Factors For Carpal Tunnel Syndrome Research Articles

Burden of carpal tunnel syndrome and its associated factors among construction industry workers in Gondar town, Ethiopia.

Carpal tunnel syndrome is characterized by symptoms such as pain, numbness, or tingling on the anterior surface of the index, middle, or radial half of the ring finger, which is frequently associated with weakness of hand grip, and nocturnal pain and/or numbness resulting from compression of the median nerve at the carpal tunnel between the carpal bones and the transverse ligament. The construction industry involves many activities aside from the building process, such as landscaping, painting, electrical supply, plastering, paving, and telecommunications. Performing such tasks involves repetition of wrist flexion and extension, forceful grip with the hand, and/or vibrations of the hand and arm. This study aimed to assess the prevalence of carpal tunnel syndrome and its associated risk factors among construction workers. An institutional-based cross-sectional study design was conducted among six construction sectors in Gondar from April to July 2021. An interviewer-administered questionnaire was prepared from the literature with a Katz hand diagram, and a physical examination and a special test (carpal compression test, Phalen's, and Tinel's test) were carried out for those participants who reported pain during the interview. Binary logistic regression was conducted with SPSS 25 to identify the associated risk factors for carpal tunnel syndrome. The strength of the association was detected by the adjusted odds ratio. A total of 333 study participants aged 18-70 years were included in this study. Among the participants, 11.7% (AOR: 95%CI: 8.1-15.3) had carpal tunnel syndrome. Age, cigarette smoking, work experience, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers with a p-value of <0.05. The magnitude of carpal tunnel syndrome was 11.7% among construction workers. Being of older age, having more experience, cigarette smoking, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers. Employers should implement work safety education programs that raise awareness about the risks of cigarette smoking and encourage employers and supervisors to seek early medical intervention and treatment for carpal tunnel syndrome before it becomes a chronic problem.

Carpal Tunnel Syndrome and Trigger Finger May Be an Early Symptom of Preclinic Type 2 Diabetes.

Type 2 diabetes (T2D) is a major risk factor for carpal tunnel syndrome (CTS) and trigger finger (TF), but less is known regarding the risk of developing T2D after being diagnosed with CTS or TF. CTS and TF could be early signs of preclinical T2D, and early detection of T2D is crucial to prevent complications and morbidity. Therefore, we investigate the association between CTS/TF and T2D in an adult population without previous T2D using big data registers in Sweden. Data were collected by crosslinking five nationwide Swedish registers. Individuals aged 40-85 years on December 31, 2010, without prior overt diabetes, were included (n = 3,948,517) and followed up from baseline (ie, a diagnosis of CTS or TF) or January 1, 2011, for controls, until a diagnosis of T2D, prescription of oral antidiabetics or insulin, or end of follow-up four years after baseline. Multivariate Cox regression models were created to calculate hazard ratios for T2D. In total, 37,346 (0.95%) patients were diagnosed with CTS, whereof 1329 (3.46%) developed T2D. There were 17,432 (0.44%) patients who developed TF, whereof 639 (3.67%) developed T2D. Among the controls, 2.73% developed T2D. Compared with controls, there was an increased risk of developing T2D after being diagnosed with either CTS (HR 1.35; 95% confidence interval 1.28-1.43) or TF (HR 1.21; 95% confidence interval 1.12-1.31). Compared with controls, a diagnosis of CTS or TF was associated with 35% and 21% higher risk for later T2D, respectively, which might indicate the existence of undetected T2D in this population.

Association of carpal tunnel syndrome risk factors with treatment modality selection focusing on corticosteroid injection and surgery: A nationwide population-based study.

Several studies have revealed the risk factors for carpal tunnel syndrome (CTS). However, no studies have evaluated the influence of these risk factors on the selection of treatment modalities for CTS. This study aimed to determine the influence of CTS risk factors on the selection of CTS treatment modalities with a focus on corticosteroid injection (CI) and surgery. We conducted a retrospective cohort study of patients aged ≥20 years with newly diagnosed CTS in the Korean health insurance review and assessment service between 2010 and 2019. We evaluated the demographic information, the existence of CTS risk factors, and the applied treatment modalities for CTS, including CI and operation. The CTS risk factors include age, sex, diabetes mellitus, osteoarthritis of the hand or wrist, rheumatoid arthritis, hypothyroidism, gout, chronic kidney disease (CKD) on dialysis, antiestrogen or aromatase inhibitor medication, and a history of distal radius fracture (DRF). Multivariable logistic regression analyses were conducted. Age over 80 years was the most significantly associated factor for the selection of CI in CTS (odd ratio [OR], 2.149; 95% confidence interval [CI], 2.092 to 2.209; P < .001). Among underlying diseases or medications, CKD on dialysis (OR, 4.001; 95% CI, 3.819-4.193; P < .001) was the most significant associated factor for the selection of operation for CTS, followed by a history of DRF (OR, 1.803; 95% CI, 1.749-1.860; P < .001). Old age was the most significantly related factor for selecting CI. Among underlying diseases or medications, CKD on dialysis and the history of DRF were the most significantly related factors for selecting operative treatment. For these patients, clinicians should proactively consider an operation to reduce the long-term discomfort and economic burdens.

Natural evolution of idiopathic carpal tunnel syndrome with respect to wrist and hand anthropometry: A prospective cohort study

ObjectiveA greater wrist depth/width ratio and wrist depth/palm length ratio are known risk factors for carpal tunnel syndrome. We hypothesized that these parameters might also predict progression in patients who were not surgically treated. MethodsSeventy-eight patients with moderately severe idiopathic carpal tunnel syndrome of at least 10 months duration at recruitment, who declined surgical treatment and steroid injection, underwent repeated neurophysiological assessments after 3 years. A > 10% increase in median SNAP latency was taken as evidence of significant deterioration. ResultsPatients with a wrist ratio ≥ 0.72 showed a statistically significant deterioration in SNAP latency from 5.46 (SD 2.09) to 7.16 (SD 1.56) ms and in SNAP amplitude from 30.19 (SD 13.8) to 16.62 (SD 14.42) µv. For those with a wrist-to-palm ratio ≥ 0.42, SNAP latency deteriorated from 5.27 (SD 1.21) to 7.1 (SD 1.52) ms, and amplitude from 32.78 (SD 13.76) to 19.45 (SD 16.62) µv. Patients with lower ratios did not show significant changes in any neurophysiological parameter. The relative risk of significant deterioration in SNAP latency in patients with a wrist ratio ≥ 0.72 was 2.04 (95% CI 1.27–3.27). ConclusionIn untreated idiopathic carpal tunnel syndrome, patients with larger wrist and wrist-to-palm ratios are more likely to show neurophysiological progression.

A systematic review Risk Factors of Carpal Tunnel Syndrome in Food Industry Workers

Carpal Tunnel Syndrome (CTS) is a health disorder that occurs due to compression of the median nerve in the carpal tunnel with the main symptoms being tingling and pain in the fingers and hands which are innervated by the median nerve. CTS is a multifactorial disease, involving various risk factors (occupational, non-occupational). CTS is at risk of occurring in various industrial sectors, especially workers in the clothing industry, food and beverage industry, and agriculture who cause repetitive movements or maintain unergonomic work postures. CTS has become the center of attention of researchers because it can cause disability in workers, disrupting work productivity. This study aims to analyze the risk factors for CTS in food industry workers. This type of research is a systematic review that was searched via Google Scholars, PubMed, Cochrane Library, ResearchGate and Science Direct with a publication deadline of the last 5 years. The research results showed that 33 journals contained the topic of CTS risk factors in food industry workers. Based on 33 journals, it was found that the factors that cause Carpal Tunnel Syndrome are divided into occupational and non-occupational risk factors. Occupational risk factors include work duration, non-ergonomic workplace, work experience, repetitive wrist movements, hand position and body posture, and exposure to vibration. Apart from that, non-occupational factors include underlying disease, age, female gender, obesity, smoking. The conclusion of this research is that the risk factors for Carpal Tunnel Syndrome (CTS) in food industry workers are caused by various things. In general, it consists of occupational and non-occupational risk factors.

Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study

BackgroundAlthough diabetes is considered a major risk factor for carpal tunnel syndrome (CTS), the characteristics of diabetic CTS have not been fully understood.ObjectiveThis study is aimed at evaluation of the clinical, electrophysiological, and ultrasonographic findings of non-diabetic and diabetic CTS.MethodsThis retrospective, cross-sectional study included patients diagnosed with CTS. Patient age, sex, involved side, body mass index, clinical and electrophysiological findings, and median nerve cross-sectional area (CSA) were identified. Diabetes was identified through patient or guardian interviews, medical records, and medication history. Linear and binary logistic regression models were established to confirm the associations between the electrophysiological findings, median nerve CSA, and clinical outcomes. Covariates, such as age, sex, body mass index, diabetes, symptom duration, and thenar muscle weakness were adjusted.ResultsOut of the 920 hands, 126 and 794 belonged to the diabetic and non-diabetic CTS groups, respectively. The patients were significantly older in the diabetic CTS group (P < 0.001). The rate of thenar weakness in the diabetic CTS group was also significantly higher than that in the non-diabetic CTS group (P = 0.009). The diabetic CTS group had a more severe electrodiagnostic grade (P = 0.001). The prolonged onset latency of the compound motor nerve action potential (CMAP) and median nerve CSA were well associated with the degree of clinical symptoms. Increased median nerve CSA was significantly associated with prolonged CMAP onset latency (β = 0.64; P = 0.012), prolonged transcarpal latency (β = 0.95; P = 0.044), and decreased CMAP amplitude (β = -0.17; P = 0.002) in the non-diabetic CTS group.ConclusionDiabetic CTS had more profound electrophysiological abnormalities. Distal motor latency and median nerve CSA were not only associated with each other, but also with clinical symptoms. Further studies are needed to investigate the pathophysiological mechanisms underlying diabetic CTS.

Risk factors for carpal tunnel syndrome

Risk factors for carpal tunnel syndrome

Incidence of Carpal Tunnel Syndrome and Other Coexisting Brachial Plexus Neuropathies in Bullseye Shooters—A Pilot Retrospective Clinical and Neurophysiological Assessment

Shooting may impact the frequency of neuropathies in the upper extremity nerves or of cervical disc–root conflicts. This study was undertaken to assess whether shooting sports trained with a handgun by civilians may influence the risk factor for carpal tunnel syndrome (CTS) and other neuropathies of the brachial plexus nerve fibers. Neurophysiological studies using surface electromyography (rEMG at rest and mcEMG during maximal contraction), electroneurography (ENG), and motor-evoked potential recordings (MEPs) were performed in a select population of nine shooters, which were rigorously screened as positive through a clinical examination for carpal tunnel syndrome and other brachial plexus neuropathies among a population of forty-two subjects, to confirm the existence of pathologies in the upper extremities. Increased muscle tension in rEMG and a simultaneous decrease in motor unit activity in mcEMG were recorded both in the proximal and distal muscles of the upper extremities more frequently in the shooters than in the healthy controls—volunteers. An ENG examination confirmed CTS in the shooting hand of four subjects (4/42; 9.5%), additionally revealing a significantly decreased F-wave at the C6–C7 levels in the dominant extremities of the shooting group in comparison to the control population (p = 0.05). All the examined subjects had revealed brachial plexus pathologies on both sides according to the results of the MEP recordings upon stimulation at the C4–C8 levels (various significant differences between the shooters and control group were found), and two had ulnar neuropathy in the wrist on the shooting side. It was concluded that shooting sports are a moderate risk factor for carpal tunnel syndrome and that they significantly influence the development of other brachial plexus neuropathies.

The Incidence of Carpal Tunnel Syndrome Diagnosis Increases after Arthroscopic Shoulder Surgery

Arthroscopic shoulder surgery has been identified as a potential risk factor for carpal tunnel syndrome (CTS). The purposes of this study were as follows: to (1) examine the percentage of patients who underwent arthroscopic shoulder procedures and later developed ipsilateral CTS within 1 year of the procedure, (2) determine the percentage of those patients with CTS who subsequently underwent an injection or release, and (3) examine comorbidities associated with developing CTS after surgery. Patients who underwent arthroscopic rotator cuff repair (RCR), labral repair, or biceps tenodesis were retrospectively identified in a national database. Within 1 year, we compared the rates of ipsilateral CTS diagnoses versus the contralateral side. The rates of comorbidities between those who did and did not develop CTS were also compared. Within 1 year, arthroscopic RCR patients (1.47% vs 1.00%; odds ratio [OR], 1.48; P < .001) and arthroscopic labral repair patients (0.76% vs 0.52%; OR, 1.47; P < .001) had a significantly higher rate of ipsilateral carpal tunnel diagnosis versus contralateral side diagnosis. Arthroscopic RCR patients were also significantly more likely to have ipsilateral carpal tunnel injection (0.16% vs 0.11%; OR, 1.45; P < .001) and release (0.46% vs 0.37%; OR, 1.24; P < .001). Patients who had an ipsilateral carpal tunnel diagnosis following arthroscopic RCR and labral repair were both significantly older (both P < .001), a higher percentage of women (both P<.001), and more likely to have had a preoperative nerve block (both P < .05). Both cohorts had significantly higher mean Elixhauser comorbidity Index (P < .001) and more comorbidities. This study demonstrated a significantly higher incidence of operative side CTS within 1 year following arthroscopic RCR and labral repairs. Arthroscopic RCR was also demonstrated to result in significantly higher rates of injections and carpal tunnel release. The cohort that developed ipsilateral CTS was older, had higher percentage of women, and had more comorbidities. Prognostic III.

Are body mass index and the systemic immune-inflammation index risk factors for carpal tunnel syndrome?

Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity that affects activities of daily living. In our study, we aimed to reveal the relationship between CTS and BMI, and to evaluate symptom severity and functionality in these patients by using the Boston CTS questionnaire. Methods: In this study, 300 patients with CTS and 100 healthy individuals without CTS whose EMG was performed in our neurology clinic electrophysiology laboratory between June 2021 and December 2021, were included. BMI, SII index, and Boston CTS questionnaire findings were compared between patients diagnosed as having mild, moderate, and severe CTS (according to electrophysiologic evaluations) and a control group consisting of healthy individuals. Results: In our study, a statistically significant difference was observed between the CTS and control groups in terms of mean age (p &amp;lt; 0.001). When the increased BMI and SII parameters were compared, a statistically significant difference was observed between the control and CTS groups (p &amp;lt; 0.001 for both). In the multivariate logistic regression analysis, it was observed that the risk of CTS increased 1.566 times as BMI increased, and the risk of CTS increased 1.005 times as the SII index increased (p &amp;lt; 0.001 for both). Conclusions: We observed that increased BMI and advanced age were risk factors for CTS. In our study, in which the relationship between the SII index and CTS was evaluated for the first time, according to our findings, inflammation was thought to play a role in the pathophysiology of CTS.

199 Rates of Upper Extremity Compression Neuropathies Among Obese Patients Compared to Non-Obese Controls and Obese Patients Who Underwent Bariatric Surgery

INTRODUCTION: Upper extremity compression neuropathies(UECN) are increasingly prevalent and decrease the quality of life of affected individuals. Studies suggest obesity as a risk factor for carpal tunnel syndrome, the most common type of UECN. METHODS: A retrospective cohort study was conducted using the PearlDiver Mariner Database, an all-payor claims database containing claims for over 53 million patients from 2010 to 2019 in all 50 US states. Rates and odds of all types of UECN were compared between 1:1:1 exact matched cohorts of obese patients who were medically managed, obese patients who underwent bariatric surgery, and nonobese patients (111,967 patients in each cohort). RESULTS: Compared with nonobese patients, patients with obesity were significantly more likely to develop any UECN (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.09–1.18), carpal tunnel syndrome (OR, 1.15; 95% CI, 1.10–1.30), and 2 or more UECN (OR, 1.34; 95% CI, 1.20–1.48). Compared with obese patients who were managed medically, obese patients who underwent bariatric surgery were significantly less likely to develop any UECN (OR, 0.87; 95% CI, 0.84–0.91) and carpal tunnel syndrome (OR, 0.85; 95% CI, 0.81–0.89). CONCLUSIONS: Obese patients have higher odds of both single and concomitant UECN, specifically carpal tunnel syndrome, compared with nonobese patients. Bariatric surgery decreases the odds of developing UECN compared with obese patients not undergoing surgical intervention.

Risk Fastors for Carpal Tunner Syndrome in Pregnant Women: A Literature Review

Carpal tunnel syndrome (CTS) is a symptom of compression neuropathy that occurs in the hands, specifically the median nerve. The incidence of carpal tunnel syndrome in adults is known to be around 0.7% -9.2% in women, while in men it is around 0.4% -2.1%. The incidence of carpal tunnel syndrome has a 3x greater risk in women compared to men and 2-3 times more common in pregnant women than those who are not pregnant. The purpose of this paper is to determine the risk factors for carpal tunnel syndrome in pregnant women. This research is a literature review as secondary research with analytic research type using observational research methods and quantitative approaches. This literature search was conducted at JKKI using keywords such as carpal tunnel syndrome, pregnant women, and risk factors. The etiology of CTS during pregnancy is still unknown but there are several risk factors that can cause carpal tunnel syndrome in pregnant women such as edema or water retention, hormonal changes, gestational hypertension with preeclampsia, diabetes mellitus, hypothyroidism, nerve hypersensitivity, sleeping position, relaxin hormone, increase in fatty tissue during pregnancy, and changes in uterine size.

Risk factors for carpal tunnel syndrome in patients attending the primary care center of a tertiary hospital in Riyadh, Saudi Arabia: A case-control study.

Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in the upper extremity, is known to be a multi-factorial disease that raises medical and nonmedical risk factors. The aim of the current study was to determine the risk factors of CTS in patients attending the primary care center at a tertiary hospital. A case-control study was conducted by reviewing all medical records of patients above the age of 18 years old diagnosed with CTS from 2015 to 2021. The selected cases were evaluated by physical examination and confirmed by a nerve conduction study. Cases and controls were matched by age, gender, and nationality, with a case-to-control ratio of 1:2. Odds ratios were calculated for association between carpel tunnel syndrome and various factors and Chi-sqauare test determined statistical significance. Multiple logistic regression was performed to adjust for confounding. The study recruited 144 cases with a mean age of 53.38 ± 12.20 years and 288 controls with a mean age of 53.80 ± 12.27 years. The majority of subjects were female (84.7%) and of Saudi nationality (68.3%). There was a significant difference in body mass index, employment status, number of years of employment, occupation, mean systolic blood pressure, mean low-density lipoprotein cholesterol level, and mean blood urea level between cases and controls (P < 0.05). Laboratory tests that were found to be significantly associated with CTS in univariate analysis were thyroid-stimulating hormone (crude odds ratio [COR] = 0.828) and urea level (COR = 0.802). In fully adjusted analyses, obesity (adjusted odds ratio [AOR] =3.080), chronic kidney disease (AOR = 3.629), and the use of corticosteroid (AOR = 0.470) were also significantly associated with CTS. Similar to the findings of other studies, this study identified several potential risk factors for CTS. More large-scale longitudinal studies are required to establish a precise causal association.

Risk Factors for Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome (CTS) is known to be the most common type of compression neuropathy of the upper extremities. Carpal Tunnel Syndrome (CTS) is caused by compression of the nerve that runs through the carpal tunnel, namely the median nerve. Carpal Tunnel Syndrome (CTS) is very often experienced by workers whose daily activities always use repetitive movements of the wrist and a fixed position for a long time. Several factors are known to be a risk factor for CTS, such as repetitive movements with force, pressure on the muscles, non-ergonomic work postures, and others. Carpal Tunnel Syndrome (CTS) is a syndrome that can actually be prevented because there are no risk factors that cannot be changed except for age.

Risk Factors for Carpal Tunnel Syndrome in Informal Sector Workers: Literature Review

CTS is one of the diseases that occurs in many workers so it is often referred to as work-related Carpal Tunnel Syndrome. The high number of informal workers allows for high accidents in the workplace. The purpose of this study is to discuss the risk factors for the incidence of CTS in informal sector workers. This research is a descriptive research with the literature review method. The literature search strategy uses a prism flow chart, and inclusion and exclusion criteria. The databases used include: PubMed, Taylor and francis, and Google Scholar. From the 20 articles, 19 of them used the cross-sectional type of research, and 1 article used the case-control type of research. The types of informal work obtained from the 20 articles are: motorcycle taxi drivers, farmers, batik and bead craftsmen, blacksmiths, stone breakers, meatball sellers, coconut peelers, woodcarvers, tailors, angkot drivers, small-scale convection, hairstylists, and butchers. Overall, the journal articles obtained discuss related to the risk factors for the incidence of CTS in informal sector workers. Repetitive movements, length of service, length of work, hand posture (awkward), age, gender, and body mass index were found to influence the incidence of CTS in informal sector workers. Meanwhile, grasping work and a history of diabetes mellitus were not found to be related to the incidence of CTS in informal sector workers.

Influence of ergonomic factors on peripheral neuropathy under HAV exposure.

Hand-arm vibration (HAV) is a risk factor for carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE). It is unclear how ergonomic factors influence the relationship between HAV exposure and CTS and UNE. We aimed to assess the relationship between cumulative HAV exposure and CTS and UNE in workers exposed to HAV from two tools with different ergonomic profiles. We performed nerve conduction studies (NCSs) of the sensory and motor median and ulnar nerves and recorded symptoms indicating CTS and UNE in workers exposed to HAV from impact wrenches or from rock drills. Exposure was measured as cumulative lifetime exposure. We used linear regression adjusted for age and body mass index to assess linear relationships. Sixty-five workers participated (33 rock drill and 32 impact wrench operators). We found inverse linear associations between cumulative HAV exposure and median nerve sensory conduction velocity in impact wrench operators and ulnar nerve motor conduction velocity in rock drill operators (beta of 0.63 and 0.75). Based on NCS findings and symptoms, seven impact wrench operators had CTS and one UNE, and four rock drill operators had CTS and six UNE. Our findings indicate that ergonomic factors influence the development of CTS and UNE under HAV exposure. The ergonomic profile seems to influence which type of neuropathy workers exposed to HAV will develop. Design of occupational exposure guidelines and future studies should be based on ergonomic profile and exposure characteristics for different tools and not merely HAV.

Bifid median nerve as an anatomical risk factor for carpal tunnel syndrome: A meta-analysis.

As the median nerve enters the carpal tunnel, it is a single nerve that soon bifurcates into lateral and medial branches into the hand. If the bifurcation is proximal to the carpel tunnel, a bifid median nerve (BMN) results. Carpal tunnel syndrome is often associated with a BMN with or without a persistent median artery. Individual keywords and MeSH phrases were searched in the Google Scholar, SCOPUS, and PubMed databases. Full texts were then collected and assessed for suitability. The prevalence of BMN at the wrist joint in normal and carpal tunnel syndrome wrists (precanal part) and the mean difference between groups were recorded. Only human data were used to test the findings. The pooled odds ratio (with minimal heterogeneity) was 1.50 [1.17-1.93, 95% CI]. The BMN cross-sectional area (CSA) was significantly greater than that of a solitary median nerve in normal wrists. The mean difference in CSA between the two was 1.50 mm2 [0.56-2.45 mm2 , 95% CI] without heterogeneity (i2 =0). Sex and laterality distributions scarcely differed between the two types of wrists. Owing to the insufficiency of data, the relationships with mean height and weight were not examined. There was a 50% greater incidence of bifid median nerves in carpal tunnel syndrome patients than in normal subjects. A bifid median nerve increases the mean CSA at the wrist joint by 1.5 mm2 . These findings indicate that the bifid median nerve is an anatomical risk factor for carpal tunnel syndrome.

Weight-Related and Personal Risk Factors of Carpal Tunnel Syndrome in the Northern Finland Birth Cohort 1966.

Background: Excess body mass is a risk factor for carpal tunnel syndrome (CTS), but the mechanisms of this are unclear. This study aimed to evaluate the association between CTS and personal risk factors of body mass index (BMI), waist circumference and waist-to-hip ratio (WHR). Methods: The study sample consisted of the Northern Finland Birth Cohort 1966 (n = 9246). At the age of 31 in 1997 and at the age of 46 in 2012, the participants underwent a clinical examination. Cohort A consisted of complete cases with a follow-up from 1997 to 2012 (n = 4701), and Cohort B was followed up from 2012 to 2018 (n = 4548). The data on diagnosed CTS were provided by the Care Register for Health Care until the end of 2018. Results: After an adjustment for confounding factors, BMI was associated with CTS among women (hazard ratio (HR) 1.47, 95% Cl 0.98–2.20 for overweight women and HR 2.22, 95% Cl 1.29–3.83 for obese women) and among both sexes combined (HR 1.35 95% Cl 0.96–1.90 for overweight and HR 1.98 95% Cl 1.22–3.22 for obese participants). Neither waist circumference nor WHR was associated with CTS. Conclusions: BMI is an independent risk factor for CTS and is more relevant for estimating the increased risk of CTS due to excess body mass than waist circumference or WHR.

The Effects of Obesity and Bariatric Surgery on Rates of Upper Extremity Compression Neuropathies.

To estimate the effects of obesity on all types of upper extremity compression neuropathies (UECN) (carpal tunnel syndrome and other median nerve, radial nerve, and ulnar nerve compression neuropathies) and to assess whether bariatric surgery modifies these effects. UECN are increasingly prevalent and decrease the quality of life of affected individuals. Studies suggest obesity as a risk factor for carpal tunnel syndrome, the most common type of UECN. A retrospective cohort study was conducted using the PearlDiver Mariner Database, an all-payor claims database containing claims for over 53 million patients from 2010 to 2019 in all 50 US states. Rates and odds of all types of UECN were compared between 1:1:1 exact matched cohorts of obese patients who were medically managed, obese patients who underwent bariatric surgery, and nonobese patients (111,967 patients in each cohort). Compared with nonobese patients, patients with obesity were significantly more likely to develop any UECN (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.09-1.18), carpal tunnel syndrome (OR, 1.15; 95% CI, 1.10-1.30), and 2 or more UECN (OR, 1.34; 95% CI, 1.20-1.48). Compared with obese patients who were managed medically, obese patients who underwent bariatric surgery were significantly less likely to develop any UECN (OR, 0.87; 95% CI, 0.84-0.91) and carpal tunnel syndrome (OR, 0.85; 95% CI, 0.81-0.89). Obese patients have higher odds of both single and concomitant UECN, specifically carpal tunnel syndrome, compared with nonobese patients. Bariatric surgery decreases the odds of developing UECN compared with obese patients not undergoing surgical intervention.

Effects of slight flexion-extension and radial-ulnar deviation postures on carpal tunnel volume

BackgroundNon-neutral wrist postures are a commonly reported risk factor for carpal tunnel syndrome. It is unclear how slight flexion-extension and radial-ulnar deviation postures affect the carpal tunnel. The objective was to determine the effects of slight non-neutral postures by quantifying carpal tunnel volume. MethodsComputed tomography images were collected on ten cadaveric specimens in target postures of −20°, −10°, −5°, 0°, 5°, 10°, and 20° of flexion and − 10°, −5°, 0°, 5°, and 10° of radial-ulnar deviation. Surface meshes of the carpal tunnel, carpal bones, radius, and third metacarpal were generated with manual segmentation. Carpal tunnel volume was calculated as the volume between proximal and distal boundaries defined with anatomical landmarks and the orientation of the tunnel. The precise wrist posture of each scan was determined with inertial-based coordinate systems of the radius and third metacarpal. FindingsThrough multiple linear regression it was determined that, over the observed range of postures, flexion-extension angle does not have a significant effect (p = 0.99) while radial-ulnar deviation angle has a significant effect of −5.9 mm3/degree (p = 0.003). The findings were consistent with previous studies of postural effects on carpal tunnel pressure. InterpretationFor the treatment and prevention of carpal tunnel syndrome, results suggest that attention should be given to slight radial-ulnar deviation postures (<10°), while slight flexion-extension postures (<20°) are of lesser consequence to carpal tunnel volume.