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Trends in the prevalence, incidence and surgical management of carpal tunnel syndrome between 1993 and 2013: an observational analysis of UK primary care records
  1. Claire L Burton,
  2. Ying Chen,
  3. Linda S Chesterton,
  4. Danielle A van der Windt
  1. Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
  1. Correspondence to Dr Claire L Burton; c.burton{at}


Objectives To describe the prevalence, incidence and surgical management of carpal tunnel syndrome (CTS), between 1993 and 2013, as recorded in the Clinical Practice Research Datalink (CPRD).

Design We completed a series of cross-sectional epidemiological analyses to observe trends over time.

Setting Primary care data collected between 1993 and 2013, stored in the CPRD.

Population Individuals aged ≥18 years were selected. Prevalent and incident episodes of CTS and episodes of surgical intervention were identified using a list of preidentified Read codes.

Analysis We defined incident episodes as those with no preceding diagnostic code for CTS in the past 2 years of data. Episodes of surgery were expressed as a percentage of the prevalent population during the same calendar year. Joinpoint regression was used to determine significant changes in the underlying trend.

Results The prevalence of CTS increased over the study period, with a particular incline between 2000 and 2004 (annual percentage change 7.81). The female-to-male prevalence ratio reduced over time from 2.74 in 1993 to 1.93 in 2013. The median age of females and males with CTS were noted to increase from 49 and 53 years, respectively in 1993 to 54 and 59 years, respectively in 2013. Incidence was also noted to increase over time. After an initial increase between 1993 and 2007, the percentage of prevalent patients with a coded surgical episode began to decrease after 2007 to 27.41% in 2013 (annual percentage change −1.7).

Conclusion This study has demonstrated that the prevalence and incidence of CTS increased over the study period between 1993 and 2013. Rates of surgery for CTS also increased over the study period; however after 2007, the per cent of patients receiving surgery showed a statistically significant decline back to the rate seen in 2004.

  • primary care
  • surgery
  • musculoskeletal disorders

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  • Contributors CB, LC, YC and DAvdW contributed to the initial draft and subsequent revisions. CB is the guarantor of the paper. All authors had full access to all of the data and can take responsibility for the integrity of the data and the accuracy of the data analysis. CB affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.

  • Funding CB is funded by the National Institute of Health Research School for Primary Care (NIHR SPCR). DAvdW is a member of PROGRESS Medical Research Council Prognosis Research Strategy (PROGRESS) Partnership (G0902393/99558).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of health. No other relationships or activities that could appear to have influenced the submitted work.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement To ensure patient privacy and confidentiality, data from the CPRD cannot be shared. Therefore, no additional data are available.

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