Work-related carpal tunnel syndrome treatment: a cross-sectional study among 106 patients

Abstract

SUMMARYThe objective is to assess the influence of sociodemographic, professional and clinical variables on the choice of treatment of work-related carpal tunnel syndrome (CTS). An exhaustive and trans-sectional study was conducted over a period of eight years, from 1st January 2006 to 31 December 2013 in the Department of Occupational Medicine at University Hospital of Mahdia, Tunisia. The study population was represented by patients with work-related carpal tunnel syndrome. Data collection was based on a questionnaire sheet, describing social, occupational and medical characteristics of patients. The study population was characterized by a large female dominance, representing 95.3% with an average age of 42±7.8 years. Patients medically treated represented 38.7% and 61.3% had had surgical treatment. After binary logistic regression, surgical indication of CTS was significantly correlated to diabetes (p=0.017), other musculoskeletal disorders (p=0.02), functional signs of CTS (acrocyanosis p=0.05; muscle weakness p=0.015; radiating pain p=0.01; painful discomfort of the hand, the forearm or arm p=0.027) and to the atrophy of thenar muscles (p=0.018). According to this study, the choice of therapy for occupational CTS depends only on clinical data. More detailed studies will be needed to refine these results.

Occupational Carpal Tunnel Syndrome: a scoping review of causes, mechanisms, diagnosis, and intervention strategies

“…Checkout operators in supermarkets, cashiers, and assembly line workers are also at risk of developing CTS ( 15 ). Furthermore, numerous workers in the clothing industry were affected by this ailment, establishing a connection between CTS as a professional disease and this complex industry ( 19 ). Interestingly, individuals engaged in electrical (TV) assembly have an increased risk of developing CTS due to the complex manipulation of extremely small components and wiring, exerting constant and continuous pressure on the median nerve ( 20 ).…”

“…It has been observed that chronic compression can result in demyelination, axonal loss, and hypoxia, contributing to both motor and sensory deficits specific to CTS ( 46 ). Importantly, inflammation, oxidative stress, and ischemia emerge as prominent pathophysiological features of this chronic condition ( 19 ). Previous studies have linked nerve edema and fibrosis to chronic inflammation, which exacerbates compression within the carpal tunnel ( 18 ).…”

“…Previous studies have linked nerve edema and fibrosis to chronic inflammation, which exacerbates compression within the carpal tunnel ( 18 ). This persistent compression disrupts blood flow, leading to ischemia, which, in turn, increases oxidative stress and further perpetuates nerve damage ( 19 ). Additionally, the pro-inflammatory cytokines, such as TNF-α, IL-1, IL-6 and IL-8 released during the inflammatory process can lead to the upregulation of fibrotic pathways, exacerbating fibrosis and further narrowing the carpal tunnel ( 45 ).…”

“…In the United States, the economic damage attributed to CTS is substantial, with estimates around $100 billion affecting insurance companies, consumers, large corporations, and private companies ( 66 ). Carpal Tunnel Syndrome has profound economic and societal implications, making it imperative to assess its impact on employers, employees, healthcare systems, and society at large ( 19 ). Drawing upon recent studies, this article evaluates the economic ramifications of CTS, explores its societal consequences, including disability claims and healthcare utilization, and discusses the implications for workforce productivity and sustainability.…”