[Inability to work before and after operation for carpal tunnel syndrome]

Carpal tunnel syndrome is the most common compressive neuropathy, affecting approximately 5.8% women and 0.6% men. In consideration of its commonness and occurrence in persons in employment age it is considered a cause of significant work absence. Operative treatment of the syndrome results in temporary decreasing of the power and dexterity of the hand, what is also a cause of inability to work. There is lack of information in Polish literature about the dimension of this problem. The objective of this study was to determinate a work absence caused by carpal tunnel syndrome, both before and after the operation.

Fifty-six employed patients, 44 women and 12 men in a mean age of 49 years (range 27-63) who underwent a mini-invasive carpal tunnel release were analyzed. Patients were asked for duration of the disease and time off work before the operation and were followed-up for 6 months with a time off work to be noted. At 6 months, a self-assessment of the satisfaction with the result was performed in a simple four-grade scale.

A mean duration of the disease in 56 employed patients was 34 months (range 2 months-20 years). Prior to the surgery, 22 patients (39%) were on sickness related sick leave for an average 2.9 months (range 3-12), After the operation all patients availed of sick leave for a mean of 2.3 months (range 1-6). Eight (14%) of the employed patients did not return to work in a 6 months follow-up for various reasons, but mostly due to weakness and reduced dexterity of the involved hand. None of the patients complained of symptoms similar to the pre-operative and in none any complication occurred. In subjective evaluation of the effectiveness of the surgery, comparing to the status before operation 31 patients (26%) were completely free of pain and other symptoms, in 80 (66%) complaints significantly reduced, in 5 (4%) remained the same and in 5 (4%) deteriorated. Statistical analysis revealed that 22 patients who availed of sick leave prior to surgery, were statistically significantly longer off work (a mean of 3 months) than 34 patients who did not were on sick leave (a mean of 1.8 months). Similarly, in 8 patients who did not return to work, 7 availed of sick leave before the operation and only one did not.

Our results show that carpal tunnel syndrome is in Poland a cause of considerable work absence. In comparison to other countries, time off work after surgery is relatively long and a proportion of patients did not return to work within 6 months, regardless that no complications occurred in these patients. We intuitively think, that a main cause of a long lasting time work off in majority of patients after carpal tunnel release is an unwillingness but no an inability to work.