Neurologic manifestations of cumulative trauma disorder.

Cumulative trauma disorders plague industry, yet definite diagnostic criteria and treatment guidelines have not been established. This study is a review of a group of 470 worker's compensation patients with upper-extremity pain. Eighty-four of these patients had neurologic symptoms that were related to repetitive activities, rather than a specific pain-producing incident. Sixty-six of these patients had some evidence of discrete nerve compression and underwent electrodiagnostic studies (EDS). From this set of patients, we established two different patterns of neurologic symptoms related to cumulative trauma disorder: type I (clinical picture fits EDS), and type II (clinical picture does not fit EDS). Surgical results are much more predictable in type I patients, with 80% getting good relief of symptoms. Surgery is much less likely to help patients with the more diffuse, type II picture.