title: Factors affecting finger and hand pain in workers with HAVS.
abstract: BACKGROUND
  Pain and its management are important aspects of hand-arm vibration syndrome (HAVS).
  
  
  OBJECTIVE
  To determine the factors associated with finger and hand pain in workers with HAVS and, specifically, to assess the impact of several neurological variables as well as the vascular component of HAVS, grip strength and age.
  
  
  METHODS
  We assessed men with HAVS at a hospital occupational medicine clinic over 2 years. Subjects scored finger and hand pain separately using the Borg Scale (0-10). The possible predictors we evaluated included the Stockholm Neurological Scale (SNS) and Stockholm Vascular Scale (SVS) stages, current perception threshold (CPT), carpal tunnel syndrome (CTS), ulnar neuropathy, grip strength and age. We carried out nerve conduction testing to confirm the presence of CTS and ulnar neuropathy and measured CPT in the fingers at 2000 Hz, 250 Hz and 5 Hz corresponding to A-beta (large myelinated), A-delta (small myelinated) and C (unmyelinated) fibres, respectively. We calculated Spearman rank correlations to examine the relation between finger and hand pain and possible predictor variables.
  
  
  RESULTS
  Among the 134 subjects, the median (25th-75th percentile) pain scores were 6 (4-8) for the fingers and 5 (1-7) for the hands. We found statistically significant correlations with finger pain for the SVS stage (r = 0.239; P < 0.01) and CTS (r = 0.184; P < 0.05). The only statistically significant correlation identified for hand pain was a negative correlation with grip strength (r = -0.185; P < 0.05).
  
  
  CONCLUSIONS
  Management of finger and hand pain in HAVS should focus on the correlates we have identified.
authors.affiliation: Department of Occupational and Environmental Health, St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada, houser@smh.toronto.on.ca.
authors.forename: R
authors.initials: R
authors.lastname: House
authors.affiliation: Engineering and Control Technology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA.
authors.forename: K
authors.initials: K
authors.lastname: Krajnak
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 0W3, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Jiang
mesh_terms: D000328:Adult; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006225:Hand / Q000503:physiopathology; D053421:Hand-Arm Vibration Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010147:Pain Measurement / Q000379:methods*; D014732:Vibration / Q000009:adverse effects
keywords: Carpal tunnel syndrome; hand–arm vibration syndrome; pain.