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Work-related carpal tunnel syndrome in Washington State workers' compensation: utilization of surgery and the duration of lost work.
Am J Ind Med. 2009 Dec; 52(12):931-42.AJ

Abstract

BACKGROUND

Work-related carpal tunnel syndrome (CTS) is a leading cause of lengthy disability.

METHODS

This population-based retrospective cohort study used Washington State workers' compensation claims for CTS to characterize associations between utilization of CTS surgery and duration of lost work. The sample included all claims (n = 8,224) filed during 1990-1994 (followed through 2000) and receiving lost-work compensation.

RESULTS

Sixty-four percent of studied workers had CTS surgery. Among workers with >1 month of lost work, the total duration was much shorter when workers had surgery, versus those who did not (median 4.3 and 6.2 months, respectively; P < 0.001); there was no difference when disability extended >6 months. When workers had surgery, disability was less likely to end before 6 months if non-CTS conditions were present, surgery occurred >3 months after claim filing, or employment was in an industry with high incidence of CTS; disability was more likely to end if the diagnosing provider and operating surgeon had higher CTS claims volume. Physical and rehabilitation medicine services were associated with lower probability of returning to work, with or without surgery.

CONCLUSIONS

There is a need to scrutinize the role of surgery and physical-rehabilitation medicine modalities in the management of CTS covered by workers' compensation. The findings suggest disability can be minimized by establishing the CTS diagnosis as early as possible and, if surgery is appropriate, conducting surgery without substantial delay and maximizing post-operative efforts to facilitate return to work. Use of surgery >6 months after filing should be considered with great caution.

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Authors+Show Affiliations

Daniell WE
Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195-7234, USA. bdaniell@u.washington.edu
Fulton-Kehoe D
No affiliation info available
Franklin GM
No affiliation info available

MeSH

AdultArthroscopyCarpal Tunnel SyndromeCohort StudiesDisability EvaluationFemaleHumansInsurance Claim ReviewMaleOccupational DiseasesPostoperative ComplicationsRecovery of FunctionRehabilitation, VocationalRetrospective StudiesSick LeaveUtilization ReviewWashingtonWorkers' Compensation

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19882743

Citation

Daniell, William E., et al. "Work-related Carpal Tunnel Syndrome in Washington State Workers' Compensation: Utilization of Surgery and the Duration of Lost Work." American Journal of Industrial Medicine, vol. 52, no. 12, 2009, pp. 931-42.
Daniell WE, Fulton-Kehoe D, Franklin GM. Work-related carpal tunnel syndrome in Washington State workers' compensation: utilization of surgery and the duration of lost work. Am J Ind Med. 2009;52(12):931-42.
Daniell, W. E., Fulton-Kehoe, D., & Franklin, G. M. (2009). Work-related carpal tunnel syndrome in Washington State workers' compensation: utilization of surgery and the duration of lost work. American Journal of Industrial Medicine, 52(12), 931-42. https://doi.org/10.1002/ajim.20765
Daniell WE, Fulton-Kehoe D, Franklin GM. Work-related Carpal Tunnel Syndrome in Washington State Workers' Compensation: Utilization of Surgery and the Duration of Lost Work. Am J Ind Med. 2009;52(12):931-42. PubMed PMID: 19882743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Work-related carpal tunnel syndrome in Washington State workers' compensation: utilization of surgery and the duration of lost work. AU - Daniell,William E, AU - Fulton-Kehoe,Deborah, AU - Franklin,Gary M, PY - 2009/11/3/entrez PY - 2009/11/3/pubmed PY - 2010/3/23/medline SP - 931 EP - 42 JF - American journal of industrial medicine JO - Am J Ind Med VL - 52 IS - 12 N2 - BACKGROUND: Work-related carpal tunnel syndrome (CTS) is a leading cause of lengthy disability. METHODS: This population-based retrospective cohort study used Washington State workers' compensation claims for CTS to characterize associations between utilization of CTS surgery and duration of lost work. The sample included all claims (n = 8,224) filed during 1990-1994 (followed through 2000) and receiving lost-work compensation. RESULTS: Sixty-four percent of studied workers had CTS surgery. Among workers with >1 month of lost work, the total duration was much shorter when workers had surgery, versus those who did not (median 4.3 and 6.2 months, respectively; P < 0.001); there was no difference when disability extended >6 months. When workers had surgery, disability was less likely to end before 6 months if non-CTS conditions were present, surgery occurred >3 months after claim filing, or employment was in an industry with high incidence of CTS; disability was more likely to end if the diagnosing provider and operating surgeon had higher CTS claims volume. Physical and rehabilitation medicine services were associated with lower probability of returning to work, with or without surgery. CONCLUSIONS: There is a need to scrutinize the role of surgery and physical-rehabilitation medicine modalities in the management of CTS covered by workers' compensation. The findings suggest disability can be minimized by establishing the CTS diagnosis as early as possible and, if surgery is appropriate, conducting surgery without substantial delay and maximizing post-operative efforts to facilitate return to work. Use of surgery >6 months after filing should be considered with great caution. SN - 1097-0274 UR - https://www.unboundmedicine.com/medline/citation/19882743/Work_related_carpal_tunnel_syndrome_in_Washington_State_workers'_compensation:_utilization_of_surgery_and_the_duration_of_lost_work_ L2 - https://doi.org/10.1002/ajim.20765 DB - PRIME DP - Unbound Medicine ER -