Distal pain and carpal tunnel syndrome diagnosis among cashiers: a longitudinal study

Characteristics of Traditional Chinese Medicine Use for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder and an occupational disease caused by repeated exercise or overuse of the hand. We investigated the characteristics of traditional Chinese medicine (TCM) use by practitioners in CTS patients, including demographic variables, socioeconomic status, previous medical conditions, health care use, and hospital characteristics for TCM health care. This cross-sectional study identified 25,965 patients newly diagnosed with CTS based on the first medical diagnosis recorded between 1999 and 2013 in the nationwide representative insurance database of Taiwan. The date of initial CTS diagnosis in outpatient data was defined as the index date, and four patients were excluded because of missing gender-related information. Patients who used TCM care as the first option at their diagnosis were classified as TCM users (n = 677; 2.61%), and all others were TCM non-users (n = 25,288; 97.4%). In the all variables-adjusted model, female patients had an adjusted odds ratio (OR; 95% CI) of TCM use of 1.35 (1.11-1.66). National Health Insurance (NHI) registration was associated with higher odds ratios of TCM use in central, southern, and eastern Taiwan than in northern Taiwan (ORs = 1.43, 1.86, and 1.82, respectively). NHI registration was associated with higher odds ratios of TCM use in rural cities than in urban cities (OR (95% CI) = 1.33 (1.02-1.72)). The TCM group had a 20% less likelihood of exhibiting symptoms, signs, and ill-defined conditions and injury and poisoning. The TCM group had a 56% lower likelihood of having diseases of the musculoskeletal system and connective tissue. Multi-level model outcomes were similar to the results of the all variables-adjusted model, except for the NHI registration outcome in rural and urban cities (OR [95% CI] = 1.33 [0.98-1.81]). Significant associations between the number of TCM visits and TCM use were observed in all logistic regression models. The study presented key demographic characteristics, health care use, and medical conditions associated with TCM use for CTS. Previous experience of TCM use may affect the use of TCM for CTS treatment. This information provides a reference for the allocations of relevant medical resources and health care providers.