The carpal tunnel syndrome. J Bone Joint Surg 1959;41:626–34.PubMed

43.

Fox W. Human performance in the cold. Hum Factors 1967;9:203–20.PubMed

44.

Morton R, Provins K. Finger numbness after acute local exposure to cold. J Appl Physical 1960;15:149.

45.

Armstrong TJ, Fine LJ, Radwin RG, Silverstein BS. Ergonomics and the effects of vibration in hand-intensive work. Scand J Work Environ Health 1987;13:286–928.PubMed

46.

Pyykko I. A longitudinal study of the vibration syndrome in Finnish forestry workers. In: Brammer AJ, Taylor W, editors, Vibration effects on the hand and arm in industry. New York: John Wiley and Sons; 1982. p. 157.

47.

Radwin RG, Armstrong TJ, Chaffin DB. Power hand tool vibration effects on grip exertions. Ergonomics 1987;30:833–55.CrossRef

48.

Faucett J, Werner RA. Non-biomechanical factors potentially affecting musculoskeletal disorders. Washington DC: National Academy Press; 1999. p. 175–99.

49.

Atcheson SG, Ward JR, Lowe W. Concurrent medical disease in work-related carpal tunnel syndrome. Arch Intern Med 1998;158:1506–12.PubMedCrossRef

50.

Stevens JC, Beard CM, O’Fallon WM, Kurland LT. Conditions associated with carpal tunnel syndrome. Mayo Clin Proc 1992;67:541–8.PubMed

51.

Albers JW, Brown MB, Sima AA, Greene DA. Frequency of median mononeuropathy in patients with mild diabetic neuropathy in the early diabetes intervention trial (EDIT). Muscle Nerve 1996;19:140–6.PubMedCrossRef

52.

Leach RE, Odon JA. Systemic causes of the carpal tunnel syndrome. Postgrad Med 1968;44:127–31.PubMed

53.

Dieck GS, Kelsey JL. An epidemiologic study of the carpal tunnel syndrome in an adult female population. Prev Med 1985;14:63–9.PubMedCrossRef

54.

Massey EW. Carpal tunnel syndrome in pregnancy. Obstet Gynecol Surv 1978;33:145–7.PubMedCrossRef

55.

Werner RA, Albers JW, Franzblau A, Armstrong TJ. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve 1994;17:632–6.PubMedCrossRef

56.

Bleecker ML, Bohlman M, Moreland R, Tipton A. Carpal tunnel syndrome: role of carpal canal size. Neurology 1985;35:1599–604.PubMed

57.

Gelmers H. Primary carpal tunnel stenosis as a cause of entrapment of the median nerve. Acta Neurochir 1981;55:317–20.CrossRef

58.

Winn FJ, Habes DJ. Carpal tunnel area as a risk factor for carpal tunnel syndrome. Muscle Nerve 1990;13: 254–8.PubMedCrossRef

59.

Gould JS, Wissinger A. Carpal tunnel syndrome in pregnancy. South Med J 1978;71:144–5.PubMed

60.

Vessey MP, Villard-Mackintosh L, Yeates D. Epidemiology of carpal tunnel syndrome in women of childbearing age. Findings in a large cohort study. Int J Epidemiol 1990;19:655–9.PubMedCrossRef

61.

Sabour M, Fadel H. The carpal tunnel syndrome: a new complication ascribed to the pill. Am J Obstet Gynecol 1970;107:1265–7.PubMed

62.

Werner RA, Albers JW, Franzblau A, Armstrong TJ. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve 1994;17:632–6.PubMedCrossRef

63.

Letz R, Gerr F. Covariates of human peripheral nerve function: I. Nerve conduction velocity and amplitude. Neurotoxicology 1994;16:95–104.

64.

Nathan PA, Keniston RC. Lockwood RS, Meadows KD. Tobacco, caffeine, alcohol, and carpal tunnel syndrome in American industry. A cross-sectional study of 1464 workers. J Occup Environ Med 1996;38: 290–8.PubMedCrossRef

65.

Nathan PA, Keniston RC. Carpal tunnel syndrome and its relation to general physical condition. Hand Clin 1993;9:253–61.PubMed

66.

Radecki P. The familial occurrence of carpal tunnel syndrome. Muscle Nerve 1994;17:325–30.PubMedCrossRef

67.

Katz JN, Losina E, Amick BC, Fossel AH, Bessette L, Keller RB. Predictors of outcomes of carpal tunnel release. Arthritis Rheum 2001;44(5):1184–93.PubMedCrossRef

68.

Butler RJ, Liao H. Job performance failure and occupational carpal tunnel claims. J Occup Rehabil 2002;12(1):1–12.PubMedCrossRef

69.

Anonymous. CTD clinic. Growing nerve-test industry sparks questions about efficacy of the ADA. CTD News 1993;2:8–9.

70.

Anonymous. CTD Clinic. Preplacement test for CTDs challenged. CTD News 1995;4:1–7.

71.

EEOC v. Rockwell International Corporation, No.95C-3824 (N.D. Ill), June 30, 1995.

72.

EEOC v. Woodbridge Corp., 2000 U.S. Dist. LEXIS 15140, 11 Am. Disabilities Cas. (BNA) 5 (W.D. Mo. Oct. 2, 2000).

73.

Werner RA, Franzblau A, Albers JW, Buchele H, Armstrong TJ. Use of screening nerve conduction studies for predicting future carpal tunnel syndrome. Occup Environ Med 1997;54:96–100.PubMedCrossRef

74.

Werner RA, Gell N, Franzblau A, Armstrong TJ. Prolonged median sensory latency as a predictor of future carpal tunnel syndrome. Muscle Nerve 2001;24:1462–7.PubMedCrossRef

75.

Nathan PA, Keniston RC, Myers LD, Meadows KD, Lockwood RS. Natural history of median nerve sensory conduction in industry: Relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years. Muscle Nerve 1998;21:711–21.PubMedCrossRef

76.

Franzblau A, Werner RA, Yihan J. Pre-Placement Nerve Testing for Carpal Tunnel Syndrome: Is it Cost Effective? JOEM 2004;46:714–9.PubMed

77.

Merchut MP, Kelly MA, Toleikis SC. Quantitative sensory thresholds in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 1990;30:119–24.PubMed

78.

Lundborg G, Gelberman RH, Minteer-Convery M, Lee YF, Hargens AR. Median nerve compression in the carpal tunnel—functional response to experimentally induced controlled pressure. J Hand Surg 1982;7:252–9.

79.

Werner RA, Franzblau A, Johnston E. Comparison of multiple frequency vibrometry testing and sensory nerve conduction measures in screening for carpal tunnel syndrome in an industrial setting. Amer J Phys Med Rehabil 1995;74:101–6.

80.

Werner RA, Franzblau A, Johnston E. Quantitative vibrometry and electrophysiological assessment in screening for carpal tunnel syndrome among industrial workers: a comparison. Arch Phys Med Rehabil 1994;75:1228–32.PubMedCrossRef

81.

Franzblau A, Werner RA, Johnston E, Torrey S. Evaluation of current perception threshold as a screening procedure among industrial workers. J Occup Med 1994;36:1015–21.PubMed

82.

Franzblau A, Werner RA, Albers JW, Olinski D, Johnston E. Workplace surveillance for carpal tunnel syndrome using hand diagrams. J Occup Rehabil 1994;4:185–98.CrossRef

83.

Werner RA, Franzblau A, Gell N. Randomized Controlled Trial of Nocturnal Splinting for Active Workers with Symptoms of Carpal Tunnel Syndrome. Arch Phys Med Rehabil 2005;86:1–7.PubMedCrossRef

84.

Szabo RM, Gelberman RH, Dimick MP. Sensibility testing in patients with carpal tunnel syndrome. J Bone Joint Surg 1984;66:60–4.PubMed

85.

Franzblau A, Armstrong TJ, Werner RA, Ulin S. A cross-sectional assessment of the ACGIH TLV for hand activity level. J Occ Rehabil 2005;15(1):57–67.CrossRef

Titel: Evaluation of Work-Related Carpal Tunnel Syndrome
verfasst von: Robert A. Werner
Publikationsdatum: 01.06.2006
Verlag: Springer US
Erschienen in: Journal of Occupational Rehabilitation / Ausgabe 2/2006
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-006-9026-3

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2006

Return to work after two years of total disability: A case report

I. Z. Schultz and R. J. Gatchel, Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention, and Prevention

Perceived effort and low back pain in non-emergency ambulance workers: Implications for rehabilitation

Cognitive Behavioural Therapy Increases Re-Employment of Job Seeking Worker's Compensation Clients

Return to work and adjustment latitude among employees on long-term sickness absence

Labor force activity among Australians with musculoskeletal disorders comorbid with depression and anxiety disorders