An occupational disease can come in two (2) forms. The most common is what we call “repetitive trauma.” This is an injury that occurs a little bit at a time. We often see these injuries with professional secretaries who spend an excessive amount of time typing and keying. Another example would be construction employees who may use the same piece of equipment over and over. Occupational injuries can have serious consequences that can often lead to surgery and severe disability.
Repetitive trauma injuries occur when a worker is required to perform constant repetitious motions. Certain individuals are more susceptible or vulnerable to sustaining injuries from repetitive trauma, but a case is compensable if the work can be shown to be the “prevailing factor” in producing the condition. There are a number of very common repetitive trauma injuries that we see occur very frequently.
Carpal tunnel syndrome is probably the most common condition that we see in our office. One of the first signs that a worker may experience is numbness or tingling in his hands and fingers. It can develop very gradually and can start out being extremely mild in nature. Some individuals will notice that they begin experiencing numbness and tingling when they are holding a steering wheel, a newspaper, or even the telephone. At first, the symptoms may simply be a little annoying, but as the disorder progresses, the numbness and tingling may become more constant. Sometimes the pain will radiate from the wrist up into the shoulder. This is often accompanied by weakened grip strength. Sometimes people with carpal tunnel will have a tendency to drop things and getting a good night’s sleep may become increasingly difficult.
Carpal tunnel syndrome is caused by pinching of the median nerve in the wrist. The median nerve passes through the narrow passageway known as the carpal tunnel. This tunnel protects the median nerve and a number of other tendons that affect the hand. Compression of the nerve can become severe, and when this happens, there can be muscle atrophy in the area below the thumb.
Sometimes carpal tunnel can be caused by medical conditions such as diabetes. However, it can also be caused by repetitive motion and vibrating tools. In today’s computer age, we often see secretaries, typists, grocery clerk scanners, forklift operators and cleaning people develop this condition.
Over the years, the workers’ compensation law has been changed in order to limit an employer’s liability for carpal tunnel injuries. Workers’ compensation claims for carpal tunnel syndrome are often disputed by insurance companies. If your claim is denied, you should contact an experienced attorney who will evaluate your case free of charge.
Carpal tunnel syndrome can sometimes be treated successfully with medication, splints, and other conservative means. The condition can be diagnosed by a routine orthopedic examination. In some cases, a doctor will order an EMG and nerve conduction tests. These electrical studies will measure the activity of the median nerve in order to determine the severity of the condition.
When carpal tunnel syndrome reaches a certain level of severity, then surgery may be necessary. There are a couple of surgical options that have advantages and disadvantages. If a worker requires surgery, then typically he will be out of work for a couple of weeks, depending on the nature of his job.
Below is an excellent article published on WebMD which describes the open carpal tunnel surgical procedure:
Open Carpal Tunnel Surgery for Carpal Tunnel Syndrome
During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.
An incision is made at the base of the palm of the hand. This allows the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.
If you have open carpal tunnel release surgery, you usually do not need to stay in the hospital. It is usually done under local anesthetic, and you can go home on the same day.
After surgery, the hand is wrapped. The stitches are removed 10 to 14 days after surgery. The pain and numbness may go away right after surgery or may take several months to subside. Try to avoid heavy use of your hand for up to 3 months.
When you return to work depends on whether the dominant hand (the hand you use most) was involved, on your work activities, and on the effort that you put into rehabilitative physical therapy.
If you have surgery on your nondominant hand and do not do repetitive, high-risk activities at work, you may return to work within 1 to 2 days, although 7 to 14 days is most common.
If you have surgery on your dominant hand and do repetitive activities at work, you may require 6 to 12 weeks for a full recovery before you can return to previous work duties. Physical therapy may speed your recovery.
Open carpal tunnel surgery is considered when:
Symptoms are still present after a long period of nonsurgical treatment. In general, surgery is not considered until after several weeks to months of non-surgical treatment. But this assumes that you are having ongoing symptoms but no sign of nerve damage. Nerve damage would make surgery more urgent.
Severe symptoms (such as persistent loss of feeling or coordination in the fingers or hand, or no strength in the thumb) restrict normal daily activities.
There is damage to the median nerve (shown by nerve test results and loss of hand or finger function), or a risk of nerve damage.
Tumors or other growths need to be removed.
Most people who have surgery for carpal tunnel syndrome have fewer or no symptoms of pain and numbness in their hands after surgery.
In rare cases, the symptoms of pain and numbness may return (the most common complication), or there may be temporary loss of strength when pinching or gripping an object, due to the cutting of the transverse carpal ligament.
If the thumb muscles have been severely weakened or wasted away, hand strength and function may be limited even after surgery.
The risk and complication rates of open surgery are very low. Major problems such as nerve damage happen in fewer than 1 out of 100 surgeries (less than 1%). There is a small risk that the median nerve or other tissues may be damaged during surgery. After open surgery, recovery may be slower than after endoscopic surgery, and there may be some pain in the wrist and hand. You may also have some tenderness around the scar. There are also the risks of any type of surgery, including possible infection and risks of general anesthesia. But most open carpal tunnel surgery is done with local anesthesia or regional block rather than with general anesthesia.
Open carpal tunnel surgery cuts open the base of the palm and requires a longer recovery period than endoscopic surgery. Temporary nerve problems may be less likely with open surgery. But painful scar tissue may be more likely to develop after open surgery than after endoscopic surgery.
Both endoscopic and open carpal tunnel release have benefits and risks. Studies do not show that one procedure is better than the other. Talk to your doctor about your options.
The second type of occupational injury involves exposure to outside elements such as fumes, chemicals or other elements. Someone who is exposed to dangerous chemicals may not feel the effects immediately. Over a period of time, these chemicals can take a toll. Mesothelioma is one of these types of occupational diseases; it is usually caused by exposure to asbestos. The effects of an occupational disease such as Mesothelioma can be devastating, but an experienced Missouri asbestos lawyer may be able to help you obtain compensation. These cases require competent and experienced legal representation in order to determine the nature and cause of an employee’s injuries.
In either case, we are here to assist injured employees who are victims of an occupational disease. Contact the Swaney Law Firm for a free consultation and let us put our experience to work for you!