Healthcare Utilization

 
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VIB.B.1

Lead Author(s): 

Jonathan S. Kirschner, MD, RMSK
Se Won Lee, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Carpal tunnel syndrome is the most common reason for electrodiagnostic test (EDx) referral.1

Conservative management includes activity modification, wrist braces, occupational therapy, and ultrasound guided steroid injections, . Carpal tunnel release to decompress the entrapped nerve is the primary surgical treatment and is commonly done if symptoms persist despite conservative management. The cost of treatment varies widely depending on the type of surgery, surgery setting, and amount of occupational therapy or lost work. Surgery is typically performed in an outpatient setting, and can be done open, with a camera or with a small incision under ultrasound. Potential complications include scarring, recurrent symptoms or nerve damage, although surgery is typically successful after appropriate diagnostic workup and conservative treatment.

Patients with radiating neck and back pain and neurologic deficits often require diagnostic studies such as MRIs and EDx to confirm the clinical impression, to investigate the underlying cause, and to determine severity. Although most radiculopathies respond to conservative management (oral pain medication, physical therapy, image guided epidural steroid injections), some patients require surgical treatment to decompress the nerve root. 

Demographics          

During 2013, there were more than 14.8 million healthcare visits made that included a diagnosis of focal neuropathy, representing nearly 1 in 20 persons in the US. Nearly all were adults over the age of 18, with most age 45 or over. Females were more likely to have a healthcare visit for focal neuropathy than males (55% of visits versus 45%), as were non-Hispanic whites. Non-Hispanic others accounted for less than 1% of focal neuropathy healthcare visits. Visits by geographic region were representative of the population. (Reference Table T6B.1.1 PDF CSV; Table 6B.1.2 PDF CSV; Table 6B.1.3 PDF CSV; and Table 6B.1.4 PDF CSV)

Healthcare Visits                

Slightly more than 1.2 in 100 health care visits in 2013 had a focal neuropathy diagnosis. Most of these visits (84%) were to a physician’s office, where the rate of focal neuropathy diagnoses was nearly 1.4% of all visits. Only 3% of the total health care visits with a focal neuropathy diagnosis were hospital discharges, yet this accounted for 427,100 discharges. A diagnosis of root neuropathy was made in 3 out of 4 diagnoses. (Reference Table 6B.1.5 PDF CSV) (G6B.B.1.2)

 

  • 1. Basiri K, Katirji B. Practical approach to electrodiagnosis of the carpal tunnel syndrome: A review. Adv Biomed Res 2015;4:50.

Edition: 

  • Fourth Edition

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