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Natural history and predictors of long-term pain and function among workers with hand symptoms
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Details:
  • Pubmed ID:
    23416766
  • Pubmed Central ID:
    PMC3695071
  • 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.

  • Document Type:
  • Collection(s):
  • Funding:
    R01 OH008017-01/OH/NIOSH CDC HHS/United States
    UL1 RR024992/RR/NCRR NIH HHS/United States
    UL1 RR024992/RR/NCRR NIH HHS/United States
    UL1 TR000448/TR/NCATS NIH HHS/United States
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