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Most people who get carpal tunnel syndrome have jobs or hobbies that involve repetitive motion of the hand, wrist, or arm. I also applies to athletes who perform sports that include repetitive motions such as golf, tennis, and similar sports that put pressure on the wrist.
Cause: Repeating the same hand, wrist, and arm movements hour after hour, day after day is the primary cause of carpal tunnel syndrome. When force is used at the same time, carpal
tunnel syndrome becomes even more likely. The disease develops when the repeated motion inflames the tendons in the wrist. This inflammation puts pressure on the nerve that runs through the carpal tunnel (a passage through the bone and ligament in the wrist).
Incidence: Carpal tunnel syndrome often occurs among workers who have jobs that involve repetitive lifting or finger and wrist motions, and sometimes in athletes that don’t perform proper stretching exercises and irresponsibly exhaust their body. People who work with computers are likely candidates too. Carpal tunnel syndrome also occurs among amateur and professional musicians, people who do needlework or other crafts involving the fingers and wrists, and food-service workers who chop and cut.
Women who are pregnant, are taking birth control pills (oral contraceptives), or are in menopause (the life stage when they stop menstruating) are more prone to get carpal tunnel syndrome. Conditions such as diabetes, thyroid disease, rheumatoid arthritis, and Lyme disease have also been linked to carpal tunnel syndrome. In addition people who weigh more than they should, do not get enough exercise, or have bad posture are at risk.
Symptoms you are likely to notice: Numbness or tingling in the hands, especially at night, is a major symptom. Hands may also become “clumsy:’ Some people feel pain in their hands, wrists, arms, or shoulders.

Symptoms your physician may observe: The physician will ask you to bend back your hand at the wrist to test the flexibility of the wrist. You may need to squeeze a device that measures the strength of the hands and fingers. Another test for the syndrome involves holding the hands together as if praying, but upside down. After a few moments the physician will ask about numbness or tingling. He or she will also tap the hands and arms lightly and ask about tingling sensations at that time. These tests will determine whether the problem is caused by carpal tunnel syndrome. They will also show the seriousness of any damage.
In some cases the physician may do a nerve conduction study, or electromyography. For this test he or she inserts needles at several places on the patient’s arm, and then runs a very low voltage of electricity through the needles. The test shows the location of any nerve damage.
Treatment options: The treatment for carpal tunnel syndrome begins with rest. The patient will need to give up activities that strain the hands and wrists temporarily. Moist heat and cold packs often help to ease the pain. The physician may prescribe anti-inflammatory drugs such as ibuprofen or naproxen for pain relief and to reduce inflammation. If there is a lot of pain and oral anti-inflammatory drugs do not help, the physician may inject cortisone. However, cortisone can cause unwanted side effects. The doctor may recommend sleeping with a wrist splint on the injured wrist. In some cases surgery may be necessary to relieve pressure on the nerve in the carpal tunnel. Most physicians, however, recommend surgery only when other treatments do not help. The physician will probably send the patient to a licensed physical therapist, who will help rebuild weakened muscles and teach stretching exercises designed to make arms and wrists more flexible.
Before returning to the activity that caused the injury, a patient needs to make lifestyle or work changes that will prevent reinjury. If you use a computer, for example, it is important to make sure it is set up correctly and that you are using good keyboarding techniques. It is also important to take frequent breaks.

Stages and progress: The longer carpal tunnel syndrome goes untreated the more extensive the nerve damage will be. The muscles of the shoulders, arms, and hands become weak, and you may develop other repetitive strain injuries.
Prevention and risk factors: Carpal tunnel syndrome is usually caused by rapidly repeated motions. When the wrist is held in an awkward position or force is used during such activities, the likelihood of injury increases.

Four things can be done to reduce the chances of getting carpal tunnel syndrome: (1) Learn how to do repetitive tasks in ways that will not strain the hands, wrists, and arms.

(2) Take frequent breaks when doing repetitive tasks.

(3) Use only as much force as is absolutely necessary to get a job done.

(4) Do stretching exercises to keep muscles flexible before beginning and after finishing a task. If you spend more than about an hour at a task, also do stretching exercises during breaks.

This mysterious condition has been known by many names over the years, including chronic mononucleosis and yuppy flu. In England it is called myalgic encephalitis, while in Japan it is known as natural killer cell syndrome. In the United States chronic fatigue syndrome, or CFS, was first officially defined in 1987. Since then a great deal of research has been done to improve diagnosis (its symptoms have been redefined at least twice since 1987) and treatment.

Cause: Researchers have not yet determined the cause of CFS. There is some evidence that the disease may result from a flaw in the immune system. Another possibility is that CFS may be caused by a virus or a yeast infection or a combination of causes. Or the source could be an infectious agent that has learned to hide from the immune system. Such hiding is likely because CFS symptoms often persist for years, unlike symptoms in ordinary viral diseases, which are either defeated by the immune system in a few weeks or lead to death.
One theory suggests that CFS is linked to low levels of certain hormones. Another idea is that it is a deficiency disease, perhaps of magnesium. New studies also show that the disease may be linked to one kind of low blood pressure.
Clustering of cases seems to occur in families, workplaces, and communities. This has raised fears that CFS is transmissible, although clearly not contagious for most people. Most researchers think that people who have CFS should not donate blood or organs until more is known about the transmission of CFS.

Incidence: Although people of all ages may get CFS, it mostly occurs in those between 22 and 44 years old. Three times as many women as men have the condition. One survey of four urban areas found that 2 to 7% of the population had symptoms that met the official criteria for CFS. According to this study, the most common profile was a white female whose illness had begun about age 30 and who had been experiencing such symptoms for about 7.5 years.

Symptoms you are likely to notice: Not surprisingly, given its official name, the primary symptom of CFS is extreme fatigue or tiredness. This fatigue is so severe that it can interfere with carrying on most usual activities. The feeling of fatigue is also made more intense by exercise, even mild exertion. By the official criteria for CFS from the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, such fatigue must last for six months before being established as chronic fatigue syndrome.
Some people with CFS may also develop a recurring sore throat without a discharge and other symptoms that usually go along with the flu. They may have aches and pains in muscles and joints, but in these cases the joints are not swollen or red. Other symptoms are painful lymph nodes in the armpits and neck, headaches, a slight fever, and chills.
People with CFS may also experience the symptoms of depression. They may become confused and irritable, and find themselves forgetting things. Typically, short-term memory is affected, but other types of memory impairment, such as absentmindedness or inability to recall names, is usually not seen.
Despite the extreme fatigue, people with CFS may also have difficulty sleeping, and when sleep does occur, it may not eliminate fatigue.

Symptoms your physician may observe: Your physician will want to determine the length of time over which you have experienced the symptoms listed above. If these symptoms have lasted for at least six months, he or she will consider CFS a likely cause. The next step will be to eliminate other possible diseases—including tuberculosis, cancer, anemia, diabetes, infection, heart disease, and AIDS—that might lead to these symptoms. In order to eliminate these other diseases, the physician will perform a series of standard medical tests, such as blood tests and X rays.
Treatment options: Just as the cause of CFS has not been determined, no cure has yet been found. In order to make the condition as easy as possible to live with, eat a well-balanced diet, get plenty of rest, and avoid stressful situations and extreme physical exertion. If your symptoms include muscle and joint pains and headaches, you may also take over-the-counter pain relievers. Some people find that avoiding foods with preservatives, dyes, and caffeine alleviates the symptoms.
A recent study has found a link between CFS and a common condition called neurally mediated hypertension that affects the way the body regulates blood pressure. The blood pressure of people with this condition drops greatly after long periods in certain situations, such as after a night’s sleep. If the person gets out of bed too quickly, he or she may get dizzy or faint.
The blood pressure condition is treated by the use of a diet that is high in salt and by blood pressure medications. The study has found that the same treatment can benefit people with CFS; however, the use of this treatment is still experimental.

Stages and progress: While there is no cure for CFS, it sometimes does go away spontaneously. That is, about one- third of the people with the disease find their symptoms disappear after anywhere from six months to two years. Other people have the symptoms decrease substantially, so that the disease no longer is as likely to interfere with their daily lives. However, for some people, the symptoms may recur in full strength periodically over many years.

History: CFS is not a new disease, although it was first officially defined by the Centers for Disease Control and Prevention in 1987. The symptoms have been reported in medical literature for over 100 years. The wide variety of symptoms has made it very difficult to separate it from other ailments. For many years it was thought that this syndrome was caused by the same virus that causes mononucleosis. But not everyone with CFS has been exposed to the virus that causes mononucleosis. Before the CDC sanctioned chronic fatigue syndrome as a specific physical ailment, some physicians had concluded that the syndrome was psychosomatic—caused by the mind instead of a disease of the body. In 1985 two doctors in California, near Lake Tahoe, realized that they had a significant number of patients who experienced similar symptoms of fatigue so severe that it became completely disabling. Their work led to the official definition, and the number of cases seems to have grown dramatically since then.