Hand-arm vibration syndrome: clinical evaluation and prevention

Increasing recognition by workers that blanching of their fingers may be due to hand-arm vibration exposure from the tools they use at work and their consequent claims for compensation emphasize a need for better clinical evaluation and prevention. We describe the symptoms and signs, and enumerate the diagnostic procedures (both screening and laboratory) necessary to establish the diagnosis and severity grading of subjects with hand-arm vibration syndrome. Although effective treatment of the condition other than avoidance of further vibration exposure is still being researched, prevention is all important. The necessary steps are identified.