Risk Factors For Carpal Tunnel Syndrome Research Articles

Case-Control Study on Individual Risk Factors of Carpal Tunnel Syndrome in Bangladeshi Population

Introduction: Carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve at the level of the wrist, physiologically characterized by increased pressure within the carpal tunnel and a decreased function of the nerve at that level. With the prevalence estimated between 7% and 18% of the adult population, CTS is the most common entrapment neuropathy of the upper extremities. It is the most common neuro-compressive disease. Objective: To assess the individual risk factors of carpal tunnel syndrome In Bangladeshi Population. Materials and Methods: The present case-control study was conduct at the Dept. of Neurology, Uttara Adhunik Medical College Hospital (UAMCH), Uttara, Dhaka, Bangladesh from January 2019 to December 2021. 3019 patients included in our study and who were diagnosed in the 84% of patients were aged 41-70 years both case and control groups. Both groups filled out a standardized questionnaire, and a standardized patient record was filled out by Neurology Department. In addition, participants with jobs involving lifting and carrying of loads were interviewed. The incidence of CTS in middle aged women was significantly higher than that in men. Results: In our study 3019 patients who were diagnosed in the 84% of patients were aged 41-70 years. Among these patients, there were 756 CTS patients aged 41-70 years without any other diseases which could cause numbness as the case group. Then there were 2263 non-CTS outpatients involved as the control group. The average BMI in case group was 22.79±2.60 and 21.49±5.03 in control group with significant difference (P<0.01). The results showed that sex, age, smoking, wrist injury, diabetes mellitus, hypothyroidism and wrist working are all risk factors of CTS. Hypertension could be a protection factor of CTS in early phase but will increase the risk in a long-term high blood pressure. Smoking, alcohol and diabetes mellitus can be predictors of moderate and severe CTS. ......................

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.

Demographical, Anatomical, Disease-Related, and Occupational Risk Factors for Carpal Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) is the most common focal mononeuropathy. It causes characteristic symptoms, including numbness and paresthesia in the hand due to median nerve compression at the wrist. Objectives: We aimed to investigate CTS prevalence and personal, psychosocial, biomedical, and occupational factors related to it comprehensively, according to scattered publications, without the simultaneous evaluation of all CTS risk factors. Methods: A total of 345 patients referred to a hand clinic with a complaint of paresthesia in upper extremities and suspected CTS. The patients underwent neurological assessment and electrodiagnostic (EDX) tests to confirm the diagnosis. The demographic information, past medical history, past trauma history, and occupational history of all the patients were recorded and finally analyzed with SPSS software. Results: Of the patients, 213 (67.1%) met the criteria for CTS, of whom 160 (75%) were female. Females were significantly more affected by CTS than males (P < 0.05). The mean age was higher in the CTS patients (53.80 ± 11.57 years) than in non-patients (42.39 ± 12.31 years, P < 0.001). No statistical relevance was found between CTS prevalence with occupational history, underlying medical conditions, positive Tinel’s and Phalen's tests, and muscle atrophy. Conclusions: We recognized age and gender as main determinants in developing CTS. We also found that older age was related to higher CTS intensity.

Radiographic Characteristics of the Distal Radius in Patients With Carpal Tunnel Syndrome: A Case-Control Study

Background: Carpal tunnel syndrome (CTS) is a common disorder with several known risk factors. However, the role of radiographic characteristics of the distal radius and risk factors of CTS has been overlooked. Objectives: To identify radiographic characteristics of the distal radius as the risk factors of CTS. Methods: In a case-control study, 60 patients with CTS who underwent surgical treatment (case group) and 60 people who underwent radiographic evaluation for reasons other than CTS (control group) were included. The case and control participants were matched for age and sex. Radiographic records of the patients were reviewed in the picture archiving and communication system, and the distal radius characteristics, including volar tilt, radius slope, radius height, and ulnar variance, were investigated. Results: The Mean±SD volar tilt was 10.49±6.42º in the case group and 16.65±5.31º in the control group (P <0.001). The Mean±SD radius inclination angle was 19.58±4.72º in the case group and 17.88±4.88º in the control group (P=0.049). The Mean±SD height of radius was 10.30±3.21 mm in the case group and 12.24±5.33 mm in the control group (P=0.017). The Mean±SD ulnar variance was 1.36±1.43 mm in the case group and 0.75±0.27 mm in the control groups (P=0.002). Conclusion: Radiological characteristics of the distal radius are significantly different between the CTS and non-CTS patients and could be regarded as the inherent risk factors of CTS development.

Carpal Tunnel Syndrome:Diagnosis and Treatment

Carpal tunnel syndrome(CTS)is a common entrapment neuropathy caused by compression of the median nerve around the wrist. The risk factors of CTS include female sex, diabetes mellitus, hypothyroidism, obesity, arthritis, hemodialysis, acromegaly, and pregnancy. CTS is characterized by paresthesia in the distribution of the median nerve. Patients are often unaware of ring-finger splitting and the combination of Tinel's sign and Phalen's test improves diagnostic accuracy. In addition, electrophysiological assessments can help to confirm a CTS diagnosis; their sensitivity ranges from 57-94% and their specificity from 51-97%. CTS negatively affects the quality of life but improvement by surgery can be expected. For conservative treatment, a neutral wrist splint worn at night or oral medication such as nonsteroidal anti-inflammatory drugs, vitamin B12, and pregabalin have been shown to be effective against CTS. CTS surgery may be indicated in patients with thenar muscle atrophy and when conservative treatment is ineffective. The surgery involves a small skin incision under a microscope and local anesthesia. Long-term outcomes with respect to pain, numbness, function, symptomatology relapse, and frequency of re-surgery do not significantly differ between patients subjected to open or endoscopic surgery.

Obesity, Type 2 Diabetes, and the Risk of Carpal Tunnel Syndrome: A Two-Sample Mendelian Randomization Study.

Some previous observational studies have reported an increased risk of carpal tunnel syndrome (CTS) in patients with obesity or type 2 diabetes (T2D), which was however, not observed in some other studies. In this study we performed a two-sample Mendelian randomization to assess the causal effect of obesity, T2D on the risk of CTS. Single nucleotide polymorphisms associated with the body mass index (BMI) and T2D were extracted from genome-wide association studies. Summary-level results of CTS were available through FinnGen repository. Univariable Mendelian randomization (MR) with inverse-variance-weighted method indicated a positive correlation of BMI with CTS risk [odds ratio (OR) 1.66, 95% confidence interval (CI), 1.39–1.97]. Genetically proxied T2D also significantly increased the risk of CTS [OR 1.17, 95% CI (1.07–1.29)]. The causal effect of BMI and T2D on CTS remained consistent after adjusting for each other with multivariable MR. Our mediation analysis indicated that 34.4% of BMI’s effect of CTS was mediated by T2D. We also assessed the effects of several BMI and glycemic related traits on CTS. Waist circumference and arm fat-free mass were also causally associated with CTS. However, the associations disappeared after adjusting for the effect of BMI. Our findings indicate that obesity and T2D are independent risk factors of CTS.

Risk Factors of Carpal Tunnel Syndrome in Taiwan: A Population-Based Cohort Study.

Carpal tunnel syndrome (CTS), 1 of the most common peripheral neuropathies of the upper extremity, has been studied for decades regarding its epidemiology and associated medical conditions. We conducted a large-scale, age- and gender-matched study from an Asian population database to investigate the relationship between the incidence and the demographic characteristics. A retrospective cohort study using data of National Health Insurance Research Database was conducted. One million enrollees in Taiwan was used to identify 9442 patients with CTS and 37,768 randomly selected controls, in a control-case ratio of 4:1. Diagnoses of CTS were ascertained from January 1, 2003, to December 31, 2012. Sociodemographic and medical characteristics were evaluated to assess the correlation with CTS. Annual incidence of CTS was approximately 0.4% during the 10-year-period in Taiwan, with higher incidence rate in female sex and middle age of group (50-59 years). Among the medical conditions, previous wrist injuries, obesity, gout, and rheumatoid arthritis were associated with CTS most significantly. Carpal tunnel syndrome has presented a relatively constant incidence in Taiwan. Female gender with middle age seemed to have the highest incident rate during a 10-year period from 2003 to 2012. Among the risk factors of CTS, previous wrist injuries, obesity, gout, and rheumatoid arthritis were demonstrated to be the most significantly correlated comorbidities.

Letter to the Editor: Landsbergis et al (2019) Titled "Work Exposures and Musculoskeletal Disorders Among Railroad Maintenance-of-Way Workers".

Letter to the Editor: Landsbergis et al (2019) Titled "Work Exposures and Musculoskeletal Disorders Among Railroad Maintenance-of-Way Workers".

Median nerve swelling is an independent risk factor of carpal tunnel syndrome in chronic hemodialysis patients

Carpal tunnel syndrome (CTS) has a wide variety of underlying causes and occurs in association with dialysis. Early diagnosis is essential to prevent permanent nerve damage and functional sequelae. We evaluated the association between CTS and cross-sectional area (CSA) of the median nerve in chronic hemodialysis (HD) patients. Patients with end-stage renal disease (ESRD) on maintenance HD via arteriovenous fistula were enrolled. We divided forty-three patients into two groups; patients diagnosed with CTS (n=19) and patients without CTS (n=24). The median nerve CSA was measured at the wrist (CSA-W) and forearm (CSA-F) by ultrasonography. Median nerve swelling was assessed by the wrist-to-forearm ratio (WFR). There were no significant differences in the underlying causes of CKD and adequacy of dialysis between the two groups (P = NS). The patients with CTS showed significantly higher WFR than the patients without CTS (P = 0.001). Univariate Cox regression analysis revealed that WFR > 1.25 (odds ratio, 6.30; 95% confidence interval, 1.44 to 27.45; P = 0.014) was associated with CTS in HD patients. The factors traditionally associated with CTS such as age, sex, diabetes, vintage of HD, β2-MG, intact PTH and Kt/V were not associated with CTS. After adjustment for age and sex, we found a strong correlation between CTS and the WFR > 1.25 (odds ratio, 10.8; 95% confidence interval, 1.85 to 62.4; P = 0.008). High WFR was associated with the development of CTS, and median nerve swelling was an independent risk factor of CTS in chronic HD patients. (Pusan National University Yangsan Hospital Review Board IRB No. 05-2015-137). This article is protected by copyright. All rights reserved.

Incidence and Reappraisal of Known Risk Factors Associated with Carpal Tunnel Syndrome: A Nationwide, 11-Year, Population-Based Study in South Korea.

Background and PurposePrevious studies have revealed various risk factors for carpal tunnel syndrome (CTS), but few large-scale studies have been conducted. We used data from the 11-year, longitudinal, nationwide population-based National Health Insurance Service–National Health Screening cohort to identify the actual risk factors for CTS.MethodsWe collected patients with CTS newly diagnosed using electrodiagnostic studies while excluding radiculopathy, plexopathy, or polyneuropathy, which can be confused with CTS. The crude and standardized incidence rates of CTS were calculated. Univariate and multivariate Cox analyses and the incidence of CTS were used to identify the risk factors for newly diagnosed CTS.ResultsThe standardized incidence was 130.8/100,000 person-years based on the World Health Organization World Standard Population as a reference. Multivariate Cox analysis identified that the risk factors for CTS were being middle-aged, female, and obese, and having rheumatoid arthritis and Raynaud's syndrome, whereas gout and hypothyroidism were not risk factors. Diabetes and end-stage renal disease did not show a significant hazard ratio, although it is implicit that the durations of these diseases affect the development of CTS.ConclusionsThis study calculated the incidence of CTS and reappraised the associated risk factors found in previous studies. This information will be helpful for determining the pathophysiology of CTS, and hence aid the establishment of effective new public health policies.

Evaluation of occupational and non-occupational risk factors associated with carpal tunnel syndrome in dentists

BACKGROUND: Musculoskeletal disorders are very prevalent among dentists. Of these disorders, carpal tunnel syndrome (CTS) is notable. OBJECTIVE: The aim of this study was to investigate the relationship between the occupational and non-occupational risk factors and CTS among dentists. METHODS: It is a cross-sectional study. We evaluated 106 dentists from dental schools in Tehran. We collected data by a general questionnaire, a hand diagram, and physical examination. A nerve conduction velocity (NCV) test was used to confirm the diagnosis of CTS. The analysis was performed using an independent T-test and logistic regressions on SPSS software. RESULTS: The prevalence of CTS among dentists was 17.9%. Significant risk factors of CTS included: vibration exposure greater than two hours per day (OR: 2.5), a wrist diameter ratio of greater than 0.7 (OR: 10.14), and female sex (OR: 13.38). CONCLUSIONS: Exposure to the hand-arm vibration should be considered as an occupational risk factor for CTS in dentists. Female dentists should take more preventive measures.

Prevalence and individual risk factors of carpal tunnel syndrome in pregnant women

Background: Prevalence of carpal tunnel syndrome (CTS) among pregnant women is very much common among the whole population. Due to rapid economic and social changes, an increasing trend of this disorder, as well as its individual risk factors, has also been observed in Pakistan. Objective: The present study aimed to find out the prevalence of CTS in pregnant women and to identify the risk factors associated with CTS in pregnancy. Material & Methods: Descriptive cross-sectional survey for the prevalence of CTS and a case-control study to find out the risk factors were administered on a sample of n=304 participants of pregnant women of Rawalpindi and Islamabad hospitals for six months from October 2016 to March 2017. Data was collected by non-probability convenient sampling through a self-structured questionnaire. The Association of risk factors was measured by odds ratio. Result: The present study showed the prevalence of CTS is 76(25%) based on Phalen’s test and the prevalence of CTS is 86(28.3%) based on Tinel’s test. History of CTS (OR=3.38) is the most common risk factor. Swelling (OR=2.74) is very common in pregnancy. Other factors including kidney disease, weightlifting, excessive household, cooking, and obesity, use of oral contraceptives, stress, smoking, sewing, diabetes, and thyroid dysfunction are also associated with CTS except for Rheumatoid arthritis, computer work and forceful griping. Conclusion: This study showed significant results regarding the prevalence and risk factors of CTS among pregnant women in the hospitals of Islamabad and Rawalpindi.

Carpal Tunnel Release Despite Normal Nerve Conduction Studies in Carpal Tunnel Syndrome Patients.

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy, often requiring carpal tunnel release (CTR) surgery. Often, a nerve conduction study (NCS) is performed before CTR; however, there are various reports questioning the sensitivity of NCS, and some patients do undergo CTR despite normal NCS results. We had the following purposes: (1) to report clinical outcome of CTS patients who undergo CTR despite normal NCS, (2) to identify the characteristics and compare those with abnormal NCS patients in terms of basic features and risk factors, and (3) to analyze and compare normal and abnormal NCS results. Medical records of 546 CTS (30 normal NCS and 516 abnormal NCS) patients were retrospectively reviewed. Of 30 normal NCS patients, 7 were excluded, leaving 23 patients in the experimental group. We investigated the influence of age, sex, operative arm, and body mass index, as well as medical conditions known to be risk factors for CTS. In normal NCS patients, as a functional score, we investigated Boston carpal tunnel scores before and after CTR. The NCS results were compared in terms of median motor and median sensory testing. In normal NCS patients, NCS data were compared with that of the contralateral nonoperated wrists. There were 18 women and 5 men in the normal NCS group (mean age 43.7 years). On physical examination, 22 (94.7%) patients showed a positive Tinel test, 19 (82.6%) showed a positive Phalen test, 8 (34.8%) complained of nocturnal paresthesia, and only 1 (4.3%) presented with thenar atrophy. In 19 of 23 patients, the Boston CTS scores showed significant improvement after CTR. Normal NCS patients were significantly younger and significantly heavier and more likely to be a current smoker. In NCS analysis of normal NCS patients, the operated wrists were closer to the reference values than nonoperated wrists. Surgeons should evaluate the possibility of other combined lesions before CTR in normal NCS patients. Normal NCS can be present with a CTS diagnosis, especially in younger patients. Nevertheless, CTR after failed conservative management, despite normal NCS, could relieve subjective symptoms and function.

Prevalence and Risk Factors of Carpal Tunnel Syndrome in Japanese Aged 50 to 89 Years.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy worldwide, but there are few reports investigating its prevalence using subjects diagnosed by both clinical symptoms and nerve conduction studies (NCSs) in a population-based cohort. This study aimed to determine the epidemiology of CTS diagnosed by sensory disturbance findings and NCSs using a randomly sampled resident population. Methods: Subjects aged between 50 and 89 years were randomly sampled from the basic resident registry of a rural Japanese town. Subjects indicating a history of CTS surgery in a written questionnaire were classified as having past CTS. Subjects with both sensory disturbance of the median nerve area and delays in NCSs were diagnosed as having present CTS. Subjects with past or present CTS were judged as affected with CTS. We calculated the prevalence of CTS and investigated for possible risk factors. Results: Seventeen subjects (14 female and 3 male) were affected with CTS among 379 enrolled subjects. Adjusting these results to Japanese population values, the weighted prevalence of CTS was 4.7% (female: 7.2%, male: 1.8%) in the Japanese population aged 50 to 89 years. Statistically significant positive correlations were found between CTS and female, higher BMI, rheumatoid arthritis, and trigger digit. In females affected with CTS, third metacarpal length was significantly shorter than in those without CTS. Conclusions: This epidemiological study clarified the prevalence of CTS among Japanese seniors as 4.7%. Female, higher BMI, rheumatoid arthritis, trigger digit, and shorter third metacarpal length in females were risk factors for CTS.

Carpal Tunnel Syndrome in Military Aviators.

The incidence of carpal tunnel syndrome (CTS) is increased in occupations exposed to repetitive motion, poor wrist posture, and vibration exposure. While all pilots are exposed to these factors, helicopter pilots are especially exposed to vibration. The study is to identify the incidence and risk factors for CTS in military aviators. Clearance was obtained from Tripler Army Medical Center IRB. The Defense Medical Epidemiological Database was queried for all new cases of CTS from 2006 to 2015. Incidence rates (IRs) were determined for helicopter pilots, fixed-wing pilots, and nonpilot officers. Poisson regression analysis was used to calculate adjusted IR in order to control for demographic factors. Race was also taken into account, where pilots would classify themselves into a white or non-white race, defined by each individual. Race was assessed in the study to see if there were any differences in IR of CTS between white and non-white pilots. We identified 7,398 new cases of CTS among 2,319,352 person-years within the study period. Increasing age, female gender, and non-white race were significantly correlated with higher IR. Fixed-wing pilots demonstrated significantly lower adjusted IR than nonpilot officers in each age group. Helicopter pilots demonstrated higher IR than fixed-wing pilots in each age group. Helicopter pilots had lower incidence of CTS early in their career compared to nonpilot officers, but by age 40+, their IR ratio was significantly higher (1.21). Analysis of the database indicates that fixed-wing pilot status is a protective factor against development of CTS among U.S. military officers. In contrast, helicopter pilots were found to be at an increased rate of CTS than their fixed-wing counterparts. Their incidence is comparable to their nonpilot officer peers early in their career, but is significantly increased at the senior level. Increasing age and female gender are risk factors in the military officer population as expected. Non-white race was found to increase risk in the military population, in contrast to reports of the civilian population.

A Review of Carpal Tunnel Syndrome and Its Association with Age, Body Mass Index, Cardiovascular Risk Factors, Hand Dominance, and Sex

Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. CTS results from compression or injury of the median nerve at the wrist within the confines of the carpal tunnel. Parameters such as age, sex, and body mass index (BMI) could be risk factors for CTS. This research work aimed to review the existing literature regarding the relationship between CTS and possible risk factors, such as age, sex, BMI, dominant hand, abdominal circumference, respiratory rate, blood pressure, and cardiac rate to determine which ones are the most influential, and therefore, take them into account in subsequent applied research in the manufacturing industry. We performed a literature search in the PubMed, EBSCO, and ScienceDirect databases using the following keywords: carpal tunnel syndrome AND (age OR sex OR BMI OR handedness OR abdominal circumference OR respiratory rate OR blood pressure OR cardiac rate). We chose 72 articles by analyzing the literature found based on selection criteria. We concluded that CTS is associated with age, female sex, and high BMI. Trends and future challenges have been proposed to delve into the relationship between risk factors and CTS, such as correlation studies on pain reduction, analysis of weight changes to predict the severity of this pathology, and its influence on clinical treatments.

Carpal Tunnel Syndrome: A Review of Literature.

Carpal tunnel syndrome (CTS) is a common medical condition that remains one of the most frequently reported forms of median nerve compression. CTS occurs when the median nerve is squeezed or compressed as it travels through the wrist. The syndrome is characterized by pain in the hand, numbness, and tingling in the distribution of the median nerve. Risk factors for CTS include obesity, monotonous wrist activity, pregnancy, genetic heredity, and rheumatoid inflammation. The diagnosis of CTS is conducted through medical assessments and electrophysiological testing, although idiopathic CTS is the most typical method of diagnosis for patients suffering from these symptoms. The pathophysiology of CTS involves a combination of mechanical trauma, increased pressure, and ischemic damage to the median nerve within the carpal tunnel. The diagnosis of CTS patients requires the respective medical professional to develop a case history associated with the characteristic signs of CTS. In addition, the doctor may question whether the patients use vibratory objects for their tasks, the parts of the arm where the sensations are felt, or if the patient may already have predisposing factors for CTS incidence. During the diagnosis of CTS, it is essential to note that other conditions may also provide similar symptoms to CTS, thus requiring vigorous diagnosis to assert the medical condition of the patients. Doctors use both non-surgical and surgical treatments when addressing CTS. Non-surgical treatments include wrist splinting, change of working position, medications, and the use of alternative non-vibrating equipment at work. On the other hand, surgical methods include open release and endoscopic surgeries. This review of literature has provided an overview of CTS with an emphasis on anatomy, epidemiology, risk factors, pathophysiology, stages of CTS, diagnosis, and management options.

Risk factors for carpal tunnel syndrome or trigger finger following distal radius fracture: a nationwide study

New-onset carpal tunnel syndrome (CTS) and trigger finger after distal radius fractures (DRFs) with or without open reduction and internal fixation (ORIF) have been reported inconsistently across different studies. This study assessed the incidence of CTS and trigger finger after DRFs using Taiwan National Health Insurance Research Database. In total, 1454 patients in the case (ORIF) cohort and 1454 patients in the control (non-ORIF) cohort were included in this retrospective study. The mean age was approximately 55 years old, and the female to male ratio was approximately 3/2. Nine patients underwent carpal tunnel release (CTR) surgery after diagnosis of CTS in the case group, and no patients did in the control group; whereas 19 cases of CTS were diagnosed without CTR in the case group, and 4 such cases were observed in the control group. Five cases of trigger finger were diagnosed in the case group, and 3 cases were diagnosed in the control group. CTS were significantly associated with ORIF for DRFs within 9 months after the fracture, whereas trigger finger was not significantly different between groups. Diabetes mellitus was a significant risk factor for CTS and trigger finger within 9 months after the incidence of DRFs.

CARPAL TUNNEL SYNDROME AMONG SYMPTOMATIC SCHOOL TEACHERS ATTENDING UNIVERSITY HOSPITAL

Introduction: School teachers are prone to various occupational problems especially musculoskeletal disorders including carpal tunnel syndrome (CTS) which may cause sick leave, absenteeism and early retirement leading to decreased productivity at work. In developing countries, a paucity of researches was done in this field. Aim of work: To assess the prevalence and the risk factors of CTS among symptomatic school teachers in Menoufia, Egypt. Materials and methods: A cross-sectional study of symptomatic school teachers at the Physical Medicine, Rheumatology and Rehabilitation Department, Menoufia University Hospital from January to October 2018. A self-administered questionnaire including participants’ personal, occupational and pain information were used. Also, nerve conduction studies were done of both right and left median nerves including motor and sensory. Results: One hundred and eighty seven school teachers responded to the study. The prevalence of CTS was reported by 62% of symptomatic teacher. Both hands of CTS teachers had significantly higher mean latency and lower amplitude and nerve conduction velocity of motor and sensory nerve studies when compared to non CTS one. The severity of carpal tunnel syndrome in both hands of CTS teachers was mainly moderate grade. The CTS was significantly prevalent among female school teachers and primary or secondary level of school. A combination of risk factors: body mass index, school level, working duration, working hours per day and working computer hours per day; were found to be significantly associated with increasing CTS. Conclusion and recommendations: The symptomatic school teachers had high prevalence of CTS which is affecting their work and education system as a whole. An implement intervention programs is needed by the higher authorities to address this issue. An adequate care, ergonomic rules and exercise program have to be recommended so as to alleviate this disorder.

Risk factors of hospitalization for carpal tunnel syndrome among the general working population.

Objectives Carpal tunnel syndrome (CTS) causes a considerable amount of sick leave and healthcare costs. The etiology of CTS is multifactorial, involving both personal and occupational risk factors. To date, few prospective cohort studies on occupational risk factors of CTS have examined the general working population. Methods The study population consisted of participants from the Northern Finland Birth Cohort of 1966 who attended the 31-year follow-up in 1997 and were working ≥3 days a week in a paid job (N=6326). Information on socio-economic status, weight and height, smoking, exposure to occupational physical factors, and long-term illnesses was collected at baseline in 1997. Data on hospitalizations due to CTS came from the Care Register for Health Care, 1997-2016. Results Between 1997 and 2016, 3.4% of the participants had been hospitalized (attended secondary care) for CTS. After adjusting for confounders, women [hazard ratio (HR) 3.77, 95% confidence interval (CI) 2.70-5.25], overweight/obese participants (HR 1.69, 95% CI 1.29-2.22), smokers (HR 1.48, 95% CI 1.12-1.96), farmers and manual workers (HR 3.02, 95% CI 1.85-4.92 compared with upper clerical workers), lower clerical workers (HR 1.74, 95% CI=1.08-2.80), workers exposed to hand vibration (HR 2.29, 95% CI 1.48-3.54) and participants with physically demanding jobs (HR 1.71, CI 1.06-2.76) were at increased risk of hospitalization for CTS. Physically demanding work increased the risk of hospitalization for CTS for overweight/obese participants at baseline, but not for participants of normal weight. Conclusions Excess body mass and occupational physical factors increase the risk of hospitalization for CTS. Excess body mass potentiates the adverse effects of strenuous work on CTS.