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Getting Back to Work After Carpal Tunnel Surgery

The results of this study from the Hand and Upper Extremity Department at Massachusetts General Hospital in Boston may be of interest to anyone with carpal tunnel syndrome. They took a look at type of work (desk versus manual labor) and its relation to return-to-work.

The patients in the study had a small open incision surgery under local anesthesia to release pressure on the median nerve (the usual cause of carpal tunnel syndrome). Desk workers were able to return-to-work sooner than manual laborers. Forceful use of the hand in manual laborers was the likely reason nondesk workers experienced more time off from work and more work restrictions when they did return.

But the study was able to also show that individual patient beliefs, expectations, and psychologic factors played an important part, too. Patients who expected to take no time off and get back to work right away did, indeed, take fewer days off and returned-to-work sooner than those who were anxious, fearful, and who expected a slow recovery time.

Younger patients who expected less time off were the first to return-to-work full-time and without restrictions. The conclusion of this was that early return-to-work after carpal tunnel surgery can be predicted by patient attitude and expectations.

Surgeons can aid patients by offering preoperative counseling to influence the patient's expectations and perspective toward quick recovery and speedy return to full work duty. Patients should be told there may be a few days of discomfort but that return-to-work for the desk worker is safe.

Manual laborers can expect a slower time to return-to-work (up to one month minimum). They should avoid activities that place force on the hand and wrist. More work restrictions may also be recommended for the manual worker.

Reference: James Cowan, BA, et al. Determinants of Return to Work After Carpal Tunnel Release. In The Journal of Hand Surgery. January 2012. Vol. 37A. No. 1. Pp. 18-27.

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