Carpal tunnel syndrome: 2nd occupational disease



What links occupational activity with carpal tunnel syndrome, admitted as an occupational disease?
Carpal tunnel syndrome: occupational disease

Carpal tunnel syndrome (CTS) causes disabling pain. The most common symptoms are: wrist pain, sensitivity impairment, tingling or numbness in the first three fingers... These feelings are associated with the compression of the median nerve at the base of the hand. This is the second condition admitted as an occupational disease (rotator cuff disease being on top of the list). Even if there are many aggravating factors, the progression of this condition can be slowed down by preventive actions.

 

Occupational aggravating factors?

CTS is attributed as an occupational disease if it occurs after the use of hand-held powered vibrating tools or repeated wrist flexion and extension movements for at least 20 hours per week, over half of the preceding 2 years(1).

Many occupations include aggravating factors of carpal tunnel syndrome due to the recurrence of movements that may damage the area in question. The incidence of CTS among workers is higher in women than men and varies according to occupational category and industry sector(3). More than a third of patients with CTS undergoes surgical treatment(2).

If the risks related to certain occupations were limited, it could avoid surgical interventions, pain, operative risk, post-operative complications or rehabilitation. Correlation between occupational activity and CTS seems obvious, but being aware of the aggravating factors can help reduce its incidence.

 

What risk factors for carpal tunnel syndrome ?

Risk factors(3) are different from what causes the condition. However, they increase the probability of developing musculoskeletal disorders (MSD).

These factors are both biomechanical and psychosocial. Biomechanical factors are linked with physical constraints of the occupation: vibrations, repetition and difficulty of tasks, handling of loads, high force in the hands, duration...

As for psychosocial factors, they’re associated stressors: social climate, deadlines, objectives, requirement, fatigue, stress, absence of support, autonomy... This factors combination may cause overuse that often results in musculoskeletal disorders .

This is the case of carpal tunnel syndrome . Using a pneumatic drill in the construction industry context can be problematic. Wrist twisting in people who use a screwdriver or in mechanics using a spanner is also a risk factor. In addition, repetitive and prolonged movements, especially in hairdressers (use of scissors) or in kinesitherapists increase the probability of having CTS.

Other factors that are not related to an occupational context aid the development of this condition, namely: trauma (fracture, sprain ...), inflammatory disease (arthritis ) or metabolic disease (diabetes, endocrine diseases causing obesity or hypothyroidism).

 

Preventive and corrective solutions for carpal tunnel syndrome

To avoid becoming a person at risk, equip your workplace with ergonomic tools to get rid of harmful movements for the wrist. Varying tasks, their duration, finding alternatives to reduce manual forces are all preventive solutions for carpal tunnel syndrome . Also, ergonomic handles can be adapted for a number of tools. More appropriate for the hand shape, they reduce poor movements and improve the well-being of teams.

 

What if braces were a solution?

A flexible brace is ideal to relieve pain associated with carpal tunnel syndrome during your activities. Thin, discreet and available in several sizes, this brace whose pattern is based on proprioception is to wear during the day and doesn’t impede mobility. It allows sensory stimulation that unconsciously makes the wearer improve daily movements. Flexible and comfortable, CARP'ACTIV™* by EPITACT® favours wrist rest.

 

And at night?

For more effectiveness, nocturnal splinting to stabilises the joint is an ideal solution. It immobilises the wrist in a neutral position to limit compression of the median nerve, and so pain.

Contrary to popular belief, the wrist doesn’t rest all night! Often bent or placed under the pillow, pressure increases in the carpal tunnel and leads to pain. With this type of brace , the joint can rest. EPITACT® has developed the CARP'IMMO™ brace*. The semi-rigid and anatomical reinforcements hold the wrist in a neutral position for more peaceful nights. For optimal results, it is advocated to wear the EPITACT® immobilisation braces for three months.

 

Drug treatments for CTS

Concomitantly with braces, drug therapy can efficiently relieve pain related to carpal tunnel syndrome . On the advice of your GP, analgesics (paracetamol) and non-steroidal anti-inflammatory drugs (NSAIDs, ibuprofen) soothe pain.

To reduce pain, homeopathy and phytotherapy are also efficient. Lastly, a medical prescription of 2 to 3 corticosteroid injections is intended to decrease swelling inside the carpal tunnel .

 

Pain remains the main warning sign to the onset of a condition. However, this is not a fatality, treat it before experiencing the first symptoms to avoid its progression. Prevention and care are the best ways to improve comfort at work and put humans at the heart of companies.

 

*These products are class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 07/2020

 

For more details about this general and simplified approach, here are further sources:

(1)Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Practice & Research Clinical Rheumatology. juin 2015;29(3):440‑53. Carpal tunnel syndrome.

(2)Atroshi I, Zhou C, Jöud A, Petersson IF, Englund M. Sickness Absence from Work among Persons with New Physician-Diagnosed Carpal Tunnel Syndrome: A Population-Based Matched-Cohort Study. PLOS ONE. 24 mars 2015;10(3):e0119795.

(3)Petit A, Ha C, Bodin J, Rigouin P, Descatha A, Brunet R, et al. Risk factors for carpal tunnel syndrome related to the work organization: A prospective surveillance study in a large working population. Applied Ergonomics. mars 2015;47:1‑10.

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