Carpal tunnel syndromeShould patients presenting with obvious symptoms of carpal tunnel syndrome (CTS) have a nerve conduction study done to confirm the diagnosis? Not necessarily, according to scientific evidence presented in the newly published 3rd edition of the American College of Occupational and Environmental Medicine’s (ACOEM’s)Occupational Medicine Practice Guidelines, Hand, Wrist, and Forearm Disorders chapter.

This treatment evidence and nearly 350 other medical recommendations dealing with more than 30 distinct disorders are contained in the chapter which is now available for free as an iTunes app. The app is available at

“It is abundantly clear from the evidence that the majority of CTS patients do not require a nerve conduction study,” said Kurt Hegmann, MD, MPH, Editor-in-Chief. The 3rd edition represents the completion of years of effort by ACOEM, its primary research partner, the University of Utah’s Rocky Mountain Center for Occupational and Environmental Health, and scores of volunteer expert panelists, reviewers, and other contributors.

Other evidence-based findings in this chapter include recommendations on human and animal bites and laceration management, arthritis, crush injuries, scaphoid fracture, triangular fibrocartilage complex tears, and post-surgical rehabilitation.

The Hand, Wrist, and Forearm Disorders chapter is part of the 3rd edition 4-volume set which includes more than 2,500 evidence-based recommendations and 12,000 references in 4,000 pages. The gold standard in effective treatment of occupational and musculoskeletal injuries and illnesses, the ACOEM Practice Guidelines is also available in an on-line version, APG-I, which allows subscribers to browse content and search via text and keyword, and ICD-9 codes. ACOEM’s guidelines development platform also supports other legislative-based guidelines including New York and California, allowing users additional access to the most current evidence-based guidelines and is the basis for the just-released Montana Utilization and Treatment Guidelines.

“The combination of ACOEM’s comprehensive evidence-based guidelines and development technology is unique for a specialty society and allows many pathways for stakeholder support, including through iTunes, and we are looking forward to the subsequent release of the entire 3rd edition as an iTunes subscription,” said Chris Wolfkiel, PhD, ACOEM’s Director of Practice Guidelines.

With the release of the 3rd edition, ACOEM has completed its transition to an enhanced evidence-based methodology, which includes original systematic reviews, evidence tables, and a completely independent multi-specialty panel development process. ACOEM is a signatory to the Council on Medical Specialty Societies Code for Interactions with Industry and its guideline development process conforms to standards called for by the Institute of Medicine.

First published in 1997, Occupational Medicine Practice Guidelines has become the leading source in the United States for evidence-based guidelines used by occupational physicians and other health care professionals. ACOEM’s Practice Guidelines are also used by insurers, employers, attorneys, and other individuals and organizations involved in health and safety in the workplace.

To learn more about APG-I and/or to order the ACOEM Occupational Medicine Practice Guidelines, visit, or call 847-818-1800.