Objective: Workers exposed to vibrating tools may develop hand-arm vibration syndrome (HAVS). We
assessed the somatosensory phenotype using quantitative sensory testing (QST) in comparison to electrophysiology
to characterize (1) the most sensitive QST parameter for detecting sensory loss, (2) the correlation
of QST and electrophysiology, and (3) the frequency of a carpal tunnel syndrome (CTS) in HAVS.
Methods: QST, cold provocation tests, fine motor skills, and median nerve neurography were used. QST
included thermal and mechanical detection and pain thresholds.
Results: Thirty-two patients were examined (54 ± 11 years, 91% men) at the more affected hand compared
to 16 matched controls. Vibration detection threshold was the most sensitive parameter to detect
sensory loss that was more pronounced in the sensitivity range of Pacinian (150 Hz, x12) than Meissner’s
corpuscles (20 Hz, x3). QST (84% abnormal) was more sensitive to detect neural dysfunction than conventional
electrophysiology (37% abnormal). Motor (34%) and sensory neurography (25%) were abnormal in
HAVS. CTS frequency was not increased (9.4%).
Conclusion: Findings are consistent with a mechanically-induced, distally pronounced motor and sensory
neuropathy independent of CTS.
Significance: HAVS involves a neuropathy predominantly affecting large fibers with a sensory damage
related to resonance frequencies of vibrating tools.