Carpal Tunnel Syndrome: It's All in the Wrist

Do you spend your days using a computer, sorting mail, or assembling small parts? If your workplace duties put stress on your wrists, you may be at risk for carpal tunnel syndrome (CTS).

CTS occurs when the median nerve, which travels through the wrist from the forearm to the hand, becomes squeezed. The median nerve is protected at the wrist by the carpal tunnel, a narrow passageway of ligament and bone. If tendons, which also pass through the carpal tunnel, become thickened or swell, the passageway narrows, pressing on the nerve.

Although many cases of CTS appear to be tied to repetitive movements at work or leisure, researchers haven't found a firm link. Repetitive motion can cause other disorders, such as bursitis or tendonitis, but it doesn't appear to cause CTS unless a person has other risk factors, according to the National Institute of Neurological Disorders and Stroke.

The most common cause of CTS appears to be heredity; some people simply have smaller tunnels and are more prone to the problem. Risk factors that may contribute to CTS include having a smaller carpal tunnel than normal; suffering a wrist sprain or fracture that causes swelling; an overactive pituitary gland; thyroid disorders; rheumatoid arthritis; diabetes; repeated use of vibrating tools; stress at work; fluid in the joints caused by pregnancy; and a cyst or tumor in the carpal tunnel. CTS occurs more frequently in women than in men.

Symptoms and signs

Symptoms of CTS come on gradually and can be in one or both hands. They frequently first appear in the morning, when a person needs to "shake out" a hand because of sleeping with flexed wrists. Other symptoms include pain in the wrist and forearm; weakness and loss of mobility in the hand; numbness in the fingers, except the little and ring fingers; tingling in the fingers when the wrist is tapped; and decreased grip strength.

Prevention

CTS can often be prevented by stretching your wrists before you begin any repetitive task and taking frequent breaks.

You also should maintain good posture when working at a computer. Keep your wrists in a straight position. You can also wear splints to keep your wrists straight.

Do these stretches before performing a repetitive task:

Rest your forearm on the edge of a table. Grasp the fingers of one hand with the other hand, and gently bend back your wrist, stretching your hand and wrist. Hold for five seconds.
Gently press your hand against a firm, flat surface, stretching your fingers and wrist. Hold for five seconds.
Clench your fists tightly, then release, fanning out your fingers. Repeat five times.

If you have mild pain or symptoms, try the following:

Take aspirin, naproxen, or ibuprofen for pain and inflammation. Use as directed.
Wear a splint from a drugstore or medical supply house for a few days and then at night for three weeks.
Strengthen your forearm muscles by squeezing a tennis ball 20 times, three times a day.
Stretch your fingers and wrists every hour.

Consult a doctor if you have:

Severe pain, swelling, and discoloration of the wrist after falling on it, hitting your hand or other trauma
Weakness, numbness, or tingling in your fingers that doesn't go away after 48 hours of self-care