Stewart, Alice M., and Goda, D. F. (1970).Brit. J. industr. Med.,27, 19-27. Vibration syndrome. Raynaud's phenomenon, or the finger blanching of men who work with vibrating tools, is undoubtedly due to vasospasm. Nevertheless the abnormal element in the situation is not a series of traumatized nerve endings but a deposition of callus under the palmar surfaces of fingers and thumbs. This deposition is a late consequence of the most distinctive, but not necessarily the most painful, of the numerous effects incurred as a result of the tool speed being completely out of the control of the operator and of the tool/component rebound being only partially under his control. The replacement of soft finger pads by rigid callus is also the only consequence of hard manual work to show how necessary it is for a structure like a finger–which is largely composed of bones, joints, tendons, and skin–to have a reservoir, the equivalent of a blood-filled sponge, between every joint to accommodate any sudden reduction in blood volume, or indeed any sudden increase in the volume of blood held in the arteries and veins relative to the amount held in the capillaries.
It is still a moot point whether users of vibrating tools have more arm complaints of a serious nature than other manual workers. They do, however, have a multiplicity of aches and pains, ascribable to various causes including tool speed and tool/component rebound, which are in toto very sensitive to such things as blunt impacts, hard components, heavy tools, awkward jobs, and inept handling of tools, whether the ineptness be due to inexperience or to advancing age. Users of vibrating tools have more pain in the hands and wrists than in the elbows and shoulders, but the pain tends to persist longer in the latter sites than in the former sites.
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