Is carpal tunnel work related ?

Genetics More Important than Work for Carpal Tunnel: Top [02/21/07]

Carpal tunnel syndrome is more likely to be associated with genetics than occupational exposure, according to a study presented last week to the American Academy of Orthopaedic Surgeons.

Dr. David Ring, senior author of the study, said his research team performed a qualitative analysis on 43 scientific studies that investigated direct or indirect risk factors for carpal tunnel syndrome, published from 1981 to 2005. Although 18 of those studies showed an association between occupational risk factors and carpal tunnel, the association was weak and plausibility was poor, the authors concluded. "This application of stringent science to theories of causation may affect claims of disability, workers' compensation and personal injury," Ring said in a press release from the academy. "It should also influence the information that physicians are providing their patients about carpal tunnel syndrome. Physicians have the power to increase or decrease illness and disability with their words. In my opinion, we should provide patients with the most optimistic, positive, practical and enabling illness concepts that are consistent with the best available scientific data."

Ring is an assistant professor of orthopedic surgery and a hand and upper extremity surgeon at Massachusetts General Hospital in Boston.

According to the study, average scores for biological factors such as genetics, race, and age were double those of occupational factors such as type of work, amount of repetitive hand use, and vibration. In addition, the average strength of causal association was about three times as strong for biological factors as it was for occupational factors.

"The belief that carpal tunnel syndrome is caused by occupational exposures is based upon limited data of variable quality with relatively low scores on a quantitative measure of causal association," the authors said. "Given the remarkable impact of such beliefs on society, it would be irresponsible of us to support an association between occupation and (carpal tunnel syndrome) without convincing evidence according to very strict criteria. Such evidence is currently lacking and (carpal tunnel syndrome) is most accurately and
most optimally considered an idiopathic condition with a substantial genetic association."

Source: American Academy of Orthopaedic Surgeons