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Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function

Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function
Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function
OBJECTIVES: To explore whether neurophysiologically confirmed carpal tunnel syndrome (CTS) has different risk factors from sensory symptoms in the hand that occur in the absence of impaired median nerve conduction.

METHODS: We compared 475 patients with neurophysiologically confirmed (NP+ve) CTS, 409 patients investigated for CTS but negative on neurophysiological testing (NP-ve), and 799 controls. Exposures to risk factors were ascertained by self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated by logistic regression.

RESULTS: NP+ve CTS was associated with obesity, use of vibratory tools, repetitive movement of the wrist or fingers, poor mental health and workplace psychosocial stressors. NP-ve illness was also related to poor mental health and occupational psychosocial stressors, but differed from NP+ve disease in showing associations also with prolonged use of computer keyboards and tendency to somatise, and no relation to obesity. In direct comparison of NP+ve relative to NP-ve cases, the most notable differences were for obesity (OR 2.7, 95%CI 1.9-3.9), somatising tendency (OR 0.6, 95%CI 0.4-0.9), diabetes (OR 1.6, 95%CI 0.9-3.1) and work with vibratory tools (OR 1.4, 95%CI 0.9-2.2).

CONCLUSIONS: When viewed in the context of earlier research, our findings suggest that obesity, diabetes, use of hand-held vibratory tools, and repeated forceful movements of the wrist and hand are causes of impaired median nerve function. In addition, sensory symptoms in the hand, whether from identifiable pathology or non-specific in origin, may be rendered more prominent and distressing by hand activity, low mood, tendency to somatise, and psychosocial stressors at work.
18
Coggon, D.
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Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Harris, E.C.
3e4bd946-3f09-45a1-8725-d35e80dd7971
Linaker, C.
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Van der Star, R.
6ca52554-5a51-4fdc-bc62-dbb10389b018
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Palmer, K.T
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Harris, E.C.
3e4bd946-3f09-45a1-8725-d35e80dd7971
Linaker, C.
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Van der Star, R.
6ca52554-5a51-4fdc-bc62-dbb10389b018
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Palmer, K.T
0cfe63f0-1d33-40ff-ae8c-6c33601df850

Coggon, D., Ntani, G., Harris, E.C., Linaker, C., Van der Star, R., Cooper, C. and Palmer, K.T (2013) Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function. 23rd International Conference on Epidemiology in Occupational Health, Utrecht, Netherlands. 17 - 20 Jun 2013. p. 18 .

Record type: Conference or Workshop Item (Other)

Abstract

OBJECTIVES: To explore whether neurophysiologically confirmed carpal tunnel syndrome (CTS) has different risk factors from sensory symptoms in the hand that occur in the absence of impaired median nerve conduction.

METHODS: We compared 475 patients with neurophysiologically confirmed (NP+ve) CTS, 409 patients investigated for CTS but negative on neurophysiological testing (NP-ve), and 799 controls. Exposures to risk factors were ascertained by self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated by logistic regression.

RESULTS: NP+ve CTS was associated with obesity, use of vibratory tools, repetitive movement of the wrist or fingers, poor mental health and workplace psychosocial stressors. NP-ve illness was also related to poor mental health and occupational psychosocial stressors, but differed from NP+ve disease in showing associations also with prolonged use of computer keyboards and tendency to somatise, and no relation to obesity. In direct comparison of NP+ve relative to NP-ve cases, the most notable differences were for obesity (OR 2.7, 95%CI 1.9-3.9), somatising tendency (OR 0.6, 95%CI 0.4-0.9), diabetes (OR 1.6, 95%CI 0.9-3.1) and work with vibratory tools (OR 1.4, 95%CI 0.9-2.2).

CONCLUSIONS: When viewed in the context of earlier research, our findings suggest that obesity, diabetes, use of hand-held vibratory tools, and repeated forceful movements of the wrist and hand are causes of impaired median nerve function. In addition, sensory symptoms in the hand, whether from identifiable pathology or non-specific in origin, may be rendered more prominent and distressing by hand activity, low mood, tendency to somatise, and psychosocial stressors at work.

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Published date: 20 June 2013
Venue - Dates: 23rd International Conference on Epidemiology in Occupational Health, Utrecht, Netherlands, 2013-06-17 - 2013-06-20
Organisations: Faculty of Medicine

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Local EPrints ID: 356182
URI: http://eprints.soton.ac.uk/id/eprint/356182
PURE UUID: 2cd81469-5e22-47a0-8359-02bbf33d09a9
ORCID for D. Coggon: ORCID iD orcid.org/0000-0003-1930-3987
ORCID for E.C. Harris: ORCID iD orcid.org/0000-0001-8037-566X
ORCID for C. Linaker: ORCID iD orcid.org/0000-0003-1091-9283
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 17 Sep 2013 15:41
Last modified: 18 Feb 2021 16:48

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Contributors

Author: D. Coggon ORCID iD
Author: G. Ntani
Author: E.C. Harris ORCID iD
Author: C. Linaker ORCID iD
Author: R. Van der Star
Author: C. Cooper ORCID iD
Author: K.T Palmer

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