Natural history and predictors of long-term pain and function among workers with hand symptoms

Details

• Alternative Title:
  Arch Phys Med Rehabil
• Personal Author:
  Descatha, Alexis ; Dale, Ann Marie ; Franzblau, Alfred ; Evanoff, Bradley
• Description:
  Objective
  
  To evaluate predictors of hand symptoms and functional impairment after three years of follow-up among workers with different types of hand symptoms including carpal tunnel syndrome (CTS). Functional status and job limitations were also analyzed as key secondary objectives.
  
  Design
  
  Cohort design of 3-years duration
  
  Setting
  
  Working population-based study
  
  Participants
  
  1107 newly employed workers without a pre-existing diagnosis of CTS. Subjects were categorized into four groups at baseline examination: no hand symptoms, any hand symptoms but not CTS (recurring symptoms in hands, wrist or fingers without neuropathic symptoms), any hand symptoms of CTS (neuropathic symptoms in the fingers and normal nerve conduction study), or confirmed CTS (CTS symptoms and abnormal nerve conduction study). Among workers with hand pain at baseline, subject and job characteristics were assessed as prognostic factors for outcomes, using bivariate and multivariate regression models.
  
  Interventions
  
  Not applicable
  
  Main outcome measure
  
  The primary outcome assessed by questionnaire at 3 years was “severe hand pain” in the past 30 days.
  
  Results
  
  At baseline, 155 workers (17.5% of 888 followed workers) reported hand symptoms, 21 had confirmed CTS. Presence of hand pain at baseline was a strong predictor of future hand pain and job impairment. Subjects with confirmed CTS at baseline were more likely to report severe hand pain, (adjusted prevalence ratios 1.98 [1.11 – 3.52]) and functional status impairment (adjusted prevalence ratios 3.37 [1.01 – 11.29]) than workers with other hand pain. Among subjects meeting our case definition for CTS at baseline, only 4 (19.1%) reported seeing a physician in the 3 year period.
  
  Conclusions
  
  Hand symptoms persisted among many workers after 3 year follow-up, especially among those with CTS, yet few symptomatic workers had seen a physician.
  
  
• Subjects:
  Adolescent Adult Aged Article Carpal Tunnel Syndrome Chronic Pain Cohort Studies Female Functional Status Hand Humans Male Middle Aged Occupational Diseases Occupational Health Occupations Pain Severity Of Illness Index Social Support Work Young Adult

  More +
• Source:
  Arch Phys Med Rehabil. 2013; 94(7):1293-1299
• Pubmed ID:
  23416766
• Pubmed Central ID:
  PMC3695071
• Document Type:
  Journal Article
• Funding:
  UL1 RR024992/RR/NCRR NIH HHS/United States ; UL1 TR000448/TR/NCATS NIH HHS/United States ; R01 OH008017-01/OH/NIOSH CDC HHS/United States
• Volume:
  94
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5a909d8cde09574aa10603b05f0f2624a59e61b6fdb360a76a26873035953488
• Download URL:
  https://stacks.cdc.gov/view/cdc/29682/cdc_29682_DS1.pdf
• File Type:
  [PDF - 268.20 KB ]