Hands and feet

September 2009

FocusHands and feet

Carpal tunnel syndrome

Can it be a work related condition?

Volume 38, No.9, September 2009 Pages 684-686

W Bruce Conolly

John H McKessar


Carpal tunnel syndrome is one of the most common hand conditions seen in clinical practice. Many in the workforce, both male and female, will develop carpal tunnel syndrome and many will claim that their workplace has caused their condition.


This article seeks to guide the examining practitioner in answering the questions of patients and insurance companies as to whether a patient with the established diagnosis of carpal tunnel syndrome has an acceptable workers’ compensation claim for treatment.


Carpal tunnel syndrome is mostly constitutional and due to intrinsic factors such as genetics, body weight, and endocrine and rheumatoid disease. Extrinsic and work related factors such as forces applied to the wrist, and working in cold temperatures and with vibrating equipment will also be discussed.

Carpal tunnel syndrome (CTS) – compression of the median nerve in the carpal tunnel (Figure 1) – manifests with numbness, pain and paresthesia in the median nerve distribution, mostly at night, and is sometimes associated with thenar muscle weakness. The painful burning, numbness and tingling may radiate up the arm to the shoulder or neck. The fingers may feel swollen and the entire arm may feel heavy.

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Correspondence afp@racgp.org.au

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