Consider how often you use your hands during the day, and the amount of constant use and motion might surprise you. We use our hands for every part of our lives, and if your hands started to hurt out of the blue or feel numb and tingly, that would have a significant impact on your life. This is what people who are developing carpal tunnel syndrome or have the condition face daily. An estimated 4-10 million Americans have carpal tunnel syndrome (CTS). You’re more likely to be affected by carpal tunnel syndrome if you’re between 40-50. Other risk factors include being female since females have smaller wrists and a smaller carpal tunnel, which can lead to CTS development—or having relatives with the condition since there is a hereditary piece for developing carpal tunnel syndrome. Doctors consider this to be a very treatable condition generally. This article will explore carpal tunnel syndrome, what causes it, and how to prevent and treat this painful condition.
What is Carpal Tunnel -ref earlier article
Before we get into what is carpal tunnel syndrome or CTS, let’s talk about the wrist and hand anatomy. You have a lot of large nerves in your hands and fingers, which allows you to use them in the dexterous and nimble way you do on a regular day-to-day basis. Most of the nerves for your thumb, hand, and fingers branch out from the median nerve, which travels through the wrist to enervate your hand and fingers.
The wrist is the joint between the hand and the forearm. It is an incredibly constructed joint formed by eight irregularly shaped bones that allow your hands and fingers a great range of motion. These bones are called:
- Trapezium
- Trapezoid
- Scaphoid
- Hamate
- Capitate
- Pisiform
- Triquetrum
- Lunate
These bones form the carpal tunnel on the top and a broad, tough, flat ligament that stretches from the base of your hand under your thumb straight across the bottom of your hand under your pinky finger creates the final side of the carpal tunnel through which the median nerve travels. If there’s pressure on or around the wrist, that can narrow the carpal tunnel or cause swelling, narrowing the tunnel. This puts pressure on the median nerve, which may lead to:
- Pain in the hand or fingers.
- Weakness of the hands, such as losing your grip on objects or being unable to grab items. The median nerve powers your pinching muscles, so if there’s pressure on the nerve, this muscle can’t work as well.
- Tingling in the hands or fingers, specifically the thumb, index, middle, and ring finger, but not the little pinky finger, because a different nerve enervates it. You may feel like you’ve been electrically shocked in these fingers, and sensations may move up the wrist and into the arm. They may only occur while doing activities like driving or holding your phone. Some people are woken up from sleeping by these sensations. You may have CTS symptoms if you find yourself shaking your hands a lot.
- Numbness of the hands or fingers.
A spectrum of carpal tunnel syndrome runs from mildly annoying to wholly debilitating, resulting in a disability. Thankfully, CTS is a preventable condition, and its surgical treatments have a high success rate, with 75-90 out of 100 patients reporting that they are symptom-free. There’s more good news—nonsurgical treatments of carpal tunnel syndrome are also quite effective, mainly if the condition isn’t too advanced.
What Causes Carpal Tunnel?
Carpal tunnel syndrome is caused by pressure in your wrist, which pinches the median nerve, and blood vessels, which results in impaired nerve function and blood flow to most of the hand and fingers. But what causes this pressure, swelling, and inflammation? One reason may be other underlying health conditions, such as:
- Diabetes
- Thyroid problems
- Fluid retention due to hormone fluctuations in pregnancy or menopause
- High blood pressure
- Rheumatoid arthritis or other autoimmune diseases
- Trauma to the wrist, such as a sprain or fracture
Carpal tunnel syndrome can be developed or aggravated by holding the wrist in an extended posture for too long and repetitive motions.
- Typing is the most common example of CTS causes, along with using a computer and a mouse or keypad.
- Using technologies like smartphones can put pressure on the wrist.
- Playing video games can also contribute to wrist and carpal tunnel pressure.
- Excessive vibrations from hand or power tools can irritate the carpal tunnel and cause inflammation and swelling.
- Any repeated movement done to excess, such as for hours on end, could potentially aggravate your wrist and carpal tunnel.
How to Prevent Carpal Tunnel
Here’s how to prevent carpal tunnel syndrome. Here are some simple ways to reduce pressure on your wrists, which may ease any discomfort or prevent the discomfort from worsening.
1. Take breaks from repetitive movements of your hands and wrists. They don’t have to be long, but as often as you can, without gaining your supervisor’s ire, take a five-minute break and stretch your wrists using some of the following exercises. This is also an excellent time to apply an anti-inflammatory topical like an arnica cream or gel. (Bonus, arnica is generally unscented.)
2. Stretching
There are many simple stretches and exercises that you can do to help relieve and prevent carpal tunnel syndrome. Do these stretches several times a day. Ask your work supervisor permission to take a few five-minute breaks throughout the day to stretch your wrists. Use common sense with all stretching exercises; don’t do it if it hurts, and do more if it feels good.
a) Make a Stop Sign
Holding your hands up by your chest, make fists. Slowly glide your fingers and thumb into a stop sign position (fingers and thumb together.). Slowly move your fingers and thumb back into a fist. Repeat 5-10 times.
b) Stop Sign B
Repeat the exercise above, except extend your fingers and thumb wide. Then slowly curl your fingers back down into a fist. Repeat 5-10 times.
c) Flex Stretches
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- Stretch your arms and hands out in front of you like you’re trying to push something away from you. Keep your fingers together. Place one hand flat against your other palm and pull your hand back. Hold for 5-10 seconds. Repeat on the other side and do 2-5 sets. You should feel a stretch on the bottom of your wrist.
- Stretch your arms straight out in front of you like you’re pushing someone away. Point the fingers of one hand down, keeping the fingers together. Using your other hand, press on the top of your bent hand towards your body. You should feel a stretch on the top of your wrist. Hold for 5-10 seconds. Repeat on the other side and do 2-5 sets.
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d) Shake it out
This is an excellent exercise if you wake up with any numbness. Hold your arms out slightly from your body and shake your hands like you’re trying to get water droplets off your fingers. Do this for about 20-30 seconds, and repeat 2-3 times.
e) Finger Tap
With your hands laying comfortably in your lap, tap each of your fingers to your thumb one at a time. Repeat 4-5 times on each hand.
f) Sit comfortably at a desk or table, bend your elbow, and lay one arm horizontally in front of you. Using your opposite elbow, massage the muscles in the top of the forearm, paying particular attention to the top by the elbow. Place the elbow tip in the thicker muscle by the elbow on the table. Slowly drag your elbow down your arm toward the wrist. Repeat, moving up or down at the start so you can access all of the tissue. Repeat on the opposite side.
g) To massage the bottom of the forearm, find a tennis ball or similar-sized therapy ball and sit in the same position as the exercise above. Take the therapy ball or tennis ball, place it under the forearm, and start to roll the forearm muscles on the ball. Tender spots include the top outer edge by the pinky finger and the muscles close to the elbow. Like in the exercise above, you want to focus on the thicker area by the elbow. Going slowly, roll the muscles by the elbow over the ball. You may feel some sharp, nervy sensations, that’s ok, there’s a lot of tension in this area.
h) Stretch out your chest by facing a wall and placing your hand on the wall at face height. Turn to the side so that you’re perpendicular to the wall, and your forearm is against the wall. Your hand should be by your shoulder. Take a step forward, keeping your arm and hand on the wall until you feel a stretch across the chest and front of the shoulder. Go gently, and get different angles by moving the hand up or down. Do equal time on each side.
3. Keep your wrists neutral
As much as you can, keep your wrists straight in line with your hands and arms, so neither bent up or bent down. This will prevent excess compression on the carpal tunnel, which can aggravate or accelerate symptoms. Try to arrange your workstation or desk ergonomically so you can work comfortably. This might look like moving tools closer or further away or using a different keyboard with wrist support.
4. Slow down there, Hulk. Do you need to type with that much force? Or grip a tool that tightly? It’s an accident, but many of us may use more energy or strength than necessary for everyday tasks. Take a few moments throughout your day to pause and assess how much power you’re using for the task at hand and if you can use less and still be effective. This will reduce the strain on your wrist and carpal tunnel.
5. How’s your back? And your chest, hips, and torso? Practicing good posture might mean some practice (and a better desk chair), but it will help support your wrists and joints’ overall health. Your feet should be comfortable on the floor, with space between the thighs and seat. Keep your shoulder blades on the back and feel your chest lift slightly. Keep your shoulders over your hips and gently engage your core to support your chest. Correct posture can help correct many muscle pains, like headaches, and support overall health.
6. Start a new fashion trend and try fingerless gloves for icy offices (whether due to air conditioning or wintertime). Keeping your wrists and hands warm helps to protect the wrist joint and keep it well lubricated. Extreme temperatures increase the risk of MSDs, and an icy cold office can be a culprit in CTS. Warm up with gloves and a space heater in the winter if allowed. If you don’t like the idea of gloves, try a sweater with long sleeves you could pull over your wrists.
7. Seek the professional help of occupational therapists. These physical therapy adjacent professionals can help you identify any misalignment or poor posture in daily activities. They coach you on how to perform regular tasks safely and in alignment. Occupational therapists can also give you more exercises and stretches to help prevent or resolve CTS. It may be a good idea to see an occupational therapist before surgery or when you start noticing symptoms.
8. If working conditions are aggravating your wrists, think about what could change to help and talk to your supervisor. They might be able to provide you with equipment that supports good ergonomics or give the go-ahead if you want to rearrange your workstation. If you’re directly under an AC vent, you could ask for a different spot, for example, since cold air stiffens joints.
How to Treat Carpal Tunnel
In this section, we’ll go over non-surgical and surgical treatment options for carpal tunnel syndrome.
- One of the most common treatments is splinting; when you wear a flexible metal brace that keeps your wrist stable, pressure on the carpal tunnel is relieved. Often the brace is worn only at night to begin.
- Avoid aggravating activities, if possible, and take breaks if not. Taking breaks from typing or using power tools can give your hands and wrist a chance to rest.
- Use ice packs if your wrist is swollen or red. Wrap ice packs in a cloth of some kind and apply for 15-20 minutes every couple of hours.
- Many people use over-the-counter pain medications like Motrin and Tylenol. While these medications aren’t a cure or a fix, they can grant short-term relief from pain. Look for nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen.
- Your doctor may prescribe prescription medications for you to take. Corticosteroids, like prednisone or lidocaine, for example, reduce inflammation and may offer some relief to the pressure on your wrist. These drugs are most effective for people with only mild symptoms or symptoms that come and go. A word of caution: if you have diabetes or are predisposed to the disease, you may have trouble with steroid medications. Extended use of steroids may make it harder to regulate your insulin.
- Try an alternative therapy like acupuncture or chiropractic care. Many people have benefited from these alternative modalities. One proven alternative health modality that helps reduce the symptoms of carpal tunnel syndrome is yoga. Yoga strengthens muscle groups that protect or impact the wrist. Specifically, study participants’ grip strength improved by doing yoga poses designed to strengthen and stretch each joint in the body. They practiced twice a week for eight weeks and significantly improved CTS symptoms.
- Stretches and exercises like the ones we list in the prevention section are also helpful for treating more serious CTS.
Now let’s talk about the surgical options for more severe cases of CTS. The primary surgery performed for carpal tunnel syndrome is called carpal tunnel release surgery, one of the most common surgical procedures in the United States. During this surgery, a small ligament called the carpal ligament is cut in half, which opens up space in the wrist. What about wrist stability? After the surgery, the ligament grows back, but it does so in such a way that more space is created in the wrist for the median nerve. You have two options for how this surgery is performed, traditionally and endoscopically, which is less invasive but has a higher chance of complications. As we mentioned before, the surgery is generally successful but talk with your doctor about which choice is right for you. The traditional surgery is done under a local anesthetic and has a longer recovery time but fewer complications. Endoscopic surgery is less invasive and has a shorter recovery time than traditional surgery.
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