Vibration Damage to the Hand: Clinical Presentation, Prognosis and Length and Severity of Vibration Required

Author(s): Friden J.

Source: J Hand Surg 26B: 471-474, 2001


Hand-Arm Vibration Syndrome (HAVS) refers to a variety of vascular and neuromuscular symptoms developing after exposure to vibratory tools.  Symptoms include hand pain and paresthesias, grip weakness, digital blanching, cold intolerance, and trophic skin lesions of the fingers.  The syndrome may mimic or occur concomitantly with carpal tunnel syndrome, cubital tunnel syndrome, primary Raynaud’s phenomenon, a connective tissue disease, or an immunologic disorder.

HAVS is a diagnosis of exclusion.  Electrodiagnostic testing is often unrevealing but may be helpful to rule out a compressive neuropathy or other neurological condition.  The syndrome is reversible in early stages with an emphasis on limiting exposure to hand-held vibrating tools.  Other treatment measures include use of padded gloves, cessation of smoking, and oral calcium channel blocking agents.  Resolution of symptoms is unusual in more severe cases.  Evidence suggests that there may be a cumulative effect of vibration on neurovascular elements (e.g., perineural fibrosis). 

Related Links
Journal of Hand Surgery