A Modern Disorder of the Workplace

Carpal tunnel syndrome is a problem of our modern times. From computer engineers to Internet surfers to fitness buffs, many of us are involved in activities that can put a strain on our wrists and hands, leading to the tingling and numbness that are the early warning signs of this syndrome.

It used to be that women were at higher risk for carpal tunnel syndrome, but recent studies have shown that more men are suffering from this debilitating condition. If you are in an occupation where you use your hands a lot, or are involved in a sport or activity that uses repetitive motion of the hands and wrists, you may be at risk. The key is knowing how to prevent this condition from occurring without sacrificing the activities you are involved in or putting in for a career change.

Carpal tunnel syndrome begins with compressions of the median nerve in the wrist. This nerve runs through the arm and the wrist, providing movement and sensation to the thumb and the first three fingers. The carpal tunnel is a narrow passage through the bones of the wrist where the median nerve converges with nine tendons, an artery and a vein.

Carpal tunnel syndrome occurs when the tendons passing through the carpal tunnel become inflamed and swell, thereby creating pressure within the carpal tunnel. As the pressure increases, the median nerve is squeezed, often to the point at which the nerve can no longer function properly. This can produce sharp pain and numbness in the hand, wrist and forearm.

Radiating pain and numbness are usually the first symptoms of carpal tunnel syndrome, following the line of the median nerve. Thus, the pain and numbness you feel may not be isolated to the hand and wrist; it may also spread to the upper arm, shoulder and sometimes the neck. As the condition progresses without treatment, you may experience weakness in certain thumb muscles, making it impossible for you to touch the tips of each finger with your thumb. It may also be difficult, or impossible, to grasp objects.

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There are many causes of carpal tunnel syndrome, but it is mainly due to overuse or repetitive movement of the wrist. Therefore, prevention of carpal tunnel syndrome involves knowledge of simple ergonomics, or body mechanics.

When typing on a computer keyboard, try not to rest your wrists on the edge of the desk. Instead, keep your arms parallel to the floor and your wrists in a neutral position. Wrist pads are available in most computer or office supply stores that will help you maintain proper positioning of the hands and wrists. It is also important to rest your hands periodically when typing. Take short breaks by shaking out your hands, stretching your arms, shoulders and neck, and getting up from your desk and walking around.

When engaging in fitness activities, it is important to use proper form as well as equipment that will protect your wrists and hands. For example, when weightlifting, do not wrap your wrists too tightly with the weightlifting gloves, and try to keep your wrists straight. When playing sports such as tennis or golf, be aware of your wrist position. It may be a good idea to seek medical attention if you feel any tingling or pain in your hands or wrists, although this discomfort doesn’t necessarily mean you have carpal tunnel syndrome.

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Prevention is one thing, treatment is another. Rest is usually the first course of treatment; in many cases, one or two weeks is sufficient, sometimes requiring that you wear a splint around the forearm and wrist. Also, anti-inflammatory medications can help decrease the swelling of the tendons and help reduce pain and numbness. More severe cases may require an injection of a steroid called cortisone into the carpal tunnel.

Surgery is usually the last resort to treating carpal tunnel syndrome. There are several surgical procedures intended to help decrease pressure on the median nerve. Recently, doctors have been using a less invasive type of surgery in which a tiny fiber optic camera is used to see inside the carpal tunnel.

Your physician can help you determine the best treatment for your condition.

In some severe cases, patients have had to make tough choices about whether to continue in jobs or careers that were causing their pain. As traumatic as this can be, it isn’t always a bad thing. A friend of mine quit his job as an accountant with a top firm after years of battling job-related carpal tunnel syndrome. Now, as a skydiving instructor, he jumps out of planes for a living and no longer suffers from the syndrome. Of course, he’s taken on a few other risks.