What is the best way to prove carpal tunnel syndrome caused by work?

Question:

What is the best way to prove carpal tunnel syndrome caused by work?

Answer:

Carpal tunnel syndrome is what is referred to when a person's median nerve becomes squeezed or pressed at the wrist.  The carpal tunnel is a narrow passageway for ligaments and bones at the base of the hand.  It contains the median nerve.  When tendons become irritated they will swell, narrowing the tunnel and compressing the median nerve.  The result of this swelling is pain and weakness in the hand as well as numbness in the wrist and hand, radiating up the arm.

Symptoms of the problem occur as burning, tingling or itching numbness in the hand and fingers, particularly in the thumb, index and middle fingers. As the symptoms become worse the person loses grip strength finding it difficult to grasp small objects or perform similar small tasks. At its worst and left untreated, the muscles in the base of the thumb waste away and some people report being unable to tell the difference between hot and cold by touch.

The causes of carpal tunnel syndrome include contributing factors such as trauma or injury to the wrist that causes swelling due to a sprain or fracture.  it can also be caused by hypothyroidism; over active pituitary gland, rheumatoid arthritis; work stress; or repeated use of vibration hand tools. There is not much by way of clinical data that indicates repetitive and forceful movements of the wrist and hand while involved in work activities causes carpal tunnel syndrome. Generally repeated motions in the course of a person's work activities result in motion disorders like bursitis and tendonitis.

In order to prove that Carpal Tunnel syndrome is the result of work is difficult but possible to do.  The individual states have differences in their workers compensation laws. Some states allow that even if an individual has a risk factor for carpal tunnel syndrome (CTS) as long as his/her work activities can be shown to "aggravate" the condition, which results in CTS, the courts generally rule in favor of the patient.  Other states are not so lenient, demanding that a person prove that CTS was actually caused by work-related activities.

When determining whether CTS is caused by work they rely heavily on the information received from doctors, surgeons and EMG/NCS tests. The best practice for proving the connection between CTS and work activities is to have at least two EMG/NCS tests. It is difficult to prove that work activities are responsible for CTS without a pre-CTS EMG/NCS test to compare results against.  Earlier EMG/NCS tests are the most effective evidence in proving the connection since the later EMG/NCS test can determine whether the CTS condition is getting worse or not.

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