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The number of carpal tunnel claims continues to rise; but the connection between the condition and workplace activity remains unclear.
TECHNOLOGICAL ADVANCEMENTS during the past few decades have dramatically improved the quality of life. Computers have changed the home and workplace environments. The manufacturing process has been streamlined with workers overseeing machines which do much of the work. These advancements, however, are not without a price. New medical problems have surfaced with labels such as "compression neuropathy," "repetitive strain injury" and "cumulative trauma disorder." This article will discuss one such condition- carpal tunnel syndrome ("CTS").
THE PROBLEM * Carpal runnel syndrome or "tardy median palsy" is a common disorder of the hands, which results in pain, weakness, and disability. While the cause of the problem is not always known, the anatomical explanation for this condition is simple. Swelling and pressure in the wrist area pinches the median nerve as it passes through the carpal tunnel, a narrow opening at the base of the palm. The result is sensory and motor disturbances.
Prevalence
The magnitude of this problem is demonstrated by several statistical facts. Almost one million people a year develop this condition necessitating medical care and causing temporary disability. Work-Related Carpal Tunnel Syndrome in Massachusetts, Commonwealth of Massachusetts, Department of Public Health. In fact, the U. S. Department of Labor has found that repetitive motions, such as typing, scanning groceries, and grasping tools, resulted in the longest absences from work, more than any other injury, with an average of 19 missed days. http://state.lbs.gov/iif/home.hmtl. CTS was the chief occupational hazard during the last decade, disabling large numbers of workers and it is the second most common surgery with more than 230,000 operations each year. National Statistics for Carpal Tunnel Syndrome, Balance Systems, Inc., www.repetitve-strain. com/national.html.
ANATOMY * The anatomical construction of the wrist explains this medical condition. Eight small bones, known as carpals, are arranged in two U-shaped rows and create the rigid floor of the carpal tunnel. see Figure 1.
The carpal bones closest to the wrist are the scaphoid, lunate, triquetral, and pisiform. Closest to the fingers are the trapezium, trapezoid, capitate, and hamate. The roof of the tunnel is formed by a thick ligament that stretches across the top of the...