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1991 <br /> <br />LOSS <br /> <br />CONTROL <br /> <br />T.C. FIELD & COMPA_NY <br /> <br />UPDATE <br /> <br />SUBJECT: CAt,PAL TUNNEL SYNDROME ( CTS ) <br /> <br />Over the last several years, the insurance industry has witnessed <br />a substantial increase in the incidence of carpal tunnel syndrome <br />cases. This increase is a direct result of changes in the <br />physiological factors of the workplace environment accompanied by <br />the natural aging process of individual workers. The National <br />Institute of Occupational Safety and Health (NIOSH) reports the <br />average cost for non-surgical treatment of CTS is approximately <br />$3,500 and surgical treatment, $30,000. If a worker is unable to <br />return to the workplace, rehabilitation costs may be as high as <br />$100,000. This problem therefore represents a significant <br />potential insurance cost for the employer. The purpose of this <br />discussion is to provide both the employer and employee with a <br />better understanding of CTS. <br /> <br />At the center of the wrist are bones and ligaments that form a <br />narrow tunnel containing tendons and a major nerve. This tunnel <br />is known as the carpal tunnel. When this major nerve is pinched <br />CTS results. Stress on the nerve may be caused by normal wear and <br />tear resulting from the natural aging process, bone dislocations <br />or fractures in the wrist area, and fluid retention caused by <br />swelling tissue in the carpal tunnel. Occupational risk factors <br />that contribute to CTS include repetitive tasks over prolonged <br />time periods, wrist deviations resulting from extreme wrist <br />postures when force is applied, mechanical stress concentrations <br />on the palm of the hand, the use of vibrating tools, congenital <br />defects, acute trauma, and systemic diseases, including cancer, <br />ganglion, diabetes, arthritis, and gout. <br /> <br />Early warning signs of this condition include several symptoms. <br />The employee may be experiencing numbness in the area of the <br />median nerve, pain and/or tingling in the hand area, nocturnal <br />pain and awakening with numbness in the forearm, wrist, and/or <br />hand, reduced pinch or grip s~rength, increased sensitivity in the <br />palm area, muscle atrophy in the palm or hand area, a burning <br />sensation in the hand or w._st area, and loss of some of the <br />normal sweat of the hand. I~ an employee experiencesany of these <br />symptoms, the employer should cake immediate action. <br /> <br />Methods of control include having employees keep their wrist in a <br />neutral position (not bent er flexed), minimizing repetitive job <br />tasks, resting the hand or hands, using the entire hand when <br />grasping an object such as a tool or machine, reducing the speed <br />and force at which the task is done, and exercising to strengthen <br />the hand and arm muscles. Other controls may include measures <br /> <br /> <br />