carpal tunnel syndrome and arthritis: overworking the #1 tool in a farmer's toolbox ned...
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Carpal Tunnel Syndrome and Arthritis: Overworking the #1 Tool in a Farmer's Toolbox
Ned Stoller, Michigan AgrAbilityAmber Wolfe, National AgrAbility Project
Thursday, December 3, 2015
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5 quick survey questions + opportunity to share comments
Session recorded and archived with PowerPoint files at www.agrability.org/Online-Training/archived
Problems: use chat window or email [email protected]
Basic Webinar Instructions
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AgrAbility: USDA-sponsored program that assists farmers, ranchers, and other agricultural workers with disabilities. Partners land grant universities with disability services
organizations. Currently 20 state projects National AgrAbility Project: Led by Purdue’s Breaking
New Ground Resource Center. Partners include: Goodwill of the Finger Lakes The Arthritis Foundation, Heartland Region University of Illinois at Urbana-Champaign Colorado State University
More information available at www.agrability.org
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Overworking the #1 tool in a
farmer’s toolbox.
An overview of Carpal Tunnel
Syndrome (CTS) of the hand and
wrist.
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Repetition, Repetition
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Overview of Carpal Tunnel Syndrome
The median nerve, along with ligaments and tendons, pass
through a narrow space in your wrist called the carpal tunnel.
CTS Overview
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Overview of Carpal Tunnel Syndrome (CTS)
Once the nerve is irritated in this narrow space, a person will begin to experience pain symptoms and eventually a reduction in strength of the hand.
Very closely associated as a form of arthritis, but it does not directly affect the carpal joint.
CTS Overview
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Estimated 1 in 10 Americans (3%)
Female to Male ratio = 4:1
Most often 30-60 years old
Statistics
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CTS Signs/Symptoms Hand weakness are common; may include stiffness,
clumsiness, and difficulty with gripping/holding things Pain, numbness, burning, loss of sensation in the wrist
area and palm of the hand (may radiate to the forearm, elbow, and shoulder)
To relieve the symptoms, patients often “flick” their wrist as if shaking down a thermometer
Nocturnal symptoms that wake the individual are more specific of CTS, especially if the patient relieves symptoms by shaking the hand/wrist
Limitations
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Limitations
If pressure continues-
the muscles can weaken and atrophy
Atrophy
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Tinel’s SignPhalen’s Test
Diagnosis
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CTS Treatment Most cases of CTS can be adequately treated with
conservative (i.e. non-surgical) management Rest, therapy, exercises Neutral-position splints NSAIDs Steroid injections (short-term relief) Ergonomics Ultrasound therapy
Surgical management is generally reserved for severe sensory loss or atrophy, and is considered after the non-invasive options
have failed to provide relief.
Options
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GENERAL MEASURES Avoid repetitive wrist and hand motions that
may exacerbate symptoms or make symptom relief difficult to achieve
Do not use vibrating hand tools or use excessive grip when driving vibrating machinery
Ergonomic measures to relieve symptoms depending on the motion that needs to be minimized
Use ergonomic assistive devices
Ergonomics
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Wrist Splints or Braces Reduce inflammation and
irritation best when worn constantly and when started within 3 months
Durability Soft- working/flexibility Hard- nighttime, increased pain
Two categories Custom (made by OT/PT) OTC splints (pre-sized)
Wear Them!
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ORAL MEDICATIONS
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Topical analgesics (creams)
Vitamin B6 Orally administered
corticosteroids
Pain Management
LOCAL INJECTION? SURGERY?
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LOCAL INJECTION
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Agricultural Tasks
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‘til pain shuts you down…
AT Devices
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Assistive Technology for Carpal Tunnel & Arthritis
AT Devices
1. Does the painful task have to be done?2. Could that task be done a different way?3. Can the task be traded with other
workers?4. Will a tool reduce pain caused by that
task?5. Would adapting a tool reduce your pain?6. Design a new tool to reduce the pain!
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Assistive Technology for Carpal Tunnel & Arthritis
AT Devices
Transplanting from flats to pots Pruning & harvesting Hand Tools Vibration – steering wheels, power tools Tractors
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Transplanting – 1000x
AT Devices
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Transplanting – 1000x
AT Devices
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Transplanting – 1000x
AT Devices
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Pruning & Harvesting – 1000x
AT Devices
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Pruning & Harvesting – 1000x
AT Devices
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Pruning & Harvesting – 1000x
AT Devices
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Pruning & Harvesting – 1000x
AT Devices
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Hand Tools – 1000x
AT Devices
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The “Easy-Grip Hand Tool”
AT Devices
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AT Devices
Right Angle Long-handle Tools
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AT Devices
Right Angle Long-handle Tool Grips
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AT Devices
Tool Balancer
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AT Devices
Vibration – Tractors & Power Tools
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AT Devices
Tractors
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AT Devices
Tractors
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AT Devices
Tractors
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AT Devices
Tractors
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AgrAbility provides direct services to farmers with injuries, illnesses or conditions of aging.
No-cost farm assessment and recommendations for specific solutions based on your condition
Funding support via Easter Seals Michigan & Michigan Rehabilitation Services
Partnership of Easter Seals Michigan, Michigan State University Extension, Michigan Farm Bureau
Supported by The Andersons, Alpha Gamma Rho, Tri-Town 4-H, Michigan Sugar, and many donors
Summary
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Conclusion Overview Carpal Tunnel Syndrome is a common, debilitating
condition for which there is an excellent prognosis, provided that the condition is recognized and the patients receive appropriate attention and treatment.
Pain and numbness in the wrist/forearm are the classic symptoms.
Home and work activities can be severely limited by CTS, debilitating the individual in many ways.
There is a simple progression of non-invasive treatments that can be applied before the option of surgery is considered.
Summary
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Sourceso American Family Physicians Groupo Arthritis Foundationo Carpal Tunnel Assocationo DeRoyal “Carpal Tunnel Syndrome, Arthritis
and Wrist Fractures” (PDF file)o FamilyDoctor Website: Carpal Tunnel Syndromeo National Institute of Neurological Disorders and
Stroke: Carpal Tunnel Syndrome Fact Sheet
References