Is There Light at the End of the Carpal Tunnel?
Repeated point-and-click motions may be the most publicized culprit, but repeated movements to assemble parts on a factory line and frequent use of motorized hand tools probably cause more cases of carpal tunnel syndrome. Repetitive stress injuries ranked among the top three causes of workplace injuries in 2002, costing more than $60 billion in lost wages, health care expenses, legal costs and worker?s compensation claims. .
Making the Diagnosis
The carpal tunnel syndrome diagnosis is very specific, involving inflammation and compression of the nerve and tendons that run through the carpal tunnel, a narrow passage linking the arm and hand that is created by the bones of the wrist and a tough ligament that binds the bones together.
In common use, painful conditions like tendonitis and osteoarthritis get lumped under the complaint of ?carpal tunnel,? making it difficult to determine what to treat.
Although research on carpal tunnel syndrome has centered on work habits and ergonomically unsound environments, recent studies suggest that factors like gender, obesity and overall stress levels could affect the risk of developing the syndrome and determine its severity.
-- Several studies suggest that women, people between the ages of 41 and 60 and those who are obese are more likely to have carpal tunnel syndrome.  A long-term study of industrial workers suggests a link between carpal tunnel syndrome and cigarette smoking. 
-- Rates of carpal tunnel syndrome increase with age for men, while the rates for women are highest between ages 45 and 54. 
Psychological distress may raise the risk of carpal tunnel syndrome. [10, 11]
-- A 2003 study found ?no compelling scientific basis? behind genetic tests for carpal tunnel syndrome risk given to 20 railroad workers seeking injury compensation from their employer. 
-- Office machinery and hand tools caused more than 60 percent of carpal tunnel syndrome diagnoses in a Massachusetts workers? comp case study. 
-- Medical data-entry workers who extended their wrists more than 20 degrees while typing were at greater risk of developing carpal tunnel syndrome than their co-workers, according to a Taiwanese study. 
-- A study of people who use computers for seven or more hours a day found no significantly higher incidence of carpal tunnel syndrome than in the general population, suggesting factors other than repetitive tasks may affect the disease?s development. 
-- New Hampshire employers who received regular inspections from local Occupational Safety and Health Administration officials saw a decline in the annual rate of carpal tunnel syndrome among their workers, from 38 cases in 10,000 to 3.8 cases in 10,000 over a five-year span. 
-- A carpal tunnel diagnosis involves more than pain: Only 1.4 percent of 5,658 Danish computer workers in a yearlong study had the full array of symptoms that are normally associated with carpal tunnel syndrome. 
-- Increased breathing rate and muscle tension across the upper body can accompany tasks like typing and using a computer mouse, possibly contributing to carpal tunnel syndrome even at ergonomic work stations. 
-- Surgical treatment relieves symptoms better than splint treatment in moderate to severe cases of carpal tunnel syndrome, according to a review of published studies. 
-- Highly repetitive tasks can damage bone in rats, suggesting that tasks like typing or hand tool use may cause similar damage in humans with carpal tunnel syndrome and other musculoskeletal disorders. 
Curing Carpal Tunnel Syndrome
Factory or office workers with a sore wrist, shooting pains up an arm and a crippled grip can testify to all the splints, pills and exercises they have tried in an attempt to find a cure for their condition. But as physicians readily admit, the exact diagnosis behind carpal tunnel syndrome and other repetitive stress disorders that affect the musculoskeletal system is still being debated. And it can be difficult to treat a disease unless its specific causes are well known.
?Because there are still so many questions about the underlying conditions, there?s uncertainty about the best type of treatment,? says Ann Barr, P.T., Ph.D., of Temple University. ?Sufferers are often prescribed a package of treatments, including physical therapy, ergonomics and medication, and we?re not sure which treatment is actually working.?
Barr and her colleagues in the Temple School of Health Professions and School of Medicine were recently awarded a $1.7 million grant from NIH?s National Institute of Arthritis and Musculoskeletal and Skin Diseases to find out whether work injuries caused by repetitive stress can be treated before they turn into a chronic disability.
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