Milking-related carpal tunnel syndrome

Abstract

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most entrapment syndrome due to compression of the median nerve through the wrist. The aim of our study is to investigate the relationship between manual milking and CTS. METHODS: From 2015 april to september, 805 had diagnosis of carpal tunnel syndrome (CTS) in Electromyography laboratory; from these 35 cases that were associated with manual milking were included in our study. Risk factors associated with CTS such as diabetes mellitus, thyroid disfunction, acromegaly, rheumatoid arthritis and pregnancy are excluded from study. The relationship between duration of manual milking and severity of CTS was investigated. RESULTS: All of the patients were female and the mean age was 54.2+-12,35. There was a statistically significant difference between severity of CTS and totally milking time, respectively mild-moderate (p<0,001), mild-severe (p<0,001) and moderate-severe (p=0,001). Negative correlation was detected between manual milking time and sensory nerve amplitudes (r=-0,465 p<0.001), sensory nerve conduction velocities (r= -0,541 p<0,001). Positive correlation between motor distal latency and manual milking time (r=0,641,p<0,001); and negative correlation between manual milking time and compound muscle action potential ( r=-0,506 p<0,001) and motor nerve conduction velocity (r=-0,313 p=0,011) was detected. DISCUSSION AND CONCLUSION: Manual milking may represent a risk factor for CTS mainly in areas where milking machines are not in common use. The severity of CTS may increase due to the cumulative effect of repetetive trauma in manual milking.

Keywords

• manual milking
• carpal tunnel syndrome
• risk factor
• entrapment neuropathy