Clinical evaluation and management of work-related carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a clinical entity characterized by pain, pa resthesias, and numbness in the distribution of the median nerve with weakn ess and atrophy of the thenar muscles in advanced cases. It is universally accepted that CTS is the clinical concomitant of compression of the median nerve as it passes through the carpal canal. It is reported To be the most common of the entrapment neuropathies. Increasing evidence suggests that oc cupational factors, including forceful use of the hands, repetitive use of the hands, and hand-ann vibration, are etiologic for CTS. When occurring as a result of occupational exposures, the term "work-related carpal tunnel s yndrome" is applied. Clinical approaches to the diagnosis and treatment of work-related CTS are described in this paper. Particular attention is paid to the clinical features and pathophysiology of CTS, the epidemiology of wo rk-related CTS, ascertainment of work-relatedness in the clinical setting, treatment including both work and non-work interventions, and control of oc cupational ergonomic risk factors that may contribute to the illness. Am. J . Ind. Med. 37:62-74, 2000. (C) 2000 Wiley-Liss, Inc.