Electrophysiological methods on diagnosis of carpal tunnel syndrome and the applied research in the field of occupational medicine

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The objective of this study is to develop a diagnostic method for the early detection of carpal tunnel syndrome (CTS), and to apply the technique to the field of occupational medicine.Sensory nerve conduction velocities in the palm-to-finger (SCV-pf), wrist-to finger (SCV-wf), wrist-to-palm (SCV-wp), and wrist-to-elbow (SCV-we) segments and the distribution of nerve conduction velocities in the right median nerve were determined among 27 female operators aged 19-37 and 19 healthy women (controls) aged 19-31 to estimate the prevalence of subclinical CTS.Also, the WF/PF ratio, dividing the SCV-wf by the SCV-pf, was calculated to assess abnormalities of nerve conduction within the carpal tunnel. The operators were engaged in data entry in front of a visual display terminal (VDT) for about 6h/day, and their working duration was between 1 and 17 (mean 6) years. The SCV-wf, SCV-wp, and WF/PF ratio in the operators were significantly lower than those in the controls. The rate of persons with the WF/PF ratio of less than 90%, i.e., below normal limits in the 19 controls, was significantly higher in the operator group (37%) than in the control group (0%). The operators complained of more symptoms related to CTS than did the controls, but any symptoms were not associated with slowing of nerve conduction velocities in the operators. In the controls, the WF/PF ratio was not closely correlated with skin temperature or age despite the presence of significant relations between skin temperature and the SCV-wf, SCV-pf, and SCV-wp ; the interpersonal variability of the WF/PF ratio was much smaller than that of all SCVs. In the light of the present and previous studies, the rate of VDT operators with subclinical CTS seems to be high, independent of its symptoms. Also, the WF/PF ratio will be a useful and reliable screening method for the early detection of CTS due to repetitive wrist and finger movements involved in work.