The hand-arm vibration syndrome causes changes in sensory perception which can lead to permanent numbness of fingers, muscle weakness and, in some cases, bouts of white finger. It is caused by working with vibrating tools. It would be unusual for you to develop hand-arm vibration syndrome unless you had used vibrating tools for at least ten years. If you stop working with vibrating tools it may prevent mild symptoms from getting worse.
Hand-arm vibration syndrome (HAVS) causes symptoms in fingers, hands and arms, as a result of using vibrating tools. It used to be called vibration white finger. The name was changed to HAVS, as other symptoms may occur in addition to white fingers.
HAVS is caused by repeated and frequent use of hand-held vibrating tools - for example, power drills, chainsaws, pneumatic drills, etc. It may also be caused by holding or working with machinery that vibrates. It is not clear how vibration causes the condition. It is probably due to slight but repeated injury to the small nerves and blood vessels in the fingers. Over time these may gradually lose some of their function and cause symptoms. Possibly, up to 1 in 10 people who work regularly with vibrating tools may develop HAVS.
Nerves are affected initially, leading to changes in sensation. This can then be followed by Raynaud's phenomenon resulting from changes in the blood vessels and resulting in a white finger. These changes also lead to muscular aches and pains.
Numbness (loss of feeling) and/or tingling (pins and needles) in one or more fingers are usually the early features. It may be mild and just affect the tips of the finger(s) and come and go. In severe cases a permanent numbness may extend along affected fingers. This may cause clumsiness and difficulty in doing fine tasks - for example, it may become difficult to fasten buttons, handle coins, screws, nails, threads, etc. In many people the severity of nerve symptoms is somewhere in between these two extremes. Sometimes one finger is badly affected with other fingers only mildly affected.
Raynaud's phenomenon comes in bouts or attacks that are triggered by cold weather or touching a cold object. A typical bout of Raynaud's phenomenon is as follows:
Some people do not have the full classic colour changes, but still develop bouts of uncomfortable, pale, cold fingers. The duration of each bout of symptoms can last from minutes to hours. The amount of pain or discomfort varies between people. Symptoms usually go after each bout, but one or more bluish fingers may persist in severe cases.
(Vibrating tools are just one cause of Raynaud's phenomenon. There are other causes too. See separate leaflet called Raynaud's Phenomenon.)
Minor damage to the muscles, joints and bones may cause aches and pains in the hands and lower arm. The strength of your grip may be weakened.
You may have some numbness or tingling which comes and goes. This may be followed by bouts of Raynaud's phenomenon on cold, wet, and windy days affecting the ends of one or more fingers. Symptoms may remain mild, but can progress if you continue to work with vibrating tools. Vibration itself rarely triggers a bout of Raynaud's phenomenon. It is cold weather or cold conditions that trigger Raynaud's phenomenon.
As the condition develops, numbness becomes permanent. This leads to muscle weakness and wasting. Bouts of Raynaud's phenomenon will become more frequent (and also in the summer) although usually only if your hands are wet.
In some cases the symptoms develop months or years after finishing working with vibrating tools.
Your description of your symptoms and the fact that you have worked for a long time with vibrating tools may be enough to clinch the diagnosis. However, tests are sometimes needed, especially if you are involved in a compensation claim. The tests may include checking your grip strength, your ability to perform fine hand movements and response of your fingers to cold.
The following steps are thought to help prevent HAVS in workers who use vibrating tools:
If you suspect that you have symptoms of HAVS then see your doctor. Also, report your concerns to your employer, works nurse, or work doctor (if there is one), and, where relevant, to your union representative. It is your employer's responsibility to make sure that you work in a safe and acceptable working environment.
This may prevent symptoms from getting worse. Bouts of Raynaud's phenomenon may ease off if symptoms are mild and you stop working with vibrating tools. However, it is not clear whether nerve symptoms can improve once they have developed. If possible, you should consider a change of job.
In addition, general advice is similar to that given to people who have Raynaud's phenomenon, whatever the cause. This aims to prevent the blood vessels going into spasm and causing the symptoms of Raynaud's phenomenon. The following are usually advised:
A medicine called nifedipine may be advised if symptoms of Raynaud's phenomenon are severe. It works by opening up (dilating) the small blood vessels. Some people take nifedipine regularly, each day, to prevent symptoms. Some people take nifedipine just during the winter, or just during cold weather spells. If you are prescribed nifedipine, read the leaflet that comes in the medicine packet for a full list of possible side-effects and cautions.
Various other medicines may be tried if nifedipine is not helpful, or causes side-effects.
HAVS does sometimes get better if you stop using vibrating tools early enough. However, if you have severe symptoms and carry on working you may find they persist, even when you do eventually stop.
Employers are aware of the risks of HAVS and this is usually disclosed to employees prior to starting work. To read more, see the Department for Work and Pensions Industrial Injuries Disablement benefit. Also listed below are other organisations which might be helpful:
TUC information about Vibration White Finger:
Health and Safety Executive information on HAVS:
Hand arm vibration; HSE 2009; Advice for Employers: