[All this correspondence occured on the SOREHAND mailing list. I've edited it somewhat to remove places where one author has extensive quoting of another. -- Dan] Date: Sun, 5 Feb 1995 13:00:35 -0700 From: "DEBORAH L. BELL" Subject: More Carpal Tunnel myths debunked Thank you for your replies to my previous post, Don't Call All Cumulative Trauma Disorders Carpal Tunnel, Please. That's one of the myths about cumulative trauma: Myth 1: All wrist Cumulative Trauma Disorders are Carpal Tunnel Syndrome. As state earlier, most wrist CTDS are tendonitis, tenosynovitis, or some other soft-tissue injury, but they can become Carpal Tunnel Syndrome if they go untreated and the repetitive use continues. Statistics from the U.S. Bureau of Labor Statistics seem to bear this out. Although there are about 300,000 cumulative traumas reported on OSHA-200 forms which the BLS samples, only about 10% of these are actually carpal tunnel syndrome. Myth 2: Cumulative Trauma is over 50% of all work-related injuries. No, Cumulative Trauma is over 50% of work-related ILLNESSES, according to the BLS statistics. But, when you combine illness AND injury statistics (there are about 500,000 illnesses but millions of injuries) then Cumulative Trauma only makes up 4% of the total work-related injuries and illnesses (The U.S. Government categorizes cumulative trauma as an illness. Don't ask me why, the Feds work in strange ways) Myth 3: Cumulative Trauma is mostly an office-work injury. Although it would seem that computer-pounders have the most injuries, that's not actually the case. Again, BLS statistics indicate that for every computer-whacker with hurt flippers, there are two blue- collar guys (or gals) out in the shop that got hand damage from jackhammers, meat packing, assembly-line work, or pushing groceries past the laser scanner. Does this mean that cumulative trauma is not important? NO. Cumulative trauma can cause very severe injuries, so everyone should continue to work on preventing CTD's and getting hurt employees to early medical intervention...the longer you wait, the worse it gets. (and for you bosses, the more it costs) But, we shouldn't perpetuate CTD myths, or the truths about CTDs could get discounted with the myths and everyone loses. Tom Bell ------------------------------ Date: Sun, 5 Feb 1995 15:57:10 -0500 From: Diana Carroll Subject: Don't Call Everything Carpal Tunnel Syndrome, PLEASE! yes indeed, one of my main annoyances in life is explaining to people that just because I have something wrong with my hands that I don't have carpal tunnel syndrome... then when I finally persuade them they dismiss what I do have. "Oh, well too bad your hands hurt but what a relief you don't have carpal tunnel!" Arg! I would love to have carpal tunnel -- at least that has a name, a diagnosis and a treatment. Instead I have the Mystery Disease which "only" leaves me unable to feed or dress myself. But it's worse than that. Like the rest of the world, before I *got* whatever it is that I have, I too thought it was only carpal tunnel that you could get from using computers. When I started showing symptoms 3 years ago, I thought it was carpal tunnel (I know now that my symptoms aren't even close) I saw my doctor who sent me for an EMG/NCSon the median nerve. Naturally, I was negative, which led me to believe that I didn't have anything real or dangerous. (I want to go back and shake that doctor -- when a patient presents with pain, numbness and tingling in the ring and pinkie fingers, spreading all the way up the ulnar side of the arm, why on earth you send them for a carpal tunnel test?! And wouldn't you think to at least mention the existence of the ulnar nerve and the possibility of damage/entrapment there? Grrr.) Anyway, all ranting aside I haven't seen anyone here use CTS as a generic term for RSI. Sometimes new people who are scared and confused think like I did and self-diagnosed CTS, but regulars here will quickly (and in my experience, kindly) educate them. I'm not quite sure what inspired your message. D!, who is in a bad mood because Dragon is misunderstanding every other word I say, literally, more grrr... -------------------------------------------------------------------______ diana@zon.mv.com "Having imagination without creativity \ OO / diana@worksta.com is like being a perfectionist and not \++/ carroll@mv.mv.com being able to do anything right." -J. Wagner \/ ------------------------------ Date: Sun, 5 Feb 1995 21:08:42 -0500 From: "Susan Maller ()" Subject: TIM BELL'S MESSAGE I am having hard time understanding what you are posting and why you are posting it. There are all kinds of RSI's that have nothing to do with CTS and never will. That doesn't minimize what people on this list must live with everyday. For example, I don't think DeQuervain's, when at it's worst, ever becomes CTS. I know; I had surgery for it and it impacted my life profoundly at the time. I was totally disabled. I also have had flexor and extensor carpi radialis tendinitis. It even showed up on an MRI, along with cysts in my wrist. Also, many forms of Arthritis can be exacerbated by overuse. I know, personally. I have really screwed up hands, but I don't have CTS. The hands are very intricate and complicated. I hardly think that the analogy of a cold eventually becoming pneumonia applies. Do you have an RSI??? I really think that most of the people on this list deserve more than having their conditions minimized to a common cold. Try going through a doctoral program with pain in your hands. It ain't easy! Many people on this list deserve a lot of credit for getting through life with their daily pain, no matter what the diagnosis may be. We share that common experience on Sorehand. ************************************** Susan J. Maller, Ph.D. Department of Educational Measurement University of South Florida Maller@madonna.coedu.usf.edu ************************************** ------------------------------ Date: Sun, 5 Feb 1995 21:25:48 -0500 From: "Susan Maller ()" Subject: one more thing.. Anyway, who really cares if once in a while someone asks me if I have CTS? So, I tell them what I do have. The people with RSI's that I have met have become quite educated about RSI's and don't call everything CTS. ************************************** Susan J. Maller, Ph.D. Department of Educational Measurement University of South Florida Maller@madonna.coedu.usf.edu ************************************** ------------------------------ Date: Sun, 5 Feb 1995 22:47:43 -0400 From: Brent Bamberger Subject: Re: Don't Call Everything Carpal Tunnel Syndrome, PLEASE! Tom?/Deborah? whoever I agree 100% tenosynovitis is the stage that can be 100% reversible and for me is the most difficult diagnosis for WC and lawyers to realize. If a person developes CTS with changes on the WEMG and axonal loss (loss of nerve Fibers) ,then this entity is not 100% reversible. I would be interested in your treatment of tenosynovitis over the years. Brent (Hand Surgeon Dayton, OHIO) ------------------------------ Date: Sun, 5 Feb 1995 22:54:02 -0400 From: Brent Bamberger Subject: Re: Don't Call Everything Carpal Tunnel Syndrome, PLEASE! I do not think that Tom/Deborah is trying to be harsh. The point is that employers /WC/Lawyers need to recognize that Tenosynovitis of the tendons of the palm side of the wrist if not contrlled may develope into CTS with the potential of permanent damage to the nerve Brent ------------------------------ Date: Sun, 5 Feb 1995 22:58:43 -0400 From: Brent Bamberger Subject: Re: Don't Call Everything Carpal Tunnel Syndrome, PLEASE! One way of looking at the EMG is that if the problem has gone on long enough to cause changes on the EMG than "nerve Damage " has occurred Carpal Tunnel release can release the nerve but it does not take care of the original problem the tenosynovitis only modification and NSAID can help brent ------------------------------ Date: Mon, 6 Feb 1995 00:43:00 -0500 From: Matt Anderson Subject: Re: Cumulative trauma trivia question > How many different names are there for the kind of injuries that > we talk about in the SOREHAND group? (And why can nobody agree > on one name?) Let's not forget: Adverse Mechanical Tension De Quervain's Syndrome Trigger Finger Schmengler's Knuckle (made up the last one) -Matt Matthew Anderson "Road to hell paved mander@unixg.ubc.ca with unbought stuffed matthew_anderson@mindlink.bc.ca dogs - not my fault." ------------------------------