Computer Professionals and Carpal Tunnel Syndrome (CTS) The value added by electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. Recovery after carpal tunnel syndrome operation: the influence of the opposite hand, if operated on in the same session Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release. An Aggressive Return‐to‐Work Program in Surgical Treatment of Carpal Tunnel Syndrome: A Comparison of Costs A Longitudinal Study of Industrial and Clerical Workers: Incidence of Carpal Tunnel Syndrome and Assessment of Risk Factors Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome. Sonographic Wrist Measurements and Detection of Anatomical Features in Carpal Tunnel Syndrome The potential value of ultrasonography in the evaluation of carpal tunnel syndrome
Carpal Tunnel Syndrome ( CTS ) is an important problem among computer professionals . Hence the prevalence of CTS among computer professionals and risk factors were studied . 648 subjects were selected from 4,276 computer professionals from 21 companies with a simple r and om sampling method . CTS was diagnosed based on clinical features . The prevalence of CTS was found to be 13.1 % ( 95 % CI 10.5–15.7 % ) . Subjects with over 8 years of computer work , over 12 hrs of work per day and system administrators were at a higher risk for CTS ( OR 3.3 , 4.9 and 2.5 respectively ) . Flexed or extended h and position had higher risk for CTS . Higher risk for CTS was found with higher exposure to computer work . Ergonomic considerations are important in facilitating proper positioning of h and while working with a computer . Further studies on CTS risk factors among computer professionals are essential for planning prevention BACKGROUND There is no clear-cut consensus on the best diagnostic criteria for carpal tunnel syndrome . The objective of this study was to compare the probability of carpal tunnel syndrome being present following electrodiagnostic testing with the probability of it being present after the diagnosis was established on the basis of a clinical evaluation alone . METHODS The study sample included patients with any peripheral nerve diagnosis who had been referred to the electrodiagnostic laboratory of an academic health-care center . The probability of carpal tunnel syndrome before electrodiagnostic testing ( pretest probability ) was estimated with use of the CTS-6 , a vali date d clinical diagnostic aid that is used to estimate the probability of carpal tunnel syndrome on the basis of the presence or absence of six clinical findings recorded as part of the history or noted on physical examination . All patients then underwent a st and ard electrodiagnostic assessment of the median nerve by a neurologist blinded to the result of the CTS-6 evaluation . Sensory nerve conduction velocity was used to classify the result of the electrodiagnostic testing as either positive or negative for carpal tunnel syndrome with use of two different criteria ( one stringent and one lax ) derived from the literature . The main outcome measure was the difference between the pretest and posttest probabilities of carpal tunnel syndrome . RESULTS One hundred and forty-three patients were studied . The pretest probability of carpal tunnel syndrome ranged between 0.10 and 0.99 ( mean [ and st and ard deviation ] , 0.81 + /- 0.22 ) . Seventy-three percent of the patients had a pretest probability of at least 0.80 . The average change in probability for these patients was -0.02 when the stringent electrodiagnostic criterion was used and -0.06 when the lax criterion was used . With either electrodiagnostic criterion , the majority of the large changes in probability were for patients for whom the pretest probability was < or = 0.50 . The probability of carpal tunnel syndrome was lowered after the electrodiagnostic testing in most of these cases . CONCLUSIONS For the majority of patients who are considered to have carpal tunnel syndrome on the basis of their history and physical examination alone , electrodiagnostic tests do not change the probability of diagnosing this condition to an extent that is clinical ly relevant Abstract In a clinical , retrospectively r and omised study , we compared the results of the operation for a carpal tunnel syndrome when one side only or both sides were simultaneously assessed in one session . Of the 125 patients examined , 47.2 % had both h and s operated on in one session , 52.8 % had only one h and operated on in one session or both h and s in two sessions . We found the bilateral simultaneous operation to be associated with better results concerning earlier return to work , earlier relief of symptoms and better patient satisfaction than the operation on one side only . These are explained by the necessity of using both h and s for daily activities and thus a guaranteed functional follow-up treatment after the bilateral operation . In conclusion , we propose operating on both h and s simultaneously whenever possible , even if the opposite h and presents with only a slight CTS , which would otherwise not be considered for operation yet BACKGROUND / AIM The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome ( CTS ) is represented by recovering the nerves sensibility , conductivity , condition and strength . Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve 's conduction speed . METHODS In this study 40 patients with CTS were r and omly divided in the two groups . In the first group ( n = 20 ) we performed the surgical decompression of the median nerve by the open release of the carpal tunnel , and in the second group ( n = 20 ) we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression . We performed the electrodiagnostic ( ED ) examinations 7 , 30 and 90 days after the surgery , and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve . RESULTS Significant differences in examined ED respective variable values in different time intervals were obtained . At the final measurements , 90 days after the surgical procedure , both groups evidence d a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients ( t = -2.116 ; p = 0.043 ) . CONCLUSION Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve Carpal tunnel syndrome is a common malady associated with modern manufacturing . An aggressive return-to-work program was begun in 1980 . A prospect i ve study was begun in 1982 , and data matured through 1988 comparing the costs of a control group of patients treated by the more traditional method ( in the author 's geographic area ) and the author 's aggressive return-to-work policy .  Sixty-seven patients with 94 carpal tunnel surgeries were studied . The results reveal that the aggressively treated group had 1 of 44 patients fail to return to work following surgery , and 3 of 23 failed to return to work from the control group . One patient of each group developed a recurrence . The tangible costs that could be computed were found to be 58 percent less in the aggressively treated group than in the control group . At the same time , the patients can maintain their st and ard of living This study followed workers over an extended period of time to identify factors which may influence the onset of  Carpal Tunnel Syndrome ( CTS ) . The purpose was to evaluate incidence of CTS and to create a predictive model of factors that play a role in the development of CTS . This prospect i ve study followed 432 industrial and clerical workers over 5.4 years . Incident cases were defined as workers who had no prior history of CTS at baseline testing and were diagnosed with CTS during the follow-up period or at the follow-up screening . On the basis of logistic regression , significant predictors for CTS include baseline median-ulnar peak latency difference , a history of wrist/h and /finger tendonitis , a history of numbness , tingling , burning , and /or pain in the h and , and work above the action level of the peak force and h and activity level threshold limit value . This longitudinal study supports findings from previous cross-sectional studies identifying both work related ergonomic stressors and physical factors as independent risk factors for CTS OBJECTIVES To determine whether nocturnal splinting of workers identified through active surveillance with symptoms consistent with carpal tunnel syndrome ( CTS ) would improve symptoms and median nerve function as well as impact medical care . DESIGN R and omized controlled trial . SETTING A Midwestern auto assembly plant . PARTICIPANTS Active workers with symptoms suggestive of CTS based on a h and diagram . INTERVENTION The treatment group received customized wrist splints , which were worn at night for 6 weeks ; the control group received ergonomic education alone . MAIN OUTCOME MEASURES Change in wrist , h and , and /or finger discomfort , carpal tunnel symptom severity index , median sensory nerve function , and the percentage of subjects who had carpal tunnel release surgery . RESULTS The splinted group , unlike the controls , had a significant reduction in wrist , h and , and /or finger discomfort and a similar trend in the Levine carpal tunnel symptom severity index , which was maintained at 12 months . A secondary analysis showed that more median nerve impairment at baseline was associated with less clinical improvement among controls but not among the splinted group . CONCLUSIONS Workers identified with CTS symptoms in an active symptom surveillance tended to benefit from a 6-week nocturnal splinting trial , and the benefits were still evident at the 1-year follow-up . The splinted group improved in terms of h and discomfort regardless of the degree of median nerve impairment , whereas the controls showed improvement only among subjects with normal median nerve function . Results suggest that a short course of nocturnal splinting may reduce wrist , h and , and /or finger discomfort among active workers with symptoms consistent with CTS Introduction . This study compares anatomical findings at wrist level in patients with known carpal tunnel syndrome ( CTS ) and controls by ultrasonography ( US ) . Material and Methods . Wrist-US investigations of 28 consecutive patients with 38 diagnosed , idiopathic CTS were compared to 49 healthy volunteers without history of CTS . Internal wrists dimensions , the presence of flexor muscle bellies in the carpal tunnel , and cross-sectional area of the median nerve were analyzed . The findings were correlated to gender , age , and BMI . Results . US demonstrated a square internal carpal tunnel configuration in CTS patients compared to controls ( P < 0.001 ) . Patients with CTS showed a trend towards the presence of flexor muscles bellies in the carpal tunnel ( odds ratio 1.77 , 95 % CI 0.337–8.33 ) . CTS was present in women with  higher BMI  ( P = 0.015 ) . Conclusion . US allowed detection of specific anatomical features at wrist level in CTS patients . This observation may enable — following confirmation in larger prospect i ve studies —risk evaluation for CTS development The authors compared ultrasonography with electrophysiology for the diagnosis of  carpal tunnel syndrome ( CTS ) on 110 clinical ly affected wrists . An increased cross sectional area in the proximal carpal tunnel larger than 0.11 cm2 in combination with compression signs on longitudinal scans proved to be highly predictive for CTS ( sensitivity , 89.1 % ; specificity , 98.0 % ) . Ultrasound was comparable to electrophysiology in the diagnosis of CTS , and in 35 % of cases changes in morphology suggested a specific therapeutic strategy
Conclusion There is insufficient epidemiological evidence that computer work causes CTS
Background This review examines evidence for an association between  computer work and carpal tunnel syndrome ( CTS ) .