Sickness absence after carpal tunnel release: a systematic review of the literature

Newington, Lisa; Stevens, Martin J.; Warwick, David; Adams, Jo; Walker‐Bone, Karen

doi:10.5271/sjweh.3762

Cited by 20 publications

(22 citation statements)

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“…In this multicentre prospective cohort study, the median duration of work absence was 20 days (range 1–99), a duration similar to that reported by other European studies. 21 Earlier return to work was associated with typing for ≥4 hours at work (as compared with more physical workplace tasks) and undergoing surgery in primary care (as compared with secondary care or private practice). Preoperative expectations about return to work were important significant predictors of actual return to work times.…”

Section: Discussionmentioning

confidence: 99%

Sickness absence after carpal tunnel release: a multicentre prospective cohort study

et al. 2021

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ObjectivesTo describe when patients return to different types of work after elective carpal tunnel release (CTR) surgery and identify the factors associated with the duration of sickness absence.DesignMulticentre prospective observational cohort study.Setting and participantsParticipants were recruited preoperatively from 16 UK centres and clinical, occupational and demographic information were collected. Participants completed a weekly diary and questionnaires at four and 12 weeks postoperatively.OutcomesThe main outcome was duration of work absence from date of surgery to date of first return to work.Results254 participants were enrolled in the study and 201 provided the follow-up data. Median duration of sickness absence was 20 days (range 1–99). Earlier return to work was associated with having surgery in primary care and a self-reported work role involving more than 4 hours of daily computer use. Being female and entitlement to more than a month of paid sick leave were both associated with longer work absences. The duration of work absence was strongly associated with the expected duration of leave, as reported by participants before surgery. Earlier return to work was not associated with poorer clinical outcomes reported 12 weeks after CTR.ConclusionsThere was wide variation in the duration of work absence after CTR across all occupational categories. A combination of occupational, demographic and clinical factors was associated with the duration of work absence, illustrating the complexity of return to work decision making. However, preoperative expectations were strongly associated with the actual duration of leave. We found no evidence that earlier return to work was harmful. Clear, consistent advice from clinicians preoperatively setting expectations of a prompt return to work could reduce unnecessary sickness absence after CTR. To enable this, clinicians need evidence-informed guidance about appropriate timescales for the safe return to different types of work.

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Section: Discussionmentioning

confidence: 99%

Sickness absence after carpal tunnel release: a multicentre prospective cohort study

et al. 2021

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“…En 2019 Newington et al 24 realizaron un estudio de cohortes prospectivo multicéntrico, con el objetivo de explorar el regreso al mundo laboral de los pacientes que se habían sometido recientemente a cirugía del túnel carpiano. Para ello se realizaron entrevistas semiestructuradas 1:1 con un subgrupo de participantes, y los entrevistados fueron seleccionados específicamente para representar una gama de características demográficas, clínicas y ocupacionales.…”

Section: Resultados Clínicosunclassified

“…Ante estos datos, es importante señalar, que este último estudio fue analizado tras haber sido los pacientes intervenidos por cirugía endoscópica del túnel carpiano bilateral simultánea, a diferencia del primero de ellos, en el que la intervención fue unilateral. Otros estudios 24 , han tomado en consideración las reflexiones de los participantes sobre su vuelta al trabajo, con incertidumbre en saber cual era la carga que representaba en su puesto laboral y por consiguiente, la duración apropiada para su retorno.…”

Section: Discussionunclassified

“…Otros autores 9,12 no han observado diferencias significativas en la clínica postoperatoria. Además de ello las expectativas de mejora y la mejora real de dichos síntomas tras la intervención son similares (a excepción de una ligera mejoría de lo esperado en el ítem de los trastornos del sueño tras la intervención), hecho no compartido por otros autores como Newington et al 24 , que esperaban que la cirugía del túnel carpiano, fuera un procedimiento "menor". Sin embargo, esto no coincidía con las experiencias de los participantes.…”

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Análisis de los determinantes que influyen en el retorno al trabajo tras intervención quirúrgica por síndrome del túnel carpiano

et al. 2020

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“…More than 90,000 CTR procedures are expected annually by 2020 in the English NHS alone [5], but there is currently no evidence-based guidance advising when it might be safe to return to functional activities, including work, after CTR. Our recent systematic review of the duration of work absence after CTR highlighted considerable variation in reported return to work times [6]. Across 56 included studies, mean time to return to work ranged from 4 to 168 days (24 weeks).…”

Section: Introductionmentioning

confidence: 99%

Return to work after carpal tunnel release surgery: a qualitative interview study

Newington

Brooks

Warwick

et al. 2019

BMC Musculoskelet Disord

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Background Carpal tunnel syndrome is a common nerve compression disorder which affects hand sensation and function. Carpal tunnel release surgery (CTR) is frequently performed to alleviate these symptoms. For many CTR patients, surgery occurs during their working lifetime, but there is currently no evidence-based guidance to inform clinicians or patients when it might be safe to return to different types of work afterwards. The aim of this qualitative study was to explore the return to work experiences of patients who had recently undergone CTR. Methods Semi-structured 1:1 interviews were conducted with a subgroup of participants recruited to a multi-centre prospective cohort study. Interviewees were purposely selected to represent a range of demographic, clinical and occupational characteristics. All had recently undergone CTR and had returned to work. Interviews were audio recorded, transcribed verbatim and analysed using the framework method. Participants were recruited until data saturation was achieved. Results Fourteen participants were interviewed: 11 women (median age 49 years, range 27–61) and 3 men (age range 51–68 years). Three key themes were identified. Theme 1 centred on the level of functional disability experienced immediately after surgery. There was an expectation that CTR would be a ‘minor’ procedure, but this did not match the participants’ experiences. Theme 2 explored the desire for validation for the time away from work, with participants recalling a need to justify their work absence to themselves as well as to their employers. Theme 3 focused on the participants’ reflections of handing their return to work and function, with many reporting uncertainties about what constituted appropriate activity loads and durations. There was a desire for specific information relating to individual work roles. Conclusion Individual return to work decision-making was largely influenced by the recommendations received. According to the views of participants, clinicians may be able to prepare patients better pre-operatively, especially with respect to function in the immediate post-operative period and by providing return to work guidance that can be tailored for individual work roles. Electronic supplementary material The online version of this article (10.1186/s12891-019-2638-5) contains supplementary material, which is available to authorized users.

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Sickness absence after carpal tunnel release: a systematic review of the literature

Cited by 20 publications

References 67 publications

Sickness absence after carpal tunnel release: a multicentre prospective cohort study

Sickness absence after carpal tunnel release: a multicentre prospective cohort study

Análisis de los determinantes que influyen en el retorno al trabajo tras intervención quirúrgica por síndrome del túnel carpiano

Return to work after carpal tunnel release surgery: a qualitative interview study

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