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Monday, November 12, 2007

Carpal Tunnel Syndrome and Occupations

Carpal Tunnel Syndrome: " How does carpal tunnel syndrome develop? Bending the wrist or moving the fingers brings muscles and tendons into action. For example, when a person bends a finger, the tendon moves about two inches. The tendons of the hand are encased in sheaths, or sleeves through which the tendons slide.

The inner wall of the sheaths contains cells that produce a slippery fluid to lubricate the tendons. Lubrication is essential for the normal and smooth functioning of the tendons. With repetitive or excessive movement of the hand, the lubrication system may malfunction.

It may not produce enough fluid or it may produce a fluid with poor lubricating qualities. Failure of the lubricating system creates friction between the tendon and its sheath causing inflammation and swelling of the tendon area.

In turn, the swelling squeezes the median nerve in the wrist or carpal tunnel. Repeated episodes of inflammation cause fibrous tissue to form. The fibrous tissue thickens the tendon sheath, and hinders tendon movement.

How common is carpal tunnel syndrome?

Although we do not have reliable estimates of the number of cases of carpal tunnel syndrome, studies of specific occupations increasingly show that the disorder is fairly common.

  1. For example, 614 out of 982 supermarket checkers surveyed reported symptoms of carpal tunnel syndrome.

  2. In one electronic manufacturing plant with 700 employees, a review of workers' compensation claims revealed a total of 52 cases of carpal tunnel syndrome over a five-year period.

  3. Out of a group of 788 meat handlers, 117 had surgical treatment for carpal tunnel syndrome over a twelve-year period.

  4. A survey of 400 American hand surgeons reported that each surgeon performed an average of 65 operations for carpal tunnel syndrome per year.

What are the occupational factors of carpal tunnel syndrome?

Carpal tunnel syndrome is particularly associated with certain tasks including:
  • repetitive hand motions
  • awkward hand positions
  • strong gripping
  • mechanical stress on the palm
  • vibration
Cashiers, hairdressers, or knitters or sewers are examples of people whose work-related tasks involve the repetitive wrist movements associated with carpal tunnel syndrome.

Bakers who flex or extend the wrist while kneading dough, and people who flex the fingers and wrist in tasks such as milking cows, using a spray paint gun, and hand-weeding are other examples.

Excessive use of vibrating hand tools may also cause carpal tunnel syndrome.
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