Hand pain other than carpal tunnel syndrome (CTS): The role of occupational factors

Andréu, José-Luis; Otón, Teresa; Silva-Fernández, Lucía; Sanz, Jesús

doi:10.1016/j.berh.2010.12.001

Cited by 23 publications

(7 citation statements)

References 58 publications

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“…Over time, ischaemia ultimately causes long-lasting effects such as irreversible damage to the flexor synovial cells and median nerve synovial thickening, with extensive fibrosis and demyelination of the median nerve [2,[7][8][9]12,54]. Hand-arm vibrations may also cause similar effects but modern and up-to-date vibrating tools have significantly reduced workers' exposure [27,[54][55][56][57].…”

Section: Discussionmentioning

confidence: 99%

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Riccò

Signorelli

2017

Med Pr

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Background: Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors. Material and Methods: A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj) for factors of interest were estimated through binary logistic regression. Results: Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person-years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107-3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743-7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917-21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200-6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689-28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (ORadj = 3.548, 95% CI: 1.379-9.131), repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248-10.395), repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100-5.960). Conclusions: Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2) :199-209

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Section: Discussionmentioning

confidence: 99%

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Riccò

Signorelli

2017

Med Pr

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“…Pain in the upper extremities proximal to the hand in HAVS is thought to be due mainly to musculoskeletal disorders associated with the use of vibratory tools, arising either from the transmitted vibration or ergonomic factors [1]. However, workers with HAVS often report pain in the fingers and hands [5] in addition to more proximal upper extremity pain. Therefore, improved understanding of the cause of finger and hand pain in HAVS would be useful.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting finger and hand pain in workers with HAVS

House

Krajnak

Jiang

2016

OCCMED

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Background Pain and its management are important aspects of hand-arm vibration syndrome (HAVS). Aims To determine the factors associated with finger and hand pain in workers with HAVS and, specifically, to assess the impact of several neurological variables as well as the vascular component of HAVS, grip strength and age. Methods We assessed men with HAVS at a hospital occupational medicine clinic over 2 years. Subjects scored finger and hand pain separately using the Borg Scale (0–10). The possible predictors we evaluated included the Stockholm Neurological Scale (SNS) and Stockholm Vascular Scale (SVS) stages, current perception threshold (CPT), carpal tunnel syndrome (CTS), ulnar neuropathy, grip strength and age. We carried out nerve conduction testing to confirm the presence of CTS and ulnar neuropathy and measured CPT in the fingers at 2000 Hz, 250 Hz and 5 Hz corresponding to A-beta (large myelinated), A-delta (small myelinated) and C (unmyelinated) fibres, respectively. We calculated Spearman rank correlations to examine the relation between finger and hand pain and possible predictor variables. Results Among the 134 subjects, the median (25th–75th percentile) pain scores were 6 (4–8) for the fingers and 5 (1–7) for the hands. We found statistically significant correlations with finger pain for the SVS stage (r = 0.239; P < 0.01) and CTS (r = 0.184; P < 0.05). The only statistically significant correlation identified for hand pain was a negative correlation with grip strength (r = −0.185; P < 0.05). Conclusions Management of finger and hand pain in HAVS should focus on the correlates we have identified.

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“…3 Consider postures where thumb is held in abduction and extension to be predisposing factors. 4 Workers who perform rapid repetitive activation involving pinching, grasping, pulling or pushing have been considered at increased risk. 5 In 1895, a Swiss surgeon Fritz de Quervain first described this condition and published five case reports.…”

Section: Introductionmentioning

confidence: 99%

Local Corticosteroid Injection for Treatment of De Quervain’s Disease

Behera¹,

Das²

2017

jebmh

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BACKGROUND De Quervain's disease or stenosing tenosynovitis of first dorsal compartment of the wrist is common wrist pathology. Pain at radial site of wrist results from resisted gliding of the abductor pollicis longus and extensor pollicis brevis tendon in the fibroosseous canal. Diagnosis is made on physical examination. MATERIALS AND METHODS A retrospective study was done in Orthopaedic Department of Kalinga Institute of Medical Sciences, Bhubaneswar, for two years from January 2014 to December 2016. 56 patients were included in the study. RESULTS Out of 56 patients treated with local intrasheath corticosteroid injections, 10 cases failed and were treated with surgical decompression. CONCLUSION Conservative management of de Quervain's disease with local hydrocortisone injection into first dorsal compartment is first line treatment of choice. Surgical decompression is done only to those patients who failed following injection.

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Hand pain other than carpal tunnel syndrome (CTS): The role of occupational factors

Cited by 23 publications

References 58 publications

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Factors affecting finger and hand pain in workers with HAVS

Local Corticosteroid Injection for Treatment of De Quervain’s Disease

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