Original paper

Journal of Occupational Rehabilitation

, Volume 16, Issue 2, pp 201-216

First online:

Evaluation of Work-Related Carpal Tunnel Syndrome

  • Robert A. WernerAffiliated withDepartment of Physical Medicine and Rehabilitation, University of Michigan Health System; Physical Medicine and Rehabilitation Service Chief, Veteran Affairs Medical Center; Department of Industrial and Environmental Health, School of Public Health, University of Michigan Email author 

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Objectives: Carpal tunnel syndrome (CTS) is common in the industrial setting but there are still some advocates who argue that CTS is not a work related problem. There are also controversies about the proper way to establish the diagnosis and whether screening for CTS in the industrial setting is warranted. Methods: A comprehensive literature review. Results: The literature does demonstrate that the prevalence of CTS in the industrial setting is significantly higher than in the general population. Numerous epidemiologic studies have identified independent risk factors, which include repetitiveness of work, forceful exertions, mechanical stress, posture, and vibration as well as several personal co-factors. The strength of these associations are discussed. The diagnostic criteria for establishing work-related CTS are discussed as well as the effectiveness of various screening methods that are commonly used in the workplace. The sensitivity and specificity of nerve conduction studies to establish or confirm the diagnosis of CTS is presented along with normative data for the industrial worker. Conclusions: CTS has both work-related and personal risk factors. The diagnosis is best established using a combination of history, symptom distribution and confirmation using the relative latency of median sensory testing using normative data. Screening for CTS in the industrial setting has questionable benefit.


Carpal tunnel syndrome Ergonomics Median nerve Nerve injury Occupational disease