Whatever Happened to the Carpal Tunnel Epidemic?

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(Photo: Foxtongue)

(Photo: Foxtongue)

This week’s episode asks “Whatever Happened to the Carpal Tunnel Epidemic?” (You can subscribe at iTunes, get the RSS feed, or listen via the media player above. You can also read the transcript; it includes credits for the music you’ll hear in the episode.)

Stephen Dubner recalls his days at The New York Times (where he wrote stuff like this, this, and this), when newsrooms were full of two kinds of people: those suffering from wrist pain and those who feared they soon would. Many people had some sort of elaborate computer keyboard setup to remedy the situation — including Steve Levitt, who used a keyboard that folded up in the middle to ease his wrist pain. (He’d been keying in hours and hours of data. Levitt claims it was worth it, by the way: the data led to a paper about campaign spending, which he says was his “first good journal publication.”)

So where did all those white-collar carpal tunnel syndrome victims go?

We get the story from Bradley Evanoff, an M.D. and a professor at Washington University in St. Louis, where he studies occupational medicine. He traces the history of the ailment and points out that the epidemic seems to have started shortly after carpal tunnel syndrome became a compensable disorder:

EVANOFF: I think that prior to around 1985 or so there are really very few cases of carpal tunnel syndrome that are paid for out of workers’ compensation. And then you see this big growth between 1985 and about 1995 where many more cases are claimed as work-related. And this is the so-called epidemic of carpal tunnel syndrome that got people quite interested in and focused on CTS in the late 80’s early 90’s.

But was the computer keyboard really such a huge risk factor? Evanoff talks about what kind of workers are at the highest risk (it’s neither economists nor journalists), and what the numbers look like today. While we don’t hear about carpal tunnel syndrome much these days, it certainly hasn’t gone away: Evanoff estimates that 1 to 2 percent of American workers suffer from it. So why don’t we hear about it more often?

Special thanks to Ryan Hagen for his help producing this episode.


Statspotting

Speaking of campaign spends - here is something for scale

http://statspotting.com/money-spent-on-2012-elections-1-year-unemployment-benefits-for-100000-americans/

Money Spent On 2012 Elections = 1 Year Unemployment Benefits For 100,000 Americans

Paul

I suffer from a variation of CTS, but I'm not sure what it's called. I spend the entire work day on the computer - emails, online conference calls, instant messages, etc. I have to read tons of web pages and documents and scroll through them. All the clicking and scrolling for 8 or more hours a day are really bothering my index finger. I've tried using my middle finger for scrolling - that helps a little. I've tried using my left hand - total failure. I've tried many different kinds of mouses - some of them help. I've become very sensitive to web sites and software that require a lot of clicking - I hate Microsoft Office 2010!
I guess I would call it Mouse Finger. Anyway, I think this is the new CTS.

Camron

Oh man, you missed a perfect opportunity to play Daft Punk's "Technologic" after Evanoff's "stack it, pack it, pull it" comment. Would have been a great segway to the end of the episode!

Alex G.

It's "segue."

joanne

I like your podcast, but was disappointed in this piece. It came off sounding like a reporter paying back a colleague he didn't like who had claimed to have carpal tunnel. Carpal tunnel, like Repetitive Stress Injury is a blanket term for a wide range of symptoms, conditions, and contributing factors. Someday, we'll realize the computer mouse was a very bad idea, or we'll take more care in teaching people not to let their arm hover over it for hours. Offices are now built ergonomically -- desks and monitors are the proper height, people use ear buds or cell phones rather than cradling phone receivers between their shoulder and ear.

Lots of doctors and drug companies made lots of money on unnecessary surgeries and painkillers, but you didn't go into that. Painful conditions do not lend themselves well to cheeky sarcasm.

Alex G.

Um, this piece did not answer the question. It said that OSHA started reimbursing for Carpal Tunnel in the 80s, around the same time that computers started becoming commonplace in the office. And it stated that, despite this, office jobs are actually low-risk for carpel tunnel compared to other, usually more physical, careers that repetitive hand motions such as meatpacking. And the podcast guesses that it got a lot of journalistic attention because of its novelty and that CPS was happening so much in news rooms. But it still did not state why the diagnosis largely went AWAY in office environments.

I could conclude one of two reasons: 1) That office environments reported a large drop-off of CPS after the mid-90s because of improved jobs (outsourced data entry for example) or improved office ergonomics due to more awareness; or 2) that news reporters just stopped paying so much attention to it because it was no longer new after the 90s. The piece doesn't answer this.

I tend to think it's #1, that workplaces and employees have both simply become more aware of CPS and have adjusted the heights of their desks and positions of the keyboard accordingly. While heavy data entry jobs have been getting outsourced to other countries or made obsolete due to improved technology not requiring data entry, I think more than enough new data entry jobs are created every day to replace them. If my guess isn't true, then this means that #2 is the reason, that there is still an epidemic of CPS in offices that journalists are just no longer reporting.

Read more...

Jeff

My life was seriously affected by RSI. I was diagnosed with Cubital Tunnel Syndrome in the mid-90's. I went from doctor to doctor who either were already carving me open on my wrists, or dismissing me as a nut case.

Curious, I had been pounding a keyboard for non-stop between 7-9 hours a day. And at night began to have my arms falling asleep on me and burning around the hand, palms, and fingers.

After spending thousands I finally got to one of the top doctor's in NYC who put me back together again after more than a year of intensive home and physical therapy.

Until this happened, I thought I was the office worker equivalent of Cal Ripken. 'You got pain in your hands? You play through it!' I had never been late to the job once-in 8 years.

And you want me to believe some heartless SOB because he's got an MD, that I was jaking my injuries? F--k him!

As for compensation: why is it that the IME, my former employer's medical expert, examined me an READILY CONCLUDED that I, in fact was suffering from this misery!

As a footnote: I was recently diagnosed with Carpal tunnel syndrome. And there is no expectation of compensation. This was a part-time job and heavy on hand movement. I wouldn't dare tell my employer about my past injury history and they fired me for being too slow. There are many factors that go into these type of occupational illnesses. Genetics, lack of ergonomics and a general ignorance about how to pace yourself.

For a doctor to deny these ailments or tie them to the pursuit of money is heartless,and shameless. I put it up there with holocaust denial.

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Scott

Hi Guys,

We enjoyed this episode but wonder if you missed some key points. When the "epidemic" of carpal tunnel swept through office workers, the Internet and web were just starting to slip out of DARPA's private play space. We used computers much differently then - they were used mostly for content CREATION, not content CONSUMPTION. And, since there was no email at the time, typing duties were concentrated on "secretaries" who spent full days "word processing" correspondence.

Today, we use computers much differently, clicking and browsing our way through the world. Even journalists, the boogymen of your analysis who use keyboards like builders use hammers, write shorter stories and interrupt their daily grind with frequent trips to email, Twitter and other sites.

In short, the world beyond the keyboard has changed, and our bodies have responded in kind.

Joanne Jones

I just caught this podcast. I started suffering carpal tunnel in the late 1990's. I was in my early 20's and was working office and manual jobs. I had carpal tunnel release surgery in 1999 and 2000 (one hand each year to minimize time out of work).

One idea I have as to why carpal tunnel isn't considered a big deal anymore is the evolution of the surgery. When my mother had this surgery in the early 90's, you had to be pretty severe and show nerve damage before they would operate. She has 3 inch scars that go from her palm up into her wrist. She had to wear a cast for weeks.

By the time I had the surgery, the surgery had improved. My scar was only an inch long on my palm and I only had to wear a dressing/brace for a couple of weeks while my incision healed. Nowadays the surgery is endoscopic, with probably even faster healing and less pain.

According to the NY Times health site, more than 500,000 people in the U.S. have this surgery each year. This is why I believe that carpal tunnel is just as prevalent today, but it's become a routine diagnosis and surgery, so is no longer news.

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Akima

This is an invention that came to mind while working on a computer 8hours a day at work for 12 years. Cast a vote or even drop your opinion on it... I love SME's (Subject Matter Experts)

http://marblar.com/idea/kvzok

Kevin

I was working in a factory in '93 which had mostly tedious manual labor. The employees, mostly women, had up to 30+ years experience in this manual labor. We saw a lot of carpal tunnel (CT) in the workers with less than 7 years on the job, and virtually none with the older work force. We had to undergo a reduction in workforce. About 6 months after that we realized, that there was very little complaint of CT. The demographic ratio remained the same. We speculated that the workforce who complained of CT thought they would get laid off because they complained (not true) stopped complaining. Since it was difficult to accurately diagnose carpel tunnel, it was a way for the younger (less motivated workforce) to get light duty work, since the older workforce never had a problem. Summary: most of the CT complaints were fictitious in order to get light duty work and time off.

Sarah

What about constant clicking on the Mouse!! I am drafting by hand (AutoCAD) - for about 15 years now. I constantly have pain in my hand - that I've taught myself to use the other as a backup for bad days.

Computer work is just plain not good for you (as I realize, are a lot of things). We need to find a way to make it healthier - like the trend for having a desk that you can raise for standing from time to time, or perhaps some other interface with the computer altogether. eh?! Come on - with all of this technology advances in the digital tech gadgets and we are still using a Mouse?!!

I like the pigeon btw.