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Long-term trends in carpal tunnel syndrome

From the Departments of Physical Medicine & Rehabilitation (R.G.), Health Sciences Research (L.J.M.), Orthopedics (P.C.A.), and Neurology (J.C.S.), College of Medicine, Mayo Clinic; and Department of Research (B.P.Y., P.C.W.), Olmsted Medical Center, Rochester, MN.

Address correspondence and reprint requests to Dr. Russell Gelfman, College of Medicine, Mayo Clinic, Rochester, MN 55905 gelfman.russell{at}mayo.edu

Objective: To assess temporal trends in carpal tunnel syndrome (CTS) incidence, surgical treatment, and work-related lost time.

Methods: Incident CTS and first-time carpal tunnel release among Olmsted County, Minnesota, residents were identified using the medical records linkage system of the Rochester Epidemiology Project; 80% of a sample were confirmed by medical record review. Work-related CTS was identified from the Minnesota Department of Labor and Industry.

Results: Altogether, 10,069 Olmsted County residents were initially diagnosed with CTS in 1981–2005. Overall incidence (adjusted to the 2000 US population) was 491 and 258 per 100,000 person-years for women vs men (p < 0.0001) and 376 per 100,000 for both sexes combined. Adjusted annual rates increased from 258 per 100,000 in 1981–1985 to 424 in 2000–2005 (p < 0.0001). The average annual incidence of carpal tunnel release surgery was 109 per 100,000, while that for work-related CTS was 11 per 100,000. An increase in young, working-age individuals seeking medical attention for symptoms of less severe CTS in the early to mid-1980s was followed in the 1990s by an increasing incidence in elderly people.

Conclusions: The incidence of medically diagnosed carpal tunnel syndrome (CTS) accelerated in the 1980s. The cause of the increase is unclear, but it corresponds to an epidemic of CTS cases resulting in lost work days that began in the mid-1980s and lasted through the mid-1990s. The elderly present with more severe disease and are more likely to have carpal tunnel surgery, which may have significant health policy implications given the aging population.

Abbreviations: CI = confidence interval; CTS = carpal tunnel syndrome; MESA = Marshfield Epidemiologic Study Area.

Supported by a grant (R01-AR30582) from the NIH, US Public Health Service. This publication was made possible by Grant 1 UL1 RR024150 from the National Center for Research Resources (NCRR), a component of the NIH, and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/. Information on Reengineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov.

Disclosure: The authors report no disclosures.

Received April 17, 1008. Accepted in final form September 23, 2008.

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