Annoying, irritating, and painful are just a few words that can describe carpal tunnel syndrome. As an increasingly common problem in the computer age, almost anyone can develop this condition.
To protect yourself or to find remedies if you already suffer from it, read on to learn about the origins and mechanics of carpal tunnel syndrome.
What Is Carpal Tunnel Syndrome?
Your wrist is not just a bone. There is a band of fibrous tissue surrounding the joint that works as a form of support and helps keep it flexible. The space between the band and the wrist bone itself is what’s referred to as the carpal tunnel. The median nerve runs the length of your arm, through the carpal tunnel, and into the hand. It controls the impulses to the thumb, index finger, middle finger, and part of the ring finger. If something causes the fibrous band to swell or if the tissue changes position, then the median nerve within the carpal tunnel can be squeezed. This is, as one would assume, irritating to the nerve.
Causes of Carpal Tunnel Syndrome
Although carpal tunnel syndrome’s symptoms are caused by the median nerve, the nerve itself is not the cause of the entrapment. There is no singular cause for carpal tunnel syndrome and what triggers it in one individual may not do so for another.
In general, every known cause does something that crowds, irritates, or compresses the median nerve. Wrist fractures, for instance, can shrink the size of the carpal tunnel and cause increased pressure on the nerve. The swelling and inflammation of arthritis can do the same. Similarly, lupus, diabetes, hyperthyroidism, and any condition that can cause swelling in the joints or soft tissues, or is capable of affecting blood flow, can trigger carpal tunnel syndrome. In some cases, a cyst can be present that presses against the median nerve.
Carpal tunnel syndrome is a common work-related condition, because many jobs involve activities that can create the irritation or other effects needed to compress the median nerve. The repeated vibrating of the hand (such as from using power tools), tendonitis caused by repetitive wrist motions (tendons run through the carpal tunnel too), and generally working with your hands or arms in an awkward position can lead to carpal tunnel syndrome.
Women are three times more likely than men to develop carpal tunnel syndrome. There are two main reasons for this. First, women are naturally smaller. This means their carpal tunnel is smaller as well and there is less available space should some form of irritation or compression arise. Second, the fluid retention that happens during menopause and pregnancy can place pressure on the joints and, by extension, the wrist.
Lastly, carpal tunnel syndrome is not always uniform in size. People can simply be born with a smaller space than others, triggering the condition.
Carpal Tunnel Syndrome Symptoms
The manner in which carpal tunnel syndrome presents itself depends on how much the median nerve is being irritated and for how long. Generally, it has a gradual progression and any sudden jump in severity is cause to see your doctor.
The condition begins with a frequent burning, tingling, itching, or numbness in the palm and thumb, index, or middle fingers. These symptoms tend to start first at night, since many people sleep with flexed wrists. In some cases, fingers can feel swollen despite no swelling being present.
Initially, the tingling or numbness may be possible to “shake out,” but it will become more constant as things progress. Sharp, shooting pains along the wrist and arm can also occur. Since the nerve’s ability to transmit signals is impaired by the compression, a loss of grip strength can arise that will make it hard to form a fist, grab small objects, and perform certain mechanical tasks. In extreme cases that are left untreated, the hand may experience a loss of sensation and be unable to feel hot or cold when touching something.
As with many conditions, early detection is the best way to avoid permanent damage. A diagnosis is made by examining the arm, wrist, and fingers while ruling out other conditions that can cause similar symptoms (such as tendonitis or bursitis).
Treating Carpal Tunnel Syndrome
In some cases, treatment merely requires treating the underlying cause (i.e. mending a fracture, easing inflammation, etc.) Regardless of the circumstance, it’s generally advised to minimize use of the hand affected and let it rest to avoid activities that aggravate the symptoms. Depending on the underlying cause, drugs may be helpful. Diuretics can help reduce fluid buildups, and anti-inflammatory medications like aspirin can reduce swelling.
Stretching and exercises designed to strengthen the joints can also help, but should be supervised by a physical therapist to avoid actions that inadvertently worsen the condition. Yoga in particular has been proven to reduce pain and improve grip strength in cases of chronic carpal tunnel syndrome.
If symptoms persist for over six months, surgical intervention can be considered. None of the procedures are overly involved and can be performed under local anesthesia as an outpatient. Carpal tunnel release surgery is actually one of the most common surgical procedures done in the U.S., so finding a hospital or clinic would not be too difficult. There are two main surgical approaches: open and endoscopic. Both aim to enlarge the carpal tunnel by cutting the carpal ligament; the only difference is in the tools and the recovery time.
Preventing Carpal Tunnel Syndrome
Anything that alleviates stress on the hands or wrist can be a good preventative measure. Most people, for instance, use more force when necessary to perform manual tasks, such as hitting keyboard keys harder than needed, thrusting or pushing doors, etc. Relief can also be provided by taking breaks periodically to stretch and flex your wrists. Alternating tasks will also reduce the amount of repetitive motions you go through. The need for breaks is heightened if vibrating equipment is used as well.
A relaxed “middle position” for your wrists is optimal since it prevents too much bending. Keeping a keyboard at elbow height or slightly lower will allow you to keep this level naturally. Ergonomics and posture are important means of easing stress on the joints and making work easier overall.
Sleeping positions or nighttime movement can put strain on the joints. Avoid sleeping on your hands, since your weight can put pressure on the median nerve. As mentioned above, some people flex their wrists when sleeping, which can provoke the condition. To avoid this, you may find using a wrist splint at night helpful. These can be purchased at any drugstore or pharmacy and should be snug, but not tight to prevent constriction.
Finally, cold temperatures can promote joint pain and stiffness. If your workplace is chilly, consider fingerless gloves to help keep warm without impeding your dexterity.
While not a particularly threatening condition, carpal tunnel syndrome is a common quality-of-life matter that is worth keeping an eye out for. It doesn’t take much to follow the avoidance tips and in doing so you’ll be able to save yourself discomfort and pain.
Sources for Today’s Article:
“Carpal Tunnel Syndrome Health Center,” WebMD web site; http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-topic-overview, last accessed August 24, 2015.
“Carpal Tunnel Syndrome and Tarsal Tunnel Syndrome,” MedicineNet.com; http://www.medicinenet.com/carpal_tunnel_syndrome/article.htm#what_is_carpal_tunnel_syndrome, last accessed August 24, 2015.