April 06, 2008
Whither carpal tunnel syndrome?

Was the epidemic of carpal tunnel syndrome overstated?

"At its height of diagnosis, anybody showing up at a doctor's office with wrist pain or hand pain was being diagnosed with carpal tunnel," said Carol Harnett, vice president of insurer Hartford Financial Services Group's group benefits division.

Since then, carpal tunnel cases have plummeted, declining 21 percent in 2006 alone, according to the Bureau of Labor Statistics. Among workers in professional and business services, the number of carpal tunnel syndrome cases fell by half between 2005 and 2006.

What changed?

First, it may not have been the white-collar epidemic it appeared to be.

A 2001 study by the Mayo Clinic found heavy computer users (up to seven hours a day) had the same rate of carpal tunnel as the general population. Harvard University headlined a 2005 news release: Computer use deleted as carpal tunnel syndrome cause.

"Clearly, if keyboarding activities were a significant risk for carpal tunnel, we should have seen, over the last 10 to 15 years, an explosion of cases," said Dr. Kurt Hegmann, director, the Rocky Mountain Center for Occupational & Environmental Health. "If keyboarding were a risk, it cannot be a strong factor."

Blue-collar workers, especially those doing assembly line work such as sewing, cleaning and meat or poultry packing, have a far greater incidence of carpal tunnel than white-collar workers, according to Bureau of Labor Statistics data.

That doesn't mean white-collar workers don't get carpal tunnel and related disorders. But it may mean such disorders were overdiagnosed when they were most in the news, resulting in an artificially high number of cases by the late 1990s. Most doctors have dropped the term RSI, calling them "musculoskeletal disorders" while government agencies like "cumulative trauma disorders."

Now, some experts think some of those patients had "referred pain" from trouble elsewhere, such as the neck. Other theories claim attention to ergonomics has prevented injuries, or that they have become underreported because they lack the immediacy of a broken bone.

For what it's worth, I'm not the most ergonomically correct typist out there, and I've never had any problems. I do on infrequent occasions feel some mild pain or numbness in my fingers or wrists, at which point I back off from the computer for a few hours, and then I'm fine. Maybe I'm just lucky, I don't know. I have plenty of coworkers who've used wrist braces and whatnot, and I'm certainly not doubting the existence of these maladies. But I can't say I'm surprised to hear that they're not as prevalent as they were once said to be.

Posted by Charles Kuffner on April 06, 2008 to Society and cultcha

Interesting... At one point in the late 90s, I had a lot of wrist pain, and thought I had CT. I made a lot of ergonomic adjustments, including replacing keyboard and mouse with an ergonomic keyboard and trackball. I wonder if some of the improvement in numbers of cases is based on prevention and awareness.

Posted by: Whosplayin on April 6, 2008 9:16 AM

Ganglion cyst surgery in 1994 included a warning during followup to always use a wrist rest/ ergonomic keyboard and take frequent breaks -- i have followed that advice religiously since then, and had no further difficulties.

however: the prospect of repeating any kind of surgery at a VA facility is its own incentive.

Posted by: The_Other_Sarah on April 6, 2008 2:16 PM