Carpal Tunnel Syndrome: Prevention [Clinical Review Discussion]

Prevention strategies for heart disease, lung disease and diabetes to name just a few are obvious and often incorporated into a physician’s practice.  It is well recognized in the search for effective treatment the best intervention is usually prevention.  Yet prevention strategies for more mundane, less life threatening conditions are commonly overlooked although many of these conditions can result in significant morbidity and impact on quality of life.  A recent Canadian study found in workers four years after carpal tunnel surgery that 46% still had moderate to severe pain, 40% had difficulty grasping small objects and only 14% were pain free.  Interestingly 36% were unable to return to their previous job, whether modifications had been made or not (1).  A separate study found 26% of workers that had surgery had to move from heavy to lighter work (2).  The incidence of carpal tunnel syndrome (CTS) has been estimated at 2.7% to 3.5% (3;4).  In certain professions, such as factory workers, the incidence has been estimated to be as high as 11.7 % (5).  Although better reporting, more sensitive testing or litigation rewards may be responsible, a 350% increase in the prevalence of carpal tunnel syndrome has occurred in the past 20 years (4).