High Expense of CTS in Canadian Workers
Statistics from 1996 indicate that workers in Ontario, Canada, are commonly affected by carpal tunnel syndrome (CTS). Nearly 1,000 of the three million workers covered by worker's compensation had CTS that was severe enough for them to miss work. Most of the patients worked on assembly lines or did fabrication work. Other jobs included clerical (office), food processing, construction, and retail. A small number of bus drivers, mechanics, and janitors were also included.

Researchers reviewed the medical charts of these patients. They looked for factors that affected treatment. They also looked for treatment that worked and the cost of work-related CTS. Workers also got a survey four years after their CTS case was opened. Questions were asked about their symptoms, severity of symptoms, and daily activities. They were also asked about recreation and when they went back to work.

The authors found that only 14 percent of patients were symptom-free. Most of the workers still had pain or numbness or both. Almost half had severe pain. More than half had moderate to very severe numbness. About one-fourth of the workers reported moderate to severe problems with daily activities. Nearly half had trouble playing an instrument, doing crafts or hobbies, or joining in sports. More than one-third couldn't go back to their job or work at all because of the CTS.

Office workers were more likely to return to work (RTW). Assembly or food processing workers were less likely to report RTW. Workers who'd had arm and hand problems in the past were also less likely to RTW. The same was true for workers with diabetes or arthritis.

The authors point out that about one of every 70 workers has CTS severe enough to miss work. Workers who miss work because of CTS are usually in their early 40s. This compares to late 50s when CTS occurs in the general population. It appears that most workers keep working with early symptoms of CTS before filing a worker's compensation claim. Those who ended up having surgery generally had a better result.

The cost of work-related CTS in Ontario is high ($8,330 for CTS in one wrist, and $15,450 for CTS in both wrists). The largest expense is for lost time benefits. Other costs included drugs, doctor visits, medical tests, and surgery.

These researchers report that a large number of Canadian workers suffer pain and loss of work and money from CTS. They were unable to say which factors had a direct cause and effect. More study is needed to answer many questions that still remain about work-related CTS.
Ralph T. Manktelow, MD, FRCS(C), et al. Carpal Tunnel Syndrome: Cross-Sectional and Outcome Study in Ontario Workers. In The Journal of Hand Surgery. March 2004. Vol. 29A. No. 2. Pp.307-317.