fitness articles

Who are at risk?

Recent studies have shown that carpal tunnel syndrome, like all other cumulative trauma disorders, is on the rise while other workplace injuries have leveled off. Some people seem to be genetically inclined to CTS. Carpal tunnel syndrome is more common in women than men, and is often found in workers whose tasks require repeating the same motion in the fingers and hand for long periods of time.

CTS has surfaced among meatpackers, assembly line workers, jackhammer operators, and employees who spend hours working at a computer or typewriter. Carpal tunnel syndrome shows up in athletes as well as homemakers.

The U.S. Department of Labor has cited carpal tunnel syndrome, as well as other cumulative trauma disorders, as the cause of 48 percent of all industrial workplace illnesses. The disease affects more than five million Americans.

SYMPTOMS

Typical times when you might experience symptoms due to carpal tunnel syndrome include while holding a phone or a newspaper, gripping a steering wheel, or sleeping. The symptoms of carpal tunnel syndrome may come and go, and include the following:-

• Numbness in your hands or fingers (especially the thumb and first two finger)

• Pain that starts in your wrist and shoots down into the palm of your hands or the surface of your fingers, or up into your forearms,

• Pain or numbness that increase at night particularly after a day during which you have used your hands more than usual in a repetitive activity, and

• Pain or numbness in your hands during pregnancy or shortly after.

• Trouble gripping objects.

• Weakness in your thumb

The symptoms are often progressive. At first you may be bothered only at night partly because fluids are more likely to accumulate in your arms and legs while your sleep. The symptoms may begin to occur at other times. Gradually, even simple tasks become painful. In some cases the disorders goes away on its own. In others cases if the conditions is not treated, it can progress until you can not use the affected hands.

CAUSES

The cause of carpal tunnel syndrome is pressure put on the median nerve. The median nerve is a mixed nerve, meaning it has a sensory function and also provides nerve signals to move your muscles (motor function). The median nerve provides sensation to your thumb, index finger, middle finger and the middle finger side of the ring finger. Pressure on the nerve can stem from anything that reduces the space for it in the carpal tunnel. Causes might include anything from bone spurs to the most common cause, which is swelling or thickening of the lining and lubricating layer (synovium) of the tendons in your carpal tunnel.

• The disorders usually occurs due to repetitive stress on one or both wrists - such as word processing operators, computer operators, chefs, factory workers, librarians and violinists.

• Hobbies such as gardening, needlework, golfing and canoeing can sometimes bring on the symptoms.

• The condition can occur in pregnant women and in women who have recently given birth, because the buildup of  fluid in their body during pregnancy puts extra pressure or nerves.

• In some cases carpal tunnel syndrome is caused by a disease such as diabetes, rheumatoid arthritis,  or hypothyroidism  that affects the blood vessels of the median nerve or the connective tissue (the carpal tunnel or ligaments) in the wrist.

• It may be caused by an injury to the wrist, such as a fracture.

Sleeping with your wrist bent sharply inward can worsen the condition.

TREATMENT OPTIONS

If you are diagnosed with carpal tunnels syndrome, your doctors may first recommend

• Slowing down the pace at which you work or resting the joint by avoiding the repetitive activity with your wrist that caused the problem. You will be given advice about how to modify your work area to put less strain on your wrists.
  

• Your doctors may recommend taking time off from work altogether to allow the inflammation to subside.
  

• Using a splint at night to keep your wrist straight can help relieve pain and other symptoms and allow your you to get a good night's sleep. Your doctors may recommend that your also wear the splint during the day to immobilize your wrist while still allowing your hands to functions.
  

• If pain is a problems ask your doctors about over the counter anti inflammatory medications (such as pirin or ibuprofen or, if you are pregnant, acetaminophen). If you are pregnant your symptoms will probably subside gradually after the pregnancy.
  

• If your pain persists your doctors may prescribe injections of a corticosteriod (synthetic hormone) such as cortisone into your wrist to reduce pain and inflammation. If the problem does not clear up after two injections of corticosteriods, you may want to consider surgery.
  

• The surgery for treating carpal tunnels syndrome, called carpal tunnel release is a relatively fast and simple procedure that is performed to relive the pressure on the median nerve. The surgery is done using local anesthesia  and usually does not require an overnight stay in the hospital. In this procedure, the surgeons cuts the ligaments that form the carpal tunnel, freezing the compressed median nerve. After 2 or 3 weeks, you can begin to use your hand again. You may not gain complete functions for about 3 months because the nerves must re-grow past the  wrist into the muscles of the hand and fingers.  At times, surgery can be done using an endoscope, a telescope-like device with a tiny television camera attached to it that allows your doctor to see inside your carpal tunnel and perform the surgery through small incisions in your hand or wrist.
  

• If carpal tunnel syndrome results from an inflammatory arthritis, such as rheumatoid arthritis, then treating the underlying condition generally also reduces the carpal tunnel syndrome symptoms. This may not be the case with all underlying conditions, such as thyroid conditions or diabetes.

PREVENTING CARPAL TUNNEL SYNDROME: 

1. Lose weight if you're overweight.

2. Get treatment for any disease you have that may cause carpal tunnel syndrome.

3. Switch hands during work tasks.

4. Don't rest your wrists on hard surfaces for long periods.

5. Don't sit or stand in the same position all day.

6. Using ergonomically correct tools. 

7. Making periodic minor adjustments in the positions of your hands or wrists while you perform a repetitive activity can make a difference and help you avoid carpal tunnel syndrome. If your work at a keyboard, type with your wrists straight bent neither up nor down. To make this adjustment, you may have to raise or lower your seat.

Stop your work periodically to rest your hands, by doing the following:-

• Make a loose fist and open and gently stretch your hands. Repeat several times.
  
  
  
  

• Stand up and place your hands palms down on a table. Press firmly with both of your hands against the table. Hold for 5 seconds and release. Repeat four times.
  
  
  
  
  
  
  

• Stand with your feet slightly apart, knee straight and hands flat on a table. With elbows slightly bent, lean forward with your weight on your wrists so that they bend back slightly.
  
  
  
  

CHECK YOUR WRISTS POSITION  AT THE KEYBOARD
Many keyboard typists and computer users are affected by carpal tunnels syndrome. Position your keyboard at a height where your wrist do not bend up or down while your type. Your elbows should be at a 90 degree angle, with your forearms parallel to the floor. To achieve the correct position, try lowering your keyboard or raising your chair.

NOTE: If you or anyone you know has symptoms of carpal tunnel syndrome, consult a physical therapist or other qualified health care practitioner for an evaluation and individualized treatment.

For more on Carpal Tunnel Syndrome: 

• Wrist Traction Device Relieves Carpal Tunnel Pain 

• American Society for Surgery of the Hand

• www.apta.org