Hand–arm vibration syndrome (HAVS)

The hand-arm vibration syndrome (HAVS) is a collection of disorders caused by hand-transmitted vibration: 

• Vascular disorders, known as vibration-induced white finger, VWF (or secondary Raynaud’s phenomenon): episodic finger blanching usually provoked by cold.
• Neurological disorders: numbness, tingling, impaired tactile sensitivity.
• Musculoskeletal disorders: impaired dexterity, reduced grip strength, etc.

Diagnosis of HAVS:

• History of symptoms

• History of vibration exposure

• Various clinical tests to exclude other disorders

• Objective measurement of vascular, neurological and musculoskeletal function:

Vascular tests:

1. Finger systolic blood pressures
2. Rewarming time after cold provocation

Neurological tests:

1. Clinical tactile threshold tests
2. Thermal thresholds
3. Vibrotactile thresholds
4. Nerve conductive velocity

Musculoskeletal function:

1. Finger dexterity
2. Hand grip force