News | Published April 22, 2014 | Written by Scott DeHart, MD, PhD, medical director, occupational health, Mount Nittany Physician Group

Carpal tunnel syndrome and the workplace

Almost all of us have been acquainted with someone suffering from carpal tunnel syndrome (CTS). It afflicts roughly one out of twenty people, more commonly in females than males, and especially in the age group of 45-60 years old. Symptoms include pain and numbness in the wrist and radiating into the hand with numbness primarily involving the thumb, index, middle, and thumb side of the ring fingers. 

CTS is attributed to an increase in pressure on the median nerve as it travels through the palm side of the wrist. However, there remains considerable uncertainty about the exact cause. There are certain medical conditions which definitely increase the risk of CTS, such as diabetes, thyroid disease, obesity, arthritis, gout, and pregnancy. However, there is substantial evidence that certain types of occupations increase the risk as well, in particular, those that involve repetitive wrist motion along with force, extreme wrist positions, and vibration exposure. It is not clear that jobs with repetitive wrist motion alone, without force or vibration, are a risk factor for CTS.  Many of the first cases noted involved those in manufacturing settings and poultry processing. 

Other professions with increased risk include tailors, mechanics, butchers, and assembly line workers. Interestingly, one of the activities most often thought of as causing CTS is the use of the computer keyboard and mouse. However, several large scientific studies have demonstrated that computer use, even more than 20 hours per week, is not associated specifically with CTS (although it may contribute to other problems such as wrist tendonitis or neck problems).

Clearly the causes of CTS are multifactoral and are not completely understood. Unfortunately, present day workers’ compensation laws require a black or white determination of whether a disorder is or is not work related, and we can see that this may not really be possible with CTS and other repetitive strain disorders similar to it. Regardless of this, if you are suffering from symptoms of CTS, it is best to see your primary care physician sooner rather than later since the longer you have the symptoms, the more difficult it will be to resolve with conservative treatment.

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