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.
