Carpal tunnel syndrome: a retrospective analysis of 262 cases and a one to one matched case-control study of 61 women pairs in relationship between manual housework and carpal tunnel syndrome.

OBJECTIVES

To get a more comprehensive recognition about carpal tunnel syndrome (CTS), especially the manual housework as its risk factor, and to facilitate early diagnosis and proper treatment.

METHODS

262 CTS patients (396 CTS hands) were analyzed retrospectively. A 1:1 matched case-control study of 61 woman pairs in relationship between manual housework and the occurrence of CTS was carried out.

RESULTS

In 262 CTS patients, 84% were female, and the dominant hand was more frequently affected; repetitive and forceful movement of the hand and wrist might be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, but 75.3% of our 396 CTS hands had all five digits involved. Conduction abnormalities appeared selectively in the median nerve distal to the wrist. In the case-control study, for manual washing, rolling or kneading dough, and knitting woolen sweater, the odds ratios (OR) of CTS between high and low intensities were 3.86 (95% confidence interval 1.79-8.33, chi 2 = 11.76, P < 0.01), 6.25 (95% confidence interval 2.50-15.63, chi 2 = 15.21, P < 0.01) and 1.13 (95% confidence interval 0.57-2.22, chi 2 = 0.125, P > 0.05) respectively; and those between long and short duration (i.e. the number of years engaging in these manual housework) were 2.33 (95% confidence interval 0.63-8.64, chi 2 = 1.6, P > 0.05), 1.88 (95% confidence interval 0.81-4.38, chi 2 = 2.13, P > 0.05) and 1 (chi 2 = 0, P > 0.05).

CONCLUSIONS

The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests. Manual washing and rolling or kneading dough might be associated with the onset of CTS.