Can poor heart health increase risk of carpal tunnel syndrome?

For the study, the researchers analyzed healthcare data from 1,224 workers in fields including manufacturing, healthcare, office jobs, and food processing. Participants were 42 years old on average, and 66% were female.

Data included physical examinations, structured interviews, anthropometric measurements, and nerve conduction studies that assessed for four common musculoskeletal conditions:

• CTS: pain in the wrist from repetitive grasping movements with the hands
• Rotator cuff tendinopathy: pain and weakness when moving the shoulder often caused by repetitive overhead activities such as throwing, raking, or washing cars
• Lateral epicondylopathy or ‘tennis elbow: pain, burning, or aching along the outside of the forearm and elbow that occurs when the forearm muscles become damaged from overuse
• Medial epicondylopathy or ‘golfer’s elbow’: pain in the inside of the elbow from overuse of forearm muscles

Other data included individualized measurements of job-related physical factors and questionnaires assessing demographic variables such as medical conditions, hobbies, and exercise habits.

The researchers also assessed participants’ cardiovascular risk from variables including:

• Age
• Tobacco use
• Diabetes
• Treated and untreated hypertension

Cardiovascular risk scores did not include cholesterol or BMI.

Participants were followed for the development of musculoskeletal symptoms on a monthly basis for nine years.

Ultimately, the researchers found that participants at a 15% higher than average risk of cardiovascular disease were four times more likely to develop one or musculoskeletal disorder than those with lower risk.

The same participants were also 17 times more likely to develop four or more musculoskeletal disorders than those with lower risk.

MNT asked Dr. Chaudhari why increased cardiovascular risk may increase the risk of musculoskeletal disorders. He said:

“This could be multifactorial. For example, increased cardiovascular diseases have a direct correlation with increased inflammation within the body, which itself can provoke musculoskeletal injuries or inflammation. Also, prolonged physical stress, suboptimal working conditions and neglect can lead to both groups of disorders.”

MNT also spoke with Dr. Jonathan Fialkow, a cardiologist at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, not involved in the study, about the link.

“Perhaps those with these common musculoskeletal disorders also may have less physical fitness and poorer diets which may also cause increased cardiac risk factors. Maybe they are more likely to get musculoskeletal issues due to lack of activity, or, conversely, they have [musculoskeletal] disorders so are less physically active,” he noted.

M. Ramin Modabber, an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, California, who was not involved in the study, told MNT that better cardiovascular function leads to better oxygen and growth factors as well as healing capacity that help the body repair when under stress.

“A discussion I have with patients on a weekly basis is to liken their tissues to the tires on their car—[except] that your tires don’t have a ‘self-healing’ mechanism. Our bodies have degenerative processes [however] we also have the ability to heal these processes if they occur at a rate that [our bodies can keep up with].”

“It makes perfect sense that if we compromise the healing side of this equation, it puts us more at risk for classic middle-age and late-middle-age conditions of wear and tear like rotator cuff tendonitis, tennis elbow, golfer’s elbow, etc.”

Dr. Fialkow noted that the findings point toward a correlation and not causation. It remains unknown whether increased cardiovascular risk increases musculoskeletal risk or if they both stem from another process, such as inflammation.

Dr. Heather Shenkman, Interventional Cardiologist and Formulator at 1MD Nutrition, not involved in the study, also told MNT:

“One major limitation is that the participants were limited to only a few sectors of the workforce from 17 different facilities. Construction, for example, a job that involves physical strenuous activity, was not a job that was included in the study.

“Knowing that cardiovascular risk factors increase the chance of having musculoskeletal problems, companies may be incentivized to focus more on the cardiovascular health of their employees,” noted Dr. Shenkman.

Dr. Fialkow, meanwhile, stressed the importance of regular check-ups.

“Perhaps patients with [muskuloskeletal] conditions should have cardiac risk assessments done with opportunities to intervene earlier in the course of their disease in hopes of preventing heart attacks, strokes, and cardiovascular deaths,” he said.

Dr. Modabber noted, however, that musculoskeletal conditions might not always arise from poor cardiovascular health.

He explained that physically active and healthy patients could also be susceptible to musculoskeletal issues if they demand more from their tissues than their healing capacity can manage—especially as age increases.