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Epidemiology of carpal tunnel syndrome in women of childbearing age. Findings in a large cohort study.

Abstract：

:There are few epidemiological data in the scientific literature about the carpal tunnel syndrome. This paper describes the characteristics of the 154 women referred to hospital for management of this condition among the 17,032 taking part in the Oxford-Family Planning Association contraceptive study. Standardized first referral rates for carpal tunnel syndrome doubled as age increased from 25-29 to 50 or more, tripled as smoking increased from zero to 25 or more cigarettes per day, doubled as total duration of oral contraceptive use increased from zero to ten years or more and doubled as Quetelet's obesity index (weight(g)/height(cm)2) increased from up to 1.99 to 2.6 or more. All these trends were statistically significant. Carpal tunnel syndrome was also found to be positively associated with a history of menstrual disorders, gastrointestinal tract symptoms and various orthopaedic conditions. The findings on cigarette smoking are of particular interest but require confirmation or refutation in another study before firm conclusions can be drawn. :Researchers analyzed 1968-1974 data of 154 women attending 1 of 17 large family planning clinics in England and Scotland and referred to a hospital for treatment of carpal tunnel syndrome (CTS) to determine CTS characteristics. The women were part of the large Oxford-Family Planning Association cohort study. A strong association between age and CTS existed, but the crude hospital referral trend (p.001) declined somewhat when considering confounding variables, e.g., smoking, (adjusted rate p.01). Cigarette smoking had a significant effect regardless of the age group (20-44 year old, p.001; 45 years plus, adjusted p.05). The researchers reported that additional research is needed to explain the mechanism involved in smoking and CTS since a mechanism is not apparent. The results showed that the longer the interval since last use of oral contraceptives (OCs) the higher the chance of acquiring CTS, but this was less significant than smoking (20-44 year old, p..01; 45 years plus, adjusted p.05). The data indicated a strong positive relationship between Quetelet's obesity index and 1st referral for CTS (20-44 year old, p..01; 45 years plus, p..05). Other significant relationships, albeit less significant than between obesity and referral, included body weight (positive) and height (negative). A negative association occurred between varicose veins and CTS. The most significant positive association between an existing disease and CTS was menstrual disorders (p=.001). Additional similar associations existed for orthopedic conditions and gastrointestinal tract symptoms. The relationships between CTS and OC use, menstrual disorders, and obesity may be related to pressure on the median nerve due to fat or edema near the carpal tunnel.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Vessey MP,Villard-Mackintosh L,Yeates D

doi

10.1093/ije/19.3.655

subject

Has Abstract

pub_date

1990-09-01 00:00:00

pages

655-9

issue

eissn

0300-5771

issn

1464-3685

journal_volume

pub_type

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Epidemiology of carpal tunnel syndrome in women of childbearing age. Findings in a large cohort study.