REDUCING THE COSTS OF CARPAL TUNNEL SYNDROME

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Carpal tunnel syndrome affects approximately two out of ev­ery 1,000 workers. Researchers at Washington University Medical School estimated the average lifetime cost of a single case at $30,000 in medical bills and lost time.

What is carpal tunnel syndrome?

Carpal tunnel syndrome occurs when the median nerve that runs through the carpal tunnel – a narrow passageway at the base of the hand – becomes pinched or compressed. Injury to the wrist or swelling of the tendons in the carpal tunnel can cause the syndrome, as can non-occupational causes such as fluid retention. Symptoms include numbness and tingling of the wrist and hand, which can progress into sharp pain. If left untreated, permanent damage to the median nerve can result.

What causes carpal tunnel syn­drome?

Doctors have associated wrist disorders with repetitive tasks since the 1960s. Carpal tunnel syndrome is also caused by force, cold tempera­tures, mechanical stress, vibration and poor pos­ture.

Who gets carpal tunnel syndrome?

Carpal tunnel syndrome occurs three times more often in women than in men, possibly be­cause women have a smaller carpal tunnel than men. Diabetics and those with other metabolic disorders, along with pregnant women, are also more likely to get carpal tunnel syndrome.

Increasing job fragmentation; an aging workforce; the increase in keyboard/computer use; improperly designed, one-size-fits-all workstations and machines; and increased workloads caused by downsizing all contribute to the explosion of carpal tunnel syn­drome and related repetitive stress injuries.

Case management

Case management can help employers re­duce the costs of carpal tunnel syndrome. Case managers guide injured workers through treatment and reha­bilitation after injury, acting as liaisons between physician and employer, and between injured worker and employer. They can be your own employees, TPAs (third-party administrators) or your insurer's employees.

Case managers should analyze injured work­ers' job tasks, along with home activities and hobbies, past injuries and former occupations to determine possible origins of the injury and to prevent continued problems. The case manager should accompany injured workers on their first visit to the doctor, to review treatment options and become familiar with the treatment plan. This will help you set up alternative work accom­modations for the worker, and creates a team at­mosphere the injured worker can rely on.

Treatments

The best ways to cut the inci­dence and severity of carpal tunnel syndrome in­volve changing work methods, retraining workers and modifying computers and other equipment to fit human forms and posture. For immediate symptom relief, the simplest treatments often work best. Your first choice of treatment should be to rest the affected joint; common anti-inflammatory medications, such as ibuprofen, can reduce swelling and pain. A brace or splint that keeps the wrist in a natural position can also reduce irritation and swelling.

Surgery is a last resort, and will not succeed unless you modify an injured employee's work methods and equipment. You may not have to completely retool to make your business ergo­nomically sound – analyze the worksite to see whether retraining employees in proper equip­ment use will do the trick.

OSHA offers several publications with guidelines for institut­ing ergonomics programs. Outside consultants can review your worksite for ergonomic safety, too. For more infor­mation on holding down carpal tunnel and other claims costs in your workplace, please contact the PCOC Insurance Program Department at Jenkins Insurance Group: (877) 860-7378.

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