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Natural history and predictors of long-term pain and function among workers with hand symptoms
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February 14 2013
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Source: Arch Phys Med Rehabil. 2013; 94(7):1293-1299
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Details:
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Alternative Title:Arch Phys Med Rehabil
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Personal Author:
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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.
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Subjects:
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Source:
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Pubmed ID:23416766
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Pubmed Central ID:PMC3695071
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Document Type:
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Funding:
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Volume:94
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Issue:7
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