Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most diagnosed peripheral nerve disorder, causes significant disability, is a leading source of lost work time, and costs billions of dollars.  In MH&E we are working with leading CTS experts to improve care for people with CTS.

In previous years we have tested conservative CTS treatment, completing a RCT to determine which splint/exercise protocol provided best care.  We found that a traditional cock-up splint paired with lumbrical stretches was most effective. 

Currently, we are working with Dr. Roll and his Musculoskeletal Sonography and Occupational Performance Laboratory to examine the trajectory of CTS in dental hygiene students.  We are also looking current best practices of CTS care to determine methods to improve the treatment of people with CTS

CTS Activities

Online CTS Screening Tool: We are developing an online tool that can screen people for CTS and help determine appropriate treatments

Develop patient-centered care models for CTS: We aim to develop a contemporary, stakeholder-driven framework for CTS that will facilitate effective individualized care, which is currently hampered by non-patient-specific, antiquated approaches. We plan to convene experts in CTS to develop a treatment taxonomy that links mechanisms of CTS to best treatment options.

Publications

Baker NA, Feller H, Freburger J. Does insurance coverage affect use of tests and treatments for working age individuals with carpal tunnel syndrome in the United States? Analysis of the National Ambulatory Medical Care Survey (2005-2014). Archives of Physical Medicine & Rehabilitation. 2019;100:1592-1598 https://doi.org/10.1016/j.apmr.2019.03.014

Baker NA, Stevans J, Terhorst L, Haas A, Kuo Y-F, Al Snih S. What types of treatment are provided for patients with carpal tunnel syndrome? A retrospective analysis of commercial insurance. PM&R. 2018;10:826-835 doi: 10.1016/j.pmrj.2018.02.004

Baker NA. Characteristics of people with work-related versus non-work related carpal tunnel syndrome: National Health Interview Survey, 2010 & 2015. [abstract]. Arthritis & Rheumatology. 2017; 69 (suppl 10).

Characteristics of People with Work-Related Versus Non-Work Related Carpal Tunnel Syndrome: National Health Interview Survey, 2010 & 2015

Baker NA. The association between arthritis and carpal tunnel syndrome: National Health Interview Survey, 2010. [abstract]. Arthritis & Rheumatology. 2016; 68 (suppl 10) http://acrabstracts.org/abstract/the-association-between-arthritis-and-carpal-tunnel-syndrome-national-health-interview-survey-2010/

Baker NA, Moehling K, Rubinstein E, Wollstein R, Gustafson NP, Baratz M.  The comparative effectiveness of combined lumbrical muscle splints and stretches on symptoms and function in carpal tunnel syndrome.  Archives of Physical Medicine and Rehabilitation. 2012;93:1-10. doi: 10.1016/j.apmr.2011.08.013

Baker NA, Livengood HM. Symptom severity and conservative treatment for carpal tunnel syndrome in association with eventual carpal tunnel release. Journal of Hand Surgery. 2014;39:1792-1798. doi: 10.1016/j.jhsa.2014.04.034

Baker NA, Moehling K, Desai, AR, Gustafson NP. The effect of carpal tunnel syndrome on grip and pinch strength compared to gender and age matched normative data. Arthritis Care & Research. 2013;65:2041-2045. doi: 10.1002/acr.22089

Brininger TL, Rogers JC, Holm MB, Baker NA, Li Z-M, Goitz RJ. Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2007;88:1429-1435. doi:10.1016/j.apmr.2007.07.019

Presentations

  • Ottenbacher K, Al Snih S, Baker NA. Answering clinically relevant questions using large datasets: Use of large datasets to inform clinical care in carpal tunnel syndrome. Peer-reviewed workshop. American College of Rheumatology/Association of Rheumatology Health Professionals 2018 Annual Scientific Meeting; 2018 Oct 22; Chicago, IL.
  • Moehling KK, Rubinstein EN, Wollstein R, Gustafson NP, Baratz ME, Baker NA. Targeted lumbrical splinting and stretching versus standard treatment on functional outcomes in persons with mild to moderate carpal tunnel syndrome. Podium presentation. 2012 American Association for Hand Surgery Annual Meeting; 2012 Jan 12; Las Vegas, NV.
  • Baker NA, Moehling KK, Rubinstein EN, Wollstein R, Gustafson NP, Baratz ME. A clinical trial of comparative effectiveness evaluating an intensive lumbrical splinting and stretching treatment on carpal tunnel symptoms and function.  Podium presentation. The American Occupational Therapy Associations 2012 Annual Conference; 2012 Apr 27; Indianapolis, IN.
  • Livengood H, Baker NA.  Exploration of the indicators for carpal tunnel release surgery: A secondary analysis. Podium presentation. American Occupational Therapy Association 2014 Annual Conference; 2014 Apr 4; Baltimore MD.
  • Baker NA. The association between arthritis and carpal tunnel syndrome: National Health Interview Survey, 2010; Podium presentation. American College of Rheumatology/Association of Rheumatology Health Professionals 2016 Annual Scientific Meeting; 2016 Nov 15; Washington, DC.
  • Baker NA. Characteristics of people with work-related versus non-work related carpal tunnel syndrome: National Health Interview Survey, 2010 & 2015. Podium presentation. American College of Rheumatology/ Association of Rheumatology Health Professionals 2017 Annual Scientific Meeting; 2017 Nov 8; San Diego, CA.
  • Roll SC, Hardison ME, Baker NA. Characterizing the occupational tasks of dental hygiene students to identify risks of developing musculoskeletal discomfort. Paper presentation. 7th Annual Occupational Therapy Summit of Scholars, 2018; Kansas City, KS.