Treatment of worker's compensation cases of carpal tunnel syndrome: an outcome study.

The primary goal of this retrospective study was to determine the most effective treatment protocol to return worker's compensation patients with carpal tunnel syndrome (CTS) to their original jobs. By examining a homogeneous subject pool and using specific, functional outcome measures determined by what is needed to reduce worker's compensation costs, a treatment protocol could be developed benefiting both the employer and employee. A total of 121 charts of worker's compensation patients with diagnoses of work-related CTS were reviewed. For inclusion in the study, patients could have no other upper extremity disorder, they must have completed treatment for the CTS, and the etiology of their CTS could not be traumatic. A total of 58 patients were included. Those who received conservative treatment followed by surgery (n = 27) were compared with those who were treated with surgery only (n = 31). A chi-square test showed a significant relationship between type of treatment and return to work (chi2(1)=4.065; p=0.044). Of the 31 patients who received only surgical treatment, 83.9% returned to original employment. Of the 27 patients who received both conservative and surgical treatment, 59.1% returned to their original employment. While this is a small sample size, the findings suggest that conservative treatment alone is not effective in returning worker's compensation patients with CTS to work.