Occupation classification predicts return to work after carpal tunnel decompression

Abstract

Abstract Background The relationship between hand function, employment status and return to work (RTW) after carpal tunnel decompression (CTD) is unclear. Aims To investigate predictors of RTW following CTD. Methods We prospectively collected pre-operative and 1-year post-operative outcomes and RTW data for all patients undergoing CTD at one centre between 29 May 2014 and 29 May 2017. We used the Standard Occupation Classification 2010. Results Pre- and post-operative results were available for 469 (79%) of the 597 patients who had CTD surgery. Pre-operatively, 219 (47%) were employed, 216 (46%) were retired, 26 (6%) were not working due to long-term illness and eight (2%) were unemployed. Complete data sets were available for 178 (81%) of the 219 employed patients, of whom 161 (90%) were able to RTW. Of the rest, five (3%) had changed jobs and 12 (7%) were unable to work. Median RTW time was 4 weeks (interquartile range [IQR] 2–6 weeks). Significantly more patients undertaking manual labour were unable to RTW (15% versus 5%; P < 0.05). There was no significant difference in mean number of weeks absent between manual (5.7; 95% confidence interval [CI] 4.9–6.5) and non-manual workers (6.2; 95% CI 4.8–7.6) (P > 0.05). Median pre-operative (difference 15.9; 95% CI 4.5–25) and post-operative (difference 43.2; 95% CI 13.6–43.2) hand function scores were significantly worse in patients who did not RTW (P < 0.05). Conclusions Most patients can RTW within 1 year of CTD. Failure to RTW is more likely in manual workers and patients with poorer pre-operative hand function.