carpal tunnel syndrome

Carpal Tunnel Syndrome: symptoms, prevention and treatment

When many of us hear of the condition "Carpal Tunnel Syndrome," we may immediately associate it with computer typing. Surprisingly, a 2001 Mayo Clinic study found that working long hours at a computer apparently does NOT increase a person's risk of developing this painful and progressive condition.

It may surprise you even more to learn that the evidence is only weak that connects carpal tunnel syndrome with work or activities involving repetitive or forceful motions (though these sort of motions have been associated other disorders such as bursitis and tendonitis).

Unfortunately, Carpal tunnel syndrome is real. It keeps an affected employee away from work an average of 27 days; that's longer than any other workplace-related injury and illness. Over the employee's lifetime, the cost of lost work and medical bills is estimated to be $30,000. Left untreated, however, carpal tunnel syndrome has the potential to cause permanent nerve and muscle damage to hands and thumbs.

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So, what is carpal tunnel syndrome, what causes it and how can it be prevented or treated?

The carpal tunnel is a narrow space between the carpal bones in your wrist. The median nerve, which controls feeling in your thumb and some fingers, as well as some of the muscles that control the hand, pass through this tiny space.

Carpal tunnel syndrome occurs when this small passageway becomes even tighter, due to inflammation or damage -- thus putting pressure on the nerve.

There are many factors that may contribute to causing Carpal Tunnel Syndrome:

  • Genetics: the carpal tunnel, through which the nerves in the wrist pass, just happens to be smaller in some people.
  • Gender: because the carpal tunnel tends to be smaller in women and, perhaps due to hormonal changes, women are three times more at risk for developing the condition.
  • Age: the condition is found almost exclusively in adults and becomes more common as we get older.
  • Health condition: wrist injury that causes inflammation, health conditions such as breast cancer, diabetes, hypothyroidism, overactive pituitary gland or rheumatoid arthritis, pregnancy or menopause, presence of cyst or tumor in the carpal tunnel. Even high levels of stress may be a contributing factor.
  • Smoking: this can cause a reduction in blood flow to the median nerve.
  • Activity: As mentioned above, some research has found little association between repetitive movement and carpal tunnel syndrome. Other studies, however, show that musicians, golfers, assembly line workers and others whose tasks involve repetitive motion, awkward hand positions and strong gripping are at a higher risk than data entry employees. The most at-risk people appear to be those who operate vibrating power tools or machinery.

Symptoms of carpal tunnel syndrome may include:

  • Initially, one may feel pain, tingling, numbness, a swelling sensation or loss of strength in one or both wrists.
  • The discomfort can progress to affect one or both hands (particularly the palm side) or arms between the hand and elbow. (Interesting is the fact that feeling in the pinky finger is not controlled by the median nerve which passes through the carpal tunnel, so the little finger may not be affected.)
  • In the early stages, symptoms may first appear at night.
  • The pain may come and go.
  • Grip may become weaker.
  • Loss of muscle mass in your hand, especially below your thumb.
  • Doctors have several ways of diagnosing carpal tunnel. One of them being the Tinel test, where tapping or pressure is applied to the nerve in the wrist. This may cause a tingling or electric shock feeling in the fingers for patients with carpal tunnel syndrome.

Prevention and self-treatment of Carpal Tunnel Syndrome:

  • Reduce hand and wrist strain by making sure that equipment is positioned and used properly. Try to maintain a good but relaxed posture.
  • If possible, take a 10-15 minute break every hour.
  • Vary your tasks or switch hands and positions periodically so that you are involving different muscles.
  • Release the "death grip." Avoid tensing muscles by tightly gripping objects unnecessarily.
  • Exercise your hand muscles. Periodically, make a tight grip; then extending the fingers for a few seconds. Bending wrists and hands in the opposite direction of how you normally use them may help to relieve built-up tension. Certain types of yoga poses may also be helpful.
  • Keep hands and arms warm since cold muscles may put you more at-risk.
  • Use your whole hand, not just fingers and thumb to hold objects.
  • Don't sleep on your hands.
  • Ask your provider about a wrist splint. This can relieve pressure and keep your wrist in a good position while you sleep.
  • Losing weight, quitting smoking, reducing alcohol and salt intake, and controlling diabetes and thyroid problems may reduce swelling in your wrist.

You should you call your doctor if:

  • you have tingling, numbness, weakness, or pain in your fingers and hand even after 2 weeks of home treatment.
  • you often have little or no feeling in your fingers and hand.
  • you cannot do simple movements, or you drop things a lot because you cannot hold onto them.
  • you cannot pinch your thumb and first finger together, or you have no thumb strength.
  • your hand muscles look smaller (especially the muscles of the thumb).
  • you have problems at work because of pain in your fingers or hand.

For more information on how to take care of your wrists, or carpal tunnel surgery, go to
http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
http://www.uwhealth.org/health/topic/major/carpal-tunnel-syndrome/hw213308.html#sec-hw213415
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001469/
http://www.womenshealth.gov/publications/our-publications/fact-sheet/carpal-tunnel-syndrome.cfm
http://www.ccohs.ca/oshanswers/diseases/carpal.html

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