Here’s a fun workplace quiz. Which is the bigger spend on workers compensation claims: lower back pain or carpal tunnel syndrome?
Most people might assume lower back pain is the larger spend but it’s not. Nearly one-third of all money spent on workers compensation claims or more than $2 billion dollars to treat this common form of wrist pain.
There exists a near universal belief – among patients and health care clinicians – that extensive computer and phone use can lead to hand problems. The most common myth remains that Carpal Tunnel Syndrome is a “computer disease” and that can cause physical harm. Nothing is further from the truth.
And, the rarely discussed economic ramifications of this are staggering. A Swedish cohort study by Atroshi et al demonstrated that frequent keyboard use was actually less common in patients with Carpal Tunnel Syndrome (CTS), albeit not statistically significant.
Not only are common conditions like CTS, trigger finger and tennis elbow NOT caused by so called “overuse” or “repetitive stress” but they are actually metabolic and hormonal related issues that are actually quite easy to treat; given the right diagnosis is made and the sufferer is seeing the right type of specialist.
Carpal Tunnel Syndrome, or CTS, is especially common in perimenopausal women, patients with diabetes and hypothyroid conditions. It is also common in third trimester pregnancies but usually resolves after delivery once fluid retention diminishes.
Unfortunately, money in the truly broken workers comp system would be better spent on compensating workers injured with true work-related accidents such as falls, crush injuries or lacerations, instead of going to a pool of patients suffering from a very common and easily treatable nerve compression disorder.
Your Computer is Not Causing Carpal Tunnel Syndrome
Despite the near universal presence of computer keyboards, mouses and mobile technology, there remains a pervasive myth that these devices can actually cause damage to the users’ hands. The worker psyche often attributes this wrist and hand pain to their tasks at work, computers, laptops, and even their mobile phones.
This creates a conundrum for the employer or direct work supervisor since the work needs to be done but that person in charge may also share the perspective that this work can ultimately be harmful.
A loss of productivity may ensue since frequent breaks may be expected or worse, the “injured” worker may report the clinical complaints as an actual work injury. This is a very different paradigm than truly risk-laden occupations, such as an electrical power lineman, or a construction worker.
Educating Workers on the Myths of Carpal Tunnel Syndrome
Education regarding carpal tunnel syndrome and other such “repetitive stress injuries” is severely lacking and the information available to the public, employers and insurance industry is based upon myths not supported in the scientific literature amongst hand specialists.
Dispelling the myth will not only have great economic impact, crucial in this age of healthcare cost containment, but also enable the sufferer to have the appropriate and speedy treatment.
Employers should focus on having their employees be seen by appropriate specialists, allowing businesses to not lose crucial employees. Furthermore, this gross and pervasive misconception is likely the tip of the iceberg regarding healthcare myths since dispelling them relies on each specialty bringing forth the facts. This requires physician engagement with the public at an educational level, coupled with interest in the popular media in bringing forth the truth, rather than continuing to regurgitate false claims.
As a result, employers may need to educate themselves on this broad topic and enact certain measures to protect their employees but also minimize disruption to workflow and the business as a whole.
Prevention Tips for Carpal Tunnel Syndrome within the Workforce
- Ensure that workstations are ergonomically optimized. This means that the desk, or other areas, are comfortable with monitor, keyboard and mouse in the correct position as per occupational therapist (OT) guidelines. This may require an assessment by an OT consultant but beware that many share the some misperceptions being described herein.
- Workers with complaints of hand pain, numbness or fatigue should be seen by an appropriate specialist. Understand that medical knowledge has increased exponentially and common sense now dictates that a hand specialist should make the assessment as primary care or occupational health physicians may know as much about the wrist as my fellow hand surgeons know about the spine – Not much, despite the fact most of us are actually orthopedic surgeons. The reality is that there is too much to know in these areas for the subspecialist orthopedist who practices in one area, let alone the generalist or primary care doctor.
- Basic education on common hand issues can go a long way. The American Society for Surgery of the Hand (ASSH) may provide some materials written for the public and/or employers, but many times a local hand specialist might be willing to give an informative review to the workplace. This can be beneficial to both parties as a missed or delayed diagnosis can be very frustrating to the specialist and certainly tragic to the sufferer, and even their employer.
Real engagement at the employer level is needed, otherwise our healthcare ecosystem and society will continue to burn cash, and time, on false premises or faulty treatments.
