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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