Identify, Treat, and Prevent Carpal Tunnel Syndrome Week 30

Identify, Treat, and Prevent Carpal Tunnel Syndrome Week 30

That tingling or numbness you’ve ignored for months in your hand and wrist suddenly becomes a sharp, piercing lightning bolt that shoots through your wrist and up your
arm. Is it just a passing cramp? More likely you have carpal tunnel syndrome (CTS)—a painful, progressive condition that affects roughly 1 out of 20 people. Its cause is compression of
a key nerve in the wrist.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome occurs when the median nerve in your forearm gets squeezed as
it passes through a narrow opening in the wrist called the carpal tunnel. Frequently, the
pressure comes from the swelling of irritated tendons in the wrist area (due to over activity)
or an injury such as a sprain or fracture. But, just as likely, the disorder can result from a
congenital predisposition—the carpal tunnel is simply too small for the size of the median
nerve. Other contributing factors may include mechanical problems in the wrist joint, work
stress, and the repeated use of vibrating hand tools. CTS is also associated with pregnancy
and diseases such as diabetes, thyroid disease, or rheumatoid arthritis. In some cases, no
cause can be identified.
What Are the Symptoms?
The following symptoms typically start gradually and can be present in one or both hands:
■ A tingling sensation or numbness in the thumb, palm, or fingers on one hand or on
both hands
■ Fingers that seem to be swollen, even with no visible swelling
■ Pain that affects one or both hands or wrists
■ Difficulty moving the fingers
■ Symptoms that first appear at night, then during the day
■ A weak grasp or grip
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Who Is at Risk?
CTS usually occurs only in adults, and women are three times more likely than men to
develop it, perhaps because the carpal tunnel itself may be smaller in women than in men.
The dominant hand is usually affected first and produces the most severe pain. The risk of
developing CTS is not confined to people in a single industry or job, but the syndrome is
especially common in those performing work involving repetitive motion. Little evidence
supports extensive computer use as a risk factor for CTS, although computer use may cause
a different form of hand pain.
How Can It Be Prevented?
At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take
frequent rest breaks, and wear splints to keep wrists straight. A complete ergonomic evaluation of the workstation, tasks, and tools can promote changes that adapt the workplace
conditions and job demands to alleviate the potential for CTS. However, research has not
conclusively shown that these workplace changes prevent the occurrence of CTS.
What Are the Treatments?
Once diagnosed, treatments for CTS should begin as early as possible. Initial treatment generally involves resting the affected hand and wrist for at least two weeks, avoiding activities
that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage
from twisting or bending. Other treatments include the following:
■ Drugs—In special circumstances, various drugs can ease the pain and swelling associated with CTS.
■ Exercise—Stretching and strengthening exercises under the supervision of a professional physical therapist can be helpful in people whose symptoms have abated.
■ Alternative therapies—Acupuncture and chiropractic care have benefited some patients
but their effectiveness remains unproved. Yoga, however, has been shown to reduce
pain and improve grip strength.
■ Surgery—Carpal tunnel release is one of the most common surgical procedures in the
United States. Surgery involves cutting the band of tissue around the wrist to reduce
the pressure on the median nerve. Surgery is typically done under local anesthesia
and does not require an overnight hospital stay. Many patients require surgery on
both wrists. Although symptoms may be relieved immediately after surgery, full
recovery from carpal tunnel surgery can take months. Recovery typically includes
physical therapy. Some patients may need to adjust job duties or even change jobs after
recovery.
For more information go to the CDC website on Ergonomics and Musculoskeletal Disorders:
www.cdc.gov/niosh/topics/ergonomics, or the Mayo Clinic web page on the topic:
www.mayoclinic.com/health/carpal-tunnel-syndrome/DS00326.

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