Management of carpal tunnel syndrome in the working population.

CTS, which has been determined to be caused or aggravated by work, can be a complex challenge. The proper diagnosis is often elusive, as a patient may have other conditions that mimic CTS. The patient's job may be a factor in the development of symptoms, but there are a host of other risk factors that should be considered in establishing the cause of the problem. While the medical and surgical treatment of CTS is not always straightforward, dealing with the social and economic aspects of this problem can be even more complex and frustrating. Trying to coordinate vocational and psychological aspects of treatment while helping the patient to stay motivated can be far more stressful than the most difficult surgical procedure. The physician may be tempted to diagnose CTS without objective evidence or to define a problem as work related without performing the necessary investigation. Labeling a patient inappropriately may cause far more harm than good [8,17,25,27]. Do not give patients with CTS the impression that they will be "crippled for life" or totally disabled.