Figure 1. Commonest distribution of symptoms of median and ulnar nerve compression

Carpal tunnel syndrome. Can it be a work related condition?

In keeping with our policy of providing objective, unbiased and independent medical reporting to guide the examining practitioner, we have posted an informative article by Dr John McKessar (Dr John McKessar FRACS, is a hand and upper limb medicolegal consultant, Sydney, New South Wales) on Carpal Tunnel Syndrome – one of the most common hand conditions seen in clinical practice.

Converging causal considerations

While it has not been possible to rule out occupational factors in having a role in the development of CTS, the article shows there can be no 100% certainty of this correlation and that the condition can be the culmination of many converging causal considerations. Szabo (Szabo R. Carpal tunnel syndrome as a repetitive motion disorder. Clin Orthop Relat Res 1998;351:78–89) reviewed a series of papers on CTS which argue for and against occupation being a significant risk factor in causation of CTS.

Widely divergent views in the literature are described here, including contributing aspects such as studies on psychological wellbeing and biological factors such as genetics, race and age. Work related factors may coexist with any of the constitutional risk factors.

Acceptable Workers’ Compensation Claim for Treatment

This article seeks to guide the examining practitioner in answering the questions of patients and insurance companies as to whether a patient with the established diagnosis of CTS has an acceptable workers’ compensation claim for treatment.

We offer this information to assist with the final decision making process across medico-legal claims.

“…I particularly like this article because it draws on the results of studies and the experience of two much respected specialists in this field. In my opinion, the article presents a very balanced view of Carpal Tunnel Syndrome and work causation …”

Managing Partner at Specialist Opinion Group