Carpal Tunnel Syndrome A Occupational Illness Essay

Carpal Tunnel Syndrome: A Occupational Illness Essay, Research Paper

The carpal tunnel is a passageway that runs from the forearm through the wrist. Bones form three walls of the tunnel and a strong, broad ligament bridges over them. The median nerve, which supplies feeling to the thumb, index (4th digit), and ring fingers (3rd digit), and the nine tendons that flex the fingers, passes through this tunnel. This nerve, also, provides function for the muscles at the base of the thumb (the Thenar muscles). Usually, carpal tunnel syndrome (CTS) is considered an inflammatory disorder caused by repetitive stress, physical injury, or medical conditions that cause the tissues around the median nerve to become swollen. The protective lining of the tendons within the carpal tunnel can become inflamed and swell or the ligament that forms the roof over the median nerve becomes thicker and broader and presses on it. Dr. L, an orthopedic surgeon stated ” It’s like stepping on a hose. Slows the flow of water through a garden hose. The compression on the (median) nerve fibers by swollen tendons and thickened ligament slows down the transmission of nerve signals through the carpal tunnel.” The result is pain, numbness, and tingling in the wrist, hand, and fingers. This does not concern the little finger (5th digit) because the median nerve does not affect it.

It is often very difficult to determine whether the primary cause of CTS is primarily due to work conditions or an underlying medical problem. CTS almost always occurs in adults and most adults work; CTS, then is very likely to be associated with the work place whether or not it is actually caused by work itself. Estimates of work-related CTS vary wildly. Some studies suggest that more than half are due to workplace factors and others that few cases of CTS are actually caused by conditions on the job. In one study, for example, obesity or diseases such as diabetes, hypothyroidism, and arthritis occurred in the majority of people with work-associated CTS. Such conditions are known contributors to CTS. It is most likely that many cases of CTS occur from a combination of factors, including a predisposing medical condition exacerbated by work stress and psychological and social stressers. In many patients with CTS, an underlying cause for the disorder cannot be discovered.

Disorders related to work that requires repetitive motion are increasing. They account for nearly half of all reported work related illness, and CTS is estimated to account for over 41% of these repetitive motion disorders. Researchers have defined six key risk factors in the workplace for the development of these disorders, including CTS: (1) repetition, (2) high force, (3) awkward joint posture, (4) direct pressure, (5) vibration, and (6) prolonged constrained posture.

Through many of the studies I have read, many believe that incorrect posture may play a large role in the development of CTS, particularly in people who work at computer and other types of keyboards. The tendency to roll the shoulders forward, round the lower back, and thrust the chin forward can shorten the neck and shoulder muscles compressing nerves in the neck. This can affect the wrist, fingers, and hand. It has been difficult to obtain reliable data on the relation between repetitive hand and wrist tasks and CTS.

Studies indicate that psychosocial factors in the workplace, such as intense deadlines, interpersonal relationships, and job design, are major contributors to carpal tunnel pain. Such psychosocial conditions are more likely to be important factors in contributing to CTS in office workers, although they also complicate the condition in workers whose work is primarily physical. This information will be in detail with further reading.

Bone dislocations and fractures can narrow the carpal tunnel exerting pressure on the median nerve. Certain other medical conditions, such as rheumatoid arthritis, diabetes, and hypothyroidism, can also cause the inflammation in the carpal tunnel that results in median nerve entrapment. These are all autoimmune diseases, meaning that the body’s immune system is abnormally attacking its own tissue. Some experts believe that CTS may actually be one of the first symptoms in a number of these diseases. CTS can also be caused by long-term hemodialysis and disease such as multiple myeloma, Waldenstrom’s macroglobulinemia, and non-Hodgkin’s lymphoma, which cause a build up of waxy starch like protein called Amyloid in the bone and joint tissues. Acromegaly, a disease that causes abnormally long bones, is a cause of CTS. A virus known as human parvovirus was suspected in a few cases of CTS that developed in both hands. Certain medications that effect the immune system, such as interleukin-2, which is administered to cancer patients, may cause temporary CTS. There have been some reports of CTS caused by anticlotting drugs, such as warfarin.

It was reported that people with a family history of CTS have a higher risk of getting it. This indicates a genetic susceptibility exists in some people. Some researchers are particularly interested in abnormalities in certain genes that regulate myelin, a fatty substance that serves as insulation for nerve fibers. Some people may be born with abnormalities of the carpal bones. It was also reported that the fluid retention during pregnancy or hormonal changes associated with menopause c