The natural course of carpal tunnel syndrome in a working population

Scand J Work Environ Health. 2010 Sep;36(5):384-93. doi: 10.5271/sjweh.2912. Epub 2010 Mar 29.

Abstract

Objective: The aim of this study was to assess prevalence, incidence, and persistence of carpal tunnel syndrome (CTS) and associated symptoms over a one-year period in a working population.

Methods: We conducted a one-year prospective study of 418 active workers in 12 worksites. Detailed health interviews, psychosocial questionnaires, and electrophysiological studies [ie, nerve conduction velocity (NCV) tests] were conducted at baseline and one-year follow-up. Individual-observed exposure assessments of wrist posture, hand activity, and hand forces were conducted.

Results: Prevalence of CTS cases at baseline was 10.8% [95% confidence interval (95% CI) 7.8-13.7%] on the dominant side and 6.0% (95% CI 3.7-87.3%) on the non-dominant side; CTS symptoms were 14.1% (95% CI 10.8-17.5%) and 11.0% (95% CI 8.0-14.0%), respectively. Incidence of CTS cases were 7.5% (95% CI 4.8-10.2%) and 5.6% (95% CI 3.3-7.9%), respectively. Higher proportions of subjects with current symptoms or positive electrophysiological test findings at baseline became CTS cases at one year compared to those with neither (28.6% and 13.9%, respectively, versus 0.5%). One-year persistence of CTS case status was 44.4% (95% CI 29.9-59.0%) for the dominant hand and 52.0% (95% CI 32.4-71.6) for non-dominant hand. There were significant differences at baseline between asymptomatic subjects and CTS cases with respect to higher job demands (P=0.027), lower job satisfaction (P=0.036), lower general health (P=0.0009), higher exposure to vibrating hand tool use (P=0.039), and greater time using a forceful power grip (P=0.035) among cases.

Conclusions: CTS symptoms more than positive NCV test results alone appear to predict CTS at one year. Persistence of CTS at one year is high.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Carpal Tunnel Syndrome / epidemiology
  • Carpal Tunnel Syndrome / physiopathology*
  • Carpal Tunnel Syndrome / psychology
  • Confidence Intervals
  • Electrophysiology
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Job Satisfaction
  • Male
  • Middle Aged
  • Neural Conduction
  • Occupational Diseases / epidemiology
  • Occupational Diseases / physiopathology*
  • Occupational Diseases / psychology
  • Occupational Exposure / adverse effects*
  • Occupational Health*
  • Prevalence
  • Prospective Studies
  • Psychometrics
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Washington / epidemiology
  • Workload