BACKGROUND: Time to return to work after carpal tunnel release is extremely variable suggesting that only a small proportion of total sick-leave is for medical reasons. AIMS: To determine factors predicting a delayed return to work. METHODS: Fifty consecutive employed patients undergoing carpal tunnel surgery were tested pre-operatively, and then at 1 month post-operatively using both questionnaires and objective testing. Further follow-up by telephone was carried out every 2 weeks up until 90 days. RESULTS: Forty-nine of the 50 workers had returned to work by 3 months. Time to return to work was extremely variable ranging from 1 to 88 days in those who returned to work. Post-operative recommendations by the surgeon also varied widely from 1 to 36 days. The surgeons' recommendations were the strongest predictors of delayed return to work [odds ratio 30.5; 95% confidence interval (CI), 3.2-288], with physical work (odds ratio 27.7; 95% CI, 1.5-507) and lack of self-rated health (odds ratio 5.0; 95% CI, 1.11-100) adding significantly to the logistic regression model, which was highly predictive (area under the receiver-operator curve of 88%). Patient symptoms and objective findings of disability did not add significantly to a logistic regression model either predicting return to work or the surgeon's recommendations. CONCLUSIONS: Our study suggests that workers will return to work in less than 3 weeks if recommended by the surgeon. A randomized controlled trial is warranted to determine if a higher proportion of workers returning in less than 3 weeks can be obtained by standardizing surgeons' recommendations.
BACKGROUND: Time to return to work after carpal tunnel release is extremely variable suggesting that only a small proportion of total sick-leave is for medical reasons. AIMS: To determine factors predicting a delayed return to work. METHODS: Fifty consecutive employed patients undergoing carpal tunnel surgery were tested pre-operatively, and then at 1 month post-operatively using both questionnaires and objective testing. Further follow-up by telephone was carried out every 2 weeks up until 90 days. RESULTS: Forty-nine of the 50 workers had returned to work by 3 months. Time to return to work was extremely variable ranging from 1 to 88 days in those who returned to work. Post-operative recommendations by the surgeon also varied widely from 1 to 36 days. The surgeons' recommendations were the strongest predictors of delayed return to work [odds ratio 30.5; 95% confidence interval (CI), 3.2-288], with physical work (odds ratio 27.7; 95% CI, 1.5-507) and lack of self-rated health (odds ratio 5.0; 95% CI, 1.11-100) adding significantly to the logistic regression model, which was highly predictive (area under the receiver-operator curve of 88%). Patient symptoms and objective findings of disability did not add significantly to a logistic regression model either predicting return to work or the surgeon's recommendations. CONCLUSIONS: Our study suggests that workers will return to work in less than 3 weeks if recommended by the surgeon. A randomized controlled trial is warranted to determine if a higher proportion of workers returning in less than 3 weeks can be obtained by standardizing surgeons' recommendations.
Authors: Lisa Newington; Martin Stevens; David Warwick; Jo Adams; Karen Walker-Bone Journal: Scand J Work Environ Health Date: 2018-08-12 Impact factor: 5.024
Authors: James I Barnes; Gabrielle Paci; Thompson Zhuang; Laurence C Baker; Steven M Asch; Robin N Kamal Journal: J Bone Joint Surg Am Date: 2021-02-17 Impact factor: 6.558
Authors: Anne-Mette H Momsen; Christina Malmose Stapelfeldt; Claus Vinther Nielsen; Maj Britt D Nielsen; Birgit Aust; Reiner Rugulies; Chris Jensen Journal: BMC Public Health Date: 2016-11-09 Impact factor: 3.295
Authors: Therese Ljungquist; Elin Hinas; Gunnar H Nilsson; Catharina Gustavsson; Britt Arrelöv; Kristina Alexanderson Journal: BMC Health Serv Res Date: 2015-08-12 Impact factor: 2.655