Does occupation predict outcome in conservatively managed carpal tunnel syndrome?

Conference: 
2020 SAPC North
Talk Code: 
B3.6
Presenter: 
Chris Stevens

THE PROBLEM:                                                                                                   

Carpal tunnel syndrome (CTS) is a common and bothersome condition causing discomfort and dysfunction of the hand and wrist. In more severe cases, CTS can impact on a patient’s ability to work and perform their usual activities of daily living. The onset of CTS is known to be associated with certain occupations but less is known about outcome.

YOUR APPROACH:

A systematic search and rapid review of the literature was performed, which identified a gap in the evidence addressing the outcome of conservatively managed CTS, as determined by occupation.

We then performed a secondary analysis of data from the INSTINCTS trial (INjection versus SplinTing in Carpal Tunnel Syndrome), which compared the effectiveness of corticosteroid injection to night splitting. In participants who were employed at baseline, we used linear regression modelling to identify if job category predicted (along with other variables) patient reported outcome at 6-months, as measured by the Boston Carpal Tunnel Questionnaire (BCTQ).

THE LEARNING:

Patients that worked in the sales and customer service industry experienced a raw BCTQ score decrease (positive prognosis outcome, as reported by patient) at 6 months from baseline. This is an exploratory finding due to the small sample size. Sex, symptom duration, high risk employment category, treatment type and age were accounted for in the model.

WHY IT MATTERS:

  • Carpal tunnel syndrome is the most common peripheral entrapment neuropathy and is known to be a leading cause of long-term work-related disability claims (Wellman et al., 2004).
  • Incidence of CTS will continue to increase under current trends.
  • There is a need for further research into occupation as a predictor of outcome in CTS.
  • It is important that patients receive reliable prognostic information that is applicable to them as an individual. This allows patients to make an informed choice with regard to future treatment.

 

Presenting author: Chris Stevens, Keele University School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK. E-mail: chris.stevens@doctors.org.uk
Co-authors:
Dr. R Wilkie, School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire ST5 5BG, UK.
Dr. C Burton, School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Keele, Staffordshire ST5 5BG, UK.