Carpal Tunnel Decompression and Occupational Productivity: Assessing Post-Surgical Work Engagement and Absenteeism

Carpal Tunnel Syndrome (CTS) imposes significant occupational and economic burdens, yet data on postoperative work outcomes in Tunisia remain limited.

This retrospective cross-sectional study (2014-2022) analyzed 118 surgically managed CTS patients from Taher Sfar Mahdia University Hospital using the BCTQ-A (symptom/function severity) and WPAI-GH (work productivity) questionnaires.

Key predictors for surgical intervention included bilateral involvement (Adj. OR=22.0, 95%CI:5.5-33.4), thumb opposition loss (p<0.001), and occupational factors like >8h workdays (p=0.04) and >20 years' seniority (p=0.05). Postoperatively, 68.3% required workstation adjustments, while 19.5% underwent job transfers. The cohort demonstrated substantial productivity impairment, with 69.4% overall work productivity loss (WPAI-GH), disproportionately affecting older (>40 years, p=0.02) and less-educated workers (p=0.02). Notably, 84.4% of patients required 30-day medical leave, aligning with global benchmarks (23.4-day average). Multivariate analysis identified nocturnal pain (p<0.001) and difficulty with bottle-opening (p<0.001) as key drivers of productivity decline.

Operated CTS appears to have a more substantial impact on work quality, likely due to surgical complications and postoperative recovery challenges. This underscores the importance of early conservative management and preventive strategies. These findings highlight the need for early ergonomic interventions, particularly in high-risk sectors like garment manufacturing (81.7% of the cohort) and multidisciplinary prevention strategies combining workplace modifications, health education, and weight management.

With CTS costing over $2B annually in the U.S. alone, proactive measures targeting long-tenured manual laborers are urgently needed to mitigate its socioeconomic impact.