Association of Neighborhood Socioeconomic Status With Time to Consultation and Surgery for Carpal Tunnel Syndrome.

PURPOSE: Carpal tunnel syndrome (CTS) accounts for substantial disability. Previous CTS studies have conflicting findings. Some studies at the ZIP-code level show that patients from socioeconomically disadvantaged communities present with worse function and face inequities in accessing care. Conversely, other studies using area deprivation index (ADI) demonstrated no differences in delays to care. Existing literature lacks evaluation of earlier stages in the clinical pathway using higher geographic granularity, which we aim to contribute. Specifically, we aim to answer: (1) is lower census tract-level (CT-level) socioeconomic status (SES) associated with longer delays from symptom onset to orthopedic hand-specialty consultation, and (2) is lower CT-level SES associated with longer delays from symptom onset to carpal tunnel release surgery?

METHODS: Retrospective chart review identified 276 patients who underwent carpal tunnel release (2022-2025). Time from symptom onset to consultation and surgery was linked to ADI and social vulnerability index, obtained from patient addresses. Linear regression tested associations between ADI, social vulnerability index and American community survey CT-level variables and time to consultation and surgery.

RESULTS: Median time from symptom onset to specialist consultation was 720.5 days, and surgery, 970.0 days, reflecting wide variability in patient-reported symptom chronicity. Area deprivation index was not associated with time to consultation or surgery. Adjusted models yielded similar findings, with confidence intervals excluding clinically meaningful delays (>6 months).

CONCLUSIONS: Neighborhood deprivation was not consistently associated with clinically meaningful delays to consultation or surgery, suggesting no detectable clinically meaningful disparity across SES strata.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.