What Is It?
Carpal Tunnel Syndrome (CTS) is a common disorder of the wrist and hand. CTS most recognizable features are pain and numbness on the palm side of the wrist and hand. Sufferers may also say their fingers feel swollen. When the condition is more severe, weakness can result causing considerable troubles with simple everyday activities such as brushing your teeth, gripping a glass or cup or even dressing in the morning. Occasionally the pain may travel up the arm. Symptoms are commonly worse in the morning.
What Is Going On?
These symptoms are a result of a nerve(median) becoming compressed as it passes through an opening in the wrist. This compression is most commonly caused by the other structures that are also in this small tunnel. These are the bones of the wrist and the tendons(muscles) that move the fingers and thumb. When these structures become damaged or inflamed, they can put pressure or irritate the median nerve. This nerve starts in the neck and travels down the arm into the hand. Because of this, poor posture or injuries to either the neck or shoulder and upper arm can be linked to this disorder. Other conditions can cause someone to be more prone to developing CTS including pregnancy, arthritis, an old fracture at the wrist, or overuse in repetitive sports/jobs.
“OTHER CONDITIONS CAN CAUSE SOMEONE TO BE MORE PRONE TO DEVELOPING CARPAL TUNNEL SYNDROME, INCLUDING PREGNANCY, ARTHRITIS, AN OLD FRACTURE AT THE WRIST, OR OVERUSE IN REPETITIVE SPORTS/JOBS”
What Can Be Done?
Like almost all conditions and disorders the first thing a person can do is be preventive. This starts with taking precautionary measures, especially if you are in a higher risk group as previously discussed. Prevention starts with stretching and being aware of improper posture and form when performing repetitive tasks in either work or play. You want to avoid prolonged positions where your wrist is bent forwards or backward. If this is impossible, take frequent breaks to reduce the stress on your wrist. If you use tools for work or racquets for sport, use large handles to loosen your grip and minimize the amount of force your muscles need to generate.
If you are already afflicted with this disorder, some of these same tactics can be useful but you are best served to be assessed by a healthcare practitioner to determine the severity as certain stretches and exercises can actually make the condition worse. When you are already experiencing pain, priority is to try and reduce the irritating action to allow healing and an ability to fix the problem. If unable to do this, treatment can take longer than normal. Treatment of the disorder is aimed at decreasing pain and inflammation in the carpal tunnel. This can be done by icing, taking medications or using treatments like electrotherapies, acupuncture, massage therapy to reduce symptoms and heal faster. If symptoms are severe, a splint can be wornat night to keep your wrist neutral and reduce stress. If someone has symptoms that are advanced and do not respond to treatment attempts, the last resort is a surgical procedure called a carpal tunnel release where the surgeon will cut the ligament covering the tunnel to release the pressure. As with all surgeries, there are inherent risks of continual symptoms and should only be done as a last resort as it is irreversible!
- Stretching and Exercises
- Massage Therapy
- Electrotherapy and Ice/Heat
- Wrist Splint/Brace
- Medications (Advil/Ibuprofen)
- Chiropractic to improve posture
- Last Resort – Surgical Release
What Can I Do At Work?
One of the major causes of developing carpal tunnel syndrome is having poor posture at your workstation. Having an ergonomic assessment done can be helpful but here are a few simple tips to help alleviate stress on your body:
- Follow the 90-90 rule! Position your elbows, hips, knees, and ankles in a 90degree position for optimal alignment.
- Position the top of your computer screen at eye level to prevent eye and neck strain
- Set the keyboard at a closer distance from you to avoid unnecessary trouble in reaching the keyboard.
- Place the keyboard in such a manner so that your arms should be parallel to your thighs.
- Keep your wrists straight, relaxed and in a neutral position in line with your forearm. When typing, the best practice is to keep your wrists floating rather than resting them on a wrist pad. But if you choose to use a wrist pad, rest the heels of your palms and not your palms. If possible, use the wrist pad between typing movements and not during typing.
- Gently press the keys and do not hold them down for extended periods.
- Perform back, shoulder, and wrist stretches and shoulder shrugs at least every hour to prevent body strain and stress