articles.swaneylawfirm.com » Occupational Disease http://articles.swaneylawfirm.com Just another WordPress weblog Thu, 23 Jun 2011 22:46:14 +0000 en hourly 1 St. Louis Work Comp Attorney Discusses Getting The Best Settlement For Your Carpal Tunnel Injuries http://articles.swaneylawfirm.com/index.php/2009/09/24/st-louis-work-comp-attorney-discusses-getting-the-best-settlement-for-your-carpal-tunnel-injuries/ http://articles.swaneylawfirm.com/index.php/2009/09/24/st-louis-work-comp-attorney-discusses-getting-the-best-settlement-for-your-carpal-tunnel-injuries/#comments Thu, 24 Sep 2009 21:59:59 +0000 tni_adm http://articles.swaneylawfirm.com/?p=144 As a work comp attorney,I have had to deal with the changes brought about by reform in the Workmans Compensation Law.The standard used to be whether work activities “triggered” carpal tunnel syndrome.The bar was then raised to proving that repetitive activities were a “substantial factor” in producing carpal tunnel. Now you must prove that work activities were the “ prevailing factor.”This means that the activities were the “domminant factor” in producing carpal tunnel. The key to an excellent result in carpal tunnel cases is having a solid medical expert who is thorough and who has great credentials. It is imprortant that the expert has a very clear picture of the nature of the work that is being performed.This includes the quantity of the work as well as the strenuosness of the work. Finally, reseach information for various types of work can add strength to the experts testimony.Today, carpal tunnel cases are being fought with great fervor and it is important that your attorney works up your case thoroughly and aggressively. Call Jeff Swaney at 314-481-7778  for a FREE CONSULTATION

]]> http://articles.swaneylawfirm.com/index.php/2009/09/24/st-louis-work-comp-attorney-discusses-getting-the-best-settlement-for-your-carpal-tunnel-injuries/feed/ 23 St. Louis Workers Compensation Attorney Explains How Work Comp Law Now Targets Older Workers http://articles.swaneylawfirm.com/index.php/2009/05/25/st-louis-workers-compensation-attorney-explains-how-work-comp-law-now-targets-older-workers/ http://articles.swaneylawfirm.com/index.php/2009/05/25/st-louis-workers-compensation-attorney-explains-how-work-comp-law-now-targets-older-workers/#comments Mon, 25 May 2009 14:58:19 +0000 tni_adm http://articles.swaneylawfirm.com/?p=68 When the  Missouri Legislature passed “Work Comp” reform in 2005 the goal was to payback insurance companies and business groups for their support. The winner always gets the spoils, but this time fairness and common sense had to take a far back seat to expediency. Older workers were punished -for aging!!  Section 190, subsection 3 states that ”Any award of compensation shall be reduced by an amount proportional to the permanent partial disability determined to be a preexisting disease or condition or attributed to the natural process of aging sufficient to cause or prolong the disability or need of treatment. Reduced by “the natural process of aging!” Believe it or not,the intent of the legislature was to punish workers for the natural aging process.

When do we punish people for aging? From the age of 35? What about 20? Why doesn’t a worker get a bonus for healing faster, if he is young? Every middle aged worker is going to have some arthritis, or may have diabetes or some frailness as time goes on. Now the older worker is to be penalized if his “natural aging” prolongs his disability or treatment. So if you don’t bounce back at 50 the way you did when you were 25 because your body has become more frail, then the insurance company should be able to make you pay for your own treatment and at the same time cut off your lost time benefits. Where’s the outrage from groups life AARP and other advocates for older citizens? Too bad we can’t reduce the pay of Missouri legislators as they get older! Nevermind, they always stand up for themselves when it comes to their own pay raises and retirement benefits, but there is no common sense when it comes to injured workers.

]]> http://articles.swaneylawfirm.com/index.php/2009/05/25/st-louis-workers-compensation-attorney-explains-how-work-comp-law-now-targets-older-workers/feed/ 6 St. Louis Work Comp Attorney Provides Information Regarding Carpal Tunnel Surgery http://articles.swaneylawfirm.com/index.php/2009/05/16/st-louis-work-comp-attorney-provides-information-regarding-carpal-tunnel-surgery/ http://articles.swaneylawfirm.com/index.php/2009/05/16/st-louis-work-comp-attorney-provides-information-regarding-carpal-tunnel-surgery/#comments Sat, 16 May 2009 16:03:37 +0000 tni_adm http://articles.swaneylawfirm.com/?p=44 See full size image

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.

See a picture of

If you have open carpal tunnel release surgery, you usually do not need to stay in the hospital. It is usually done under

What To Expect After Surgery

transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.open carpal tunnel release surgery.local anesthetic and you can go home on the same day.

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.

Why It Is Done

  • Symptoms are still present after a long period of nonsurgical treatment. In general, surgery is not considered until after 3 to 12 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.

How Well It Works

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.

Risks

1

What To Think About

2risks of general anesthesia. But most open carpal tunnel surgery is done with local anesthesia or regional block rather than with general anesthesia.

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.

Complete the

32 Should I have surgery for carpal tunnel syndrome? surgery information form (PDF)

Citations

  1.  
  2.  
  3.  

Katz JM, Simmons BP (2002). Carpal tunnel syndrome. New England Journal of Medicine, 346(23): 1807–1812.Scholten RJPM, et al. (2007). Surgical treatment options for carpal tunnel syndrome. Cochrane Database of Systematic Reviews (4).Ashworth N (2007). Carpal tunnel syndrome, search date December 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer William M. Green, MD – Emergency Medicine
Specialist Medical Reviewer Patrick J. McMahon, MD – Orthopedics
Specialist Medical Reviewer David Pichora, MD, FRCSC – Orthopedic Surgery
Last Updated October 29, 2008

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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.

See a picture of open carpal tunnel release surgery.

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.

What To Expect After Surgery

After surgery, the hand is wrapped. The stitches are removed 10 to 14 days after surgery. You may be directed to wear a splint for several weeks. 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.

Why It Is Done

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 3 to 12 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.

How Well It Works

Most people who have surgery for carpal tunnel syndrome have fewer or no symptoms of pain and numbness in their hand after surgery. More than 70 out of 100 people are satisfied with their results, and as many as 90 out of 100 people have no night pain after surgery. 1

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.

Risks

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%). 2 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.

What To Think About

Open carpal tunnel surgery cuts open the base of the palm and requires a longer recovery period than endoscopic surgery. Painful scar tissue may be more likely to develop after open surgery than after endoscopic surgery. 3

Both endoscopic and open carpal tunnel release have benefits and risks. Studies do not show that one procedure is better than the other. 2 Talk to your doctor about your options.

Should I have surgery for carpal tunnel syndrome?

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Citations

  1. Katz JM, Simmons BP (2002). Carpal tunnel syndrome. New England Journal of Medicine, 346(23): 1807–1812.
  2. Scholten RJPM, et al. (2007). Surgical treatment options for carpal tunnel syndrome. Cochrane Database of Systematic Reviews (4).
  3. Ashworth N (2007). Carpal tunnel syndrome, search date December 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer William M. Green, MD – Emergency Medicine
Specialist Medical Reviewer Patrick J. McMahon, MD – Orthopedics
Specialist Medical Reviewer David Pichora, MD, FRCSC – Orthopedic Surgery
Last Updated October 29, 2008

WebMD Medical Reference from Healthwise

Last Updated: October 29, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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