Some of IWIRC’s clients/employers will swear that it is contagious. The problem: carpal tunnel syndrome. And it now seems that many downstate Illinois employers are giving into this “contagion.”

According to a Peoria Journal Star article, “workers in Illinois have gotten thousands of tax-free dollars in workers' compensation with largely nothing more than a doctor's note…The Belleville News-Democrat reports such cases, many involving wrist or elbow issues, often are resolved without the claimant needing surgery, treatment or even a lawyer.” Ninety-five percent of 3,500 unrepresented workers got settlements last year without following the administrative process.

Carpal tunnel syndrome (CTS) is a painful problem caused when increased pressure in the carpal tunnel of the wrist (where the nerves and tendons pass from the forearm to the hand) cause the hand to develop numbness, lose strength, and in some cases, muscle control.

One would think that more would be known regarding the best way to diagnose and treat the malady (and settlements do neither). But no consensus exists, say Drs. Franzblau and Werner of the University of Michigan. “Symptoms of pain, numbness and tingling in the hands are common in the general population,” but the prevalence [of actual carpal tunnel syndrome] is about three percent in the general population. In spite of its rather infrequent incidence, U.S. doctors perform about 200,000 surgeries at a cost of more than $1 billion annually.

While workers often attribute the causes of CTS to the workplace, many believe it is more of a lifestyle injury. George Piligian, occupational medicine physician in New York, states that while work-related, forceful, repetitive motion contributes to CTS, so can pregnancy, arthritis and diabetes. Hobbies such as quilting, playing the guitar, golfing, and working in the yard can also play a role. Taking this a step further, hand surgeon Peter Nathan believes “non-work factors such as age, exercise and body weight play the largest part in triggering CTS…The older you are, the fatter you are and the less you exercise, the more prone you are to CTS. Work factors play only peripheral roles.” Recent research concludes that there is little evidence that typing is a causal factor.

Treatment includes both non-surgical and surgical interventions. In simplest terms, the faster one reports symptoms and early, conservative interventions are implemented, the more likely a quick recovery becomes and less likely the need for surgery. When surgical interventions are used, the successful outcomes are about 90 percent, according to one surgeon. Willard Schuler, a Colorado orthopedic surgeon, states, "If the procedure is not successful, then the problem probably wasn't CTS in the first place." Susan Mackinnon, a professor of surgery at Washington University in St. Louis, states that most of the time, conservative interventions (i.e., non-surgical) take care of the problem, making a lot of surgeries unwarranted. “Based on our [study] results, surgery often is neither necessary nor recommended.”

The question asked by a lot of employers is, what to do? The first step is to encourage early symptom reporting. Remember: the earlier the symptoms are treated, the less likely the need for surgery. Second, inquire about the worker’s hobbies and interests as well as his or her physical job demands. Be vigilant without first opening the purse. The more documentation you have regarding the work and the worker’s outside activities, the more likely the best outcome can be attained. iBi