Transcript Presentation file - National AgrAbility Project

Carpal Tunnel Syndrome and Arthritis:
Overworking the #1 Tool in a Farmer's
Toolbox
Ned Stoller, Michigan AgrAbility
Amber Wolfe, National AgrAbility Project
Thursday, December 3, 2015
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 AgrAbility:
USDA-sponsored program that
assists farmers, ranchers, and other
agricultural workers with disabilities.
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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
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More information available at www.agrability.org
Overworking the #1
tool in a farmer’s
toolbox.
An overview of
Carpal Tunnel
Syndrome (CTS) of
the hand and wrist.
Repetition, Repetition
CTS Overview
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
Overview of Carpal Tunnel
Syndrome (CTS)
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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.
Statistics
 Estimated
 Female
 Most
1 in 10 Americans (3%)
to Male ratio = 4:1
often 30-60 years old
Limitations
CTS Signs/Symptoms
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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)
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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
Atrophy
Limitations
If pressure
continuesthe muscles
can weaken
and atrophy
Diagnosis
Tinel’s Sign
Phalen’s Test
Options
CTS Treatment

Most cases of CTS can be adequately treated with
conservative (i.e. non-surgical) management
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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.
Ergonomics
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
Wear Them!
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
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categories
Custom (made by OT/PT)
OTC splints (pre-sized)
Pain Management
ORAL
MEDICATIONS
 Nonsteroidal
antiinflammatory drugs
(NSAIDs)
 Topical analgesics
(creams)
 Vitamin B6
 Orally administered
corticosteroids
LOCAL INJECTION? SURGERY?
LOCAL INJECTION
Agricultural Tasks
AT Devices
‘til pain shuts you down…
AT Devices
Assistive Technology for
Carpal Tunnel & Arthritis
1.
2.
3.
4.
5.
6.
Does the painful task have to be done?
Could that task be done a different way?
Can the task be traded with other workers?
Will a tool reduce pain caused by that task?
Would adapting a tool reduce your pain?
Design a new tool to reduce the pain!
AT Devices
Assistive Technology for
Carpal Tunnel & Arthritis
 Transplanting
from flats to pots
 Pruning & harvesting
 Hand Tools
 Vibration – steering wheels, power tools
 Tractors
AT Devices
Transplanting – 1000x
AT Devices
Transplanting – 1000x
AT Devices
Transplanting – 1000x
AT Devices
Pruning & Harvesting – 1000x
AT Devices
Pruning & Harvesting – 1000x
AT Devices
Pruning & Harvesting – 1000x
AT Devices
Pruning &
Harvesting
– 1000x
AT Devices
Hand Tools – 1000x
AT Devices
The
“Easy-Grip
Hand Tool”
AT Devices
Right Angle Long-handle Tools
AT Devices
Right Angle
Long-handle
Tool Grips
AT Devices
Tool
Balancer
AT Devices
Vibration – Tractors & Power
Tools
AT Devices
Tractors
AT Devices
Tractors
AT Devices
Tractors
AT Devices
Tractors
Summary

AgrAbility provides direct services to farmers with
injuries, illnesses or conditions of aging.
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No-cost farm assessment and recommendations for
specific solutions based on your condition
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Funding support via Easter Seals Michigan &
Michigan Rehabilitation Services
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Partnership of Easter Seals Michigan, Michigan State
University Extension, Michigan Farm Bureau

Supported by The Andersons, Alpha Gamma Rho, TriTown 4-H, Michigan Sugar, and many donors
Summary
Conclusion Overview
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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.
References
Sources
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American Family Physicians Group
Arthritis Foundation
Carpal Tunnel Assocation
DeRoyal “Carpal Tunnel Syndrome, Arthritis and
Wrist Fractures” (PDF file)
FamilyDoctor Website: Carpal Tunnel Syndrome
National Institute of Neurological Disorders and
Stroke: Carpal Tunnel Syndrome Fact Sheet