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Carpal Tunnel Syndrome and Hand-Arm Vibration SyndromeA Diagnostic Enigma
Peter L. Pelmear, MD, FFOM, FACOEM;
William Taylor, MD, DSc, FRCP, FFOM
Arch Neurol. 1994;51(4):416-420.
Abstract
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Objective
This article serves to draw attention to the risk to workers from repetitive strain and hand-arm vibration in the workplace and to the diagnostic difficulty in distinguishing carpal tunnel syndrome from the sensorineural component of hand-arm vibration syndrome.
Data Sources
Journal publications, textbooks on hand-arm vibration, guidelines of the International Standards Organisation, and European Economic Community directives.
Study Selection
Recent reports and current standards.
Conclusion
Carpal tunnel syndrome can be distinguished from hand-arm vibration syndrome if all factors—anatomical, associated physiological and medical conditions, work exposure history, and ulnar nerve involvement—are evaluated. In some circumstances, the conditions may be present together. A correct diagnosis is crucial because surgical intervention is not usually beneficial if hand-arm vibration exposure has been a contributing factor. The further reduction in grip strength may constitute a serious additional handicap for a worker.
Author Affiliations
From the Department of Occupational and Environmental Health, St Michael's Hospital, Toronto, Ontario (Dr Pelmear), and the Department of Occupational Medicine, University of Dundee (Scotland) (Dr Taylor).
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ABSTRACT
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