My Surgical Treatment Recommendations for Cubital Tunnel Syndrome

The Volume of Carpal Tunnel Cases: Is it Changing?

An article in the Omaha World-Herald appearing Monday, April 7, 2008, titled "Carpal Tunnel Cases Dipped Sharply", supposedly listing the Associated Press as a source of the information, is seriously flawed and misleading.  I believe it has been reported by someone very inexperienced in the topic with the typical problem of quoting the ignorant.  First is a reference to RSI, or repetitive strain injury, which in essence was a figment of people's imagination "down under."  The courts in Australia threw out the diagnosis and sent many disgruntled workers back to work.  Many of these people probably had carpal tunnel syndrome which went misdiagnosed, with the majority of the people seeking compensation rather than a solution.  According to the Bureau of Labor Statistics, claims were made that carpal tunnel syndrome cases have plummeted, declining 21% in 2006 alone and that among workers in professional business services, the number of carpal tunnel syndrome cases fell by one-half between 2005 and 2006.  In fact, what has occurred is not a decrease in the number of people presenting with carpal tunnel syndrome which is a genetically-influenced, naturally developing, accompaniment of aging in those genetically predisposed, but a decrease in the number of people trying to receive treatment or benefits under worker's compensation.  This is because of:

• (a) the combination of greater awareness via educators such as the Carpal Tunnel Relief Center;
• (b) refusal of the insurers or employers to accept that the problem is work causation;
• (c) wider-spread use of accurate diagnostic methodology with appropriately performed nerve conduction studies;
• (d) employees fearful of claiming a problem under work and thus being treated on a private pay/private insurer basis in fear of loss of their job or seniority on a job, etc.

Thus, overall, the title of the article was incorrect, some of the information in the article was grossly in error, and the concept of "preventative things such as exercise," which are inferred in the article have never been a proven benefit for this spontaneously occurring problem.  The only accurate statement that I encountered and perhaps the most useful one in the entire article was that in the last paragraph which stated that Dr. Hagemann, Director of the Rocky Mountain Center for Occupational and Environmental Health, which sounds like a private, nongovernmental agency claimed that, "Some of the reduction in cases may be due to the realization that it is a common situation; there is no rush to do anything about it."  I differ in my recommendations to do something about it because it will only worsen over time and cause sleep deprivation, and interferes with a person's lifestyle.  Early treatment results in a better outcome and less interference with one's lifestyle.  Certainly it is generally not an emergency condition.