Causes of Carpal Tunnel Syndrome and MN Workers' Comp.

Carpal tunnel syndrome is one of the most common work-related injuries we see in our Minnesota workers’ compensation law practice. Carpal tunnel syndrome is not only painful, but it can interfere with your ability to do your job. 

If your work activities substantially contributed to your development of carpal tunnel syndrome, you may be eligible for Minnesota workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and rehabilitation benefits.

In Minnesota, when carpal tunnel syndrome is caused by a worker’s day-to-day activities, or where it develops over time as a result of an employee’s work, it is known as a repetitive motion injury, or a Gillette-type injury.

Unfortunately, workers’ compensation cases involving carpal tunnel syndrome are also very commonly disputed by workers’ compensation insurance companies. Rather than acknowledging that your work activities contributed to the development of your condition, the workers’ compensation insurance company will usually try to point to some other cause, such as obesity, diabetes, or no cause at all.

In fact I’ve seen a number of independent medical examiners simply conclude that females over the age of 40 are more likely to develop carpal tunnel syndrome, and that therefore, the workers’ job activities are not a substantial contributing factor to her carpal tunnel syndrome.

Carpal tunnel syndrome occurs when there is pressure on the median nerve as it passes through the carpal tunnel in your wrist. This pressure causes sensations of tingling, numbness, pain, and/or weakness in parts of your hand.

Things that can contribute to the development of carpal tunnel syndrome include:

• Repetitive or forceful hand and wrist movements that cause the membranes surrounding the tendons to swell putting pressure on the median nerve. 
• Work that requires awkward positioning of the hands or wrists for long periods can also put pressure on the median nerve or cause swelling of the tendons. 
• Work activities that cause hand-arm vibration for long periods can contribute to carpal tunnel syndrome. 
•  Broken wrist bones, dislocated bones, new bone growth or bone spurs can put pressure on the median nerve.
• Conditions or illnesses that cause swelling in the joints and soft tissues, or restricted blood flow to the hands, such as obesity, rheumatoid arthritis, gout, diabetes, lupus, or hypothyroidism can result in pressure on the median nerve. 
• Buildup of fluid, or edema, in the carpal tunnel, caused by pregnancy or conditions such as rheumatoid arthritis or diabetes, can put extra pressure on the median nerve. 
• Smoking may contribute to carpal tunnel syndrome by affecting blood flow to the median nerve. 

If you’ve developed carpal tunnel syndrome as a result of your work activities, a Minnesota workers’ compensation lawyer can help protect your rights. For a free no-obligation case consultation call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Pronator Teres Syndrome and Minnesota Workers' Compensation

Repetitive motion injuries, or cumulative trauma injuries, are commonly known as Gillette injuries under Minnesota workers’ compensation law.

Because the symptoms of carpal tunnel syndrome and pronator teres syndrome are similar, it is often difficult to determine which nerve has been injured when a person experiences symptoms in his or her fingers, hands, wrists, forearms, and elbows.

Pronator teres syndrome (also referred to as Pronator syndrome) is an upper extremity nerve entrapment syndrome involving the median nerve.

PTS develops from compression of the median nerve by the pronator teres muscle, and is sometimes referred to as pronator syndrome. The term pronator syndrome also can include median nerve compression by other structures in the elbow, such as the ligament of Struthers or the bicipital aponeurosis (lacertus fibrosus). Compression can be due to muscle hypertonicity or fibrous bands within the muscle pressing on the nerve. In some cases, pressure is placed on the nerve by anatomical anomalies, such as the nerve traveling deep to both heads of the pronator teres. In this situation, the nerve might be compressed against the ulna by the pronator teres muscle itself.

Symptoms of pronator syndrome include a diffuse forearm ache, usually resulting from prolonged muscular effort. Paresthesia may also be noted in the median field of the hand. There may also be tenderness over the area of entrapment, which can lead to pain in the forearm. Pressure on the area of nerve entrapment may cause abnormal sensations down the path of the median nerve. This is known as Tinel’s sign. People suffering from pronator syndrome may also experience decreased strength to muscles in the forearm. Specifically, victims of pronator teres syndrome may result in a decreased ability to pronate the wrist, a loss of wrist flexion, partial loss of finger flexion, and a loss of thumb opposition. In contrast, people with carpal tunnel syndrome will not demonstrate weakness in wrist flexion, wrist pronation, or finger flexion.

People with carpal tunnel syndrome and pronator teres syndrome both experience sensory loss, however the patterns of sensory loss differ. Pronator syndrome causes sensory loss in the entire median nerve field of the hand. In contrast, carpal tunnel syndrome causes sensory loss primarily in the thumb and fingers. Additionally, pronator teres syndrome pain is exacerbated by repetitive elbow flexion, and symptoms arise in the forearm as well as the hand. Carpal tunnel syndrome, on the other hand, is aggravated by wrist movements, and forearm pain is not as common or as severe.

People with carpal tunnel syndrome frequently report night pain, while individuals with pronator syndrome generally do not. This is because prolonged wrist flexion during sleep aggravates carpal tunnel syndrome, whereas wrist flexion does not affect the pronator teres muscle.

Treatment for pronator teres syndrome may include conservative therapies such as massage and physical therapy, ultrasound, anti-inflammatory medications, pain medications, or corticosteroid injections. If conservative therapies fail, decompressive surgery may be necessary.

People suffering from pronator teres syndrome as the result of repetitive motions at work are entitled to workers’ compensation benefits under Minnesota law, including medical benefits, wage loss benefits, permanency benefits, and/or rehabilitation benefits. Unfortunately, workers who suffer from pronator teres syndrome may ultimately be medically required to avoid the types of repetitive motions required by their jobs.

If you’ve been diagnosed with pronator teres syndrome as the result of your work related activities, you should report the injury to your employer, and consider retaining an experienced workers’ compensation lawyer to make sure you get the benefits you are entitled to. To schedule a free, no-obligation consultation with one of our attorneys, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

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Carpal Tunnel Syndrome and Minnesota Workers' Compensation

Carpal tunnel syndrome is one of the most common work-related injuries we see in our practice.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes compressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers. The carpal “tunnel” is a narrow, rigid passageway of ligaments and bones at the wrist, and it houses the median nerve and tendons. Thickening of the tendons due to irritation or other swelling can cause the tunnel to narrow and cause compression on the median nerve. Compression of the median nerve can cause pain, weakness, and numbness into the hand and wrist, which can radiate up into the arm.

Symptoms of carpal tunnel syndrome can include:

• A burning sensation in the palm and fingers.
• Tingling or numbness in the palm and fingers.
• An itching sensation in the palm and fingers.
• A sensation of swelling, with or without actual visible swelling.
• Waking at night due to pain, burning, or numbness in the hands.
• Decreased grip strength.
• Difficulty grasping small objects.
• Loss of the ability to feel hot or cold.
• Sensation that the hands are “falling asleep.”
  

Usually, work-related carpal tunnel syndrome is the result of long-term repetitive motions. Carpal tunnel syndrome is commonly referred to as a repetitive motion injury or a Gillette-type injury under Minnesota workers’ compensation law.

Contrary to popular belief, carpal tunnel syndrome is not an injury that occurs only to office workers, nor is it an injury that only women experience. We frequently see injured workers, both men and women, with carpal tunnel syndrome as the result of repetitive motions in the following lines of employment:

• Assemblers
• Manufacturers
• Heavy Equipment Operators
• Press Operators
• Machine Operators
• Factory Workers
• Dental Hygienists
• Hairstylists
• Secretaries
• Administrative Assistants
• Data Entry Personnel
• Food Processors
• Packaging Workers
• Finishers
  

In order to diagnose carpal tunnel syndrome, frequently a doctor will examine the affected wrist for tenderness, swelling, warmth, and discoloration. The fingers will also be tested for sensation, and muscles at the base of the hand will be tested for strength and signs of atrophy. The doctor may order laboratory tests and X-rays to rule out other conditions. If carpal tunnel syndrome is suspected, a doctor may order a nerve conduction study to diagnose damage to the median nerve. Ultrasound imaging may also be used to confirm a diagnosis of carpal tunnel syndrome.

Conservative treatment for carpal tunnel syndrome often involves avoiding repetitive motions, icing, splints or braces, anti-inflammatory medication, pain medication, corticosteriodal medications or injections, and/or physical therapy and exercise.

If conservative treatments are not effective at relieving symptoms, surgical treatment may be indicated. Carpal tunnel release is one of the most common surgical procedures in the United States. Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve. It can be an open release surgery or an endoscopic surgery. It is often an outpatient procedure, performed under local anesthesia. Following surgery, patients usually require physical therapy to restore wrist strength, and they may need to adjust their job duties or even change jobs to avoid recurrence of the injury.

Carpal tunnel syndrome is a serious injury, and it can cause an employee to lose a lot of time from work. If the employee’s job duties require repetitive motions, and the employer cannot (or will not) accommodate an employee’s need to avoid repetitive motions, that employee may also lose his or her job. Work-related carpal tunnel syndrome is covered by Minnesota workers’ compensation. If you suffer from work-related carpal tunnel syndrome, you may be entitled to medical benefits, wage loss benefits, permanency benefits, and rehabilitation benefits.

In addition to work-related repetitive motions, it is also thought that carpal tunnel syndrome may be a genetic condition, or that it is related to diabetes, arthritis, and obesity. Workers’ compensation insurance companies frequently argue that an employee’s carpal tunnel syndrome was caused by something other than his or her work activities. Moreover, it is often very difficult for an employee to go back to work in his or her original position if the job duties include repetitive motions. Some employers cannot or will not accommodate an employee’s need to avoid repetitive work, and suddenly that employee finds his or herself looking for a new line of work. If you suffer from work-related carpal tunnel syndrome, it is wise to consult with an experienced workers’ compensation lawyer.

In our experience, workers’ compensation insurance companies frequently dispute that the employee’s carpal tunnel syndrome was caused by the employee’s work. To schedule a free, no obligation consultation, call Meuser & Associates at 877-746-5680 or click here to send us an email.

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Nerve Conduction Studies and Workers’ Compensation Injuries

Many types of work injuries, such as disc herniations that impinge on nerves, carpal tunnel syndrome, or ulnar neuropathy can cause nerve damage or insufficiencies.

A nerve conduction study is often done to evaluate paresthesias (numbness, tingling, burning) and or/weakness of the arms and legs. Some common disorders which can be diagnosed by nerve conduction studies are peripheral neuropathy, carpal tunnel syndrome, ulnar neuropathy, Guillain-Barré syndrome, Facioscapulohumeral muscular dystrophy, and spinal disc herniation.

During a nerve conduction study, specific nerves are stimulated and the study records their ability to send the impulse to the muscle. The study can show where there is damage to or a blockage of the nerve pathway. This can help isolate the location of abnormal sensations, such as numbness, tingling, or pain.

In the study, several flat metal disc electrodes are taped or pasted to your skin. A shock-emitting electrode is placed directly over the nerve to be studied. A recording electrode is placed over the muscles supplied by that nerve. Several, brief electrical pulses are sent to the nerve. You will feel a brief, burning pain, a tingling sensation and a twitching of the muscle when the electrical pulse is applied. It feels like the tingling you feel when you rub your feet on the carpet then touch a metal object. Each pulse is very brief (less than a millisecond).

The time it takes the muscle to contract in response to the electrical pulse is recorded. The speed of the response is called the conduction velocity. Nerve conduction studies show whether the nerves transmit electrical impulses to the muscles or up the sensory nerves at normal speeds (conduction velocities). Sensory nerves allow the brain to respond to pain, touch, temperature and vibration. Different nerves have different normal conduction velocities.

The results of a nerve conduction study can help diagnose a work-related injury. If the workers’ compensation insurer is denying payment for a nerve conduction study, if they are denying pre-approval for an appointment, or if you have sustained carpal tunnel syndrome, a disc herniation, ulnar neuropathy, or any other work related nerve injury, give us a call at 877-746-5680 or click here to send us an email to schedule a free consultation.

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