Carpal tunnel syndrome

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What is it

If you put in long hours at a repetitive hand intensive task working on an assembly line or in the garment industry, typing or computer keyboarding, or knitting or playing piano you could develop carpal tunnel syndrome, or CIS. Deriving its name from the Greek karpos, or wrist CTS is a painful disorder of the wrist and hand that results from compression of the median nerve at the wrist by surrounding tissue or excess fluid

The carpal tunnel is the passageway, composed of bone and ligament, through which a major nerve system of the forearm passes into the hand. These nerves control the muscles in this area, as well as the nine tendons that allow your fingers to flex. The wear and tear of repeated movement thickens the lubricating membrane of the tendons and presses the nerves against the hard bone. This process, called nerve entrapment, can be caused not only by repetitive strain, but by bone dislocation or fracture, arthritis, and fluid retention (as may occur in pregnancy) anything that narrows the tunnel and compresses the nerve.

Thousands of cases of CIS are diagnosed each year, and women are far more susceptible to it than men because women tend to do the kinds of industrial, office, and domestic jobs that promote CTS. In addition, their carpal tunnel space is smaller by nature.


  • Burning, tingling, and numbness in your hands, especially in the thumb and first three fingers. Usually symptoms first occur early in the morning or at night, and may also awaken you at night. This nocturnal awakening is a hallmark of the ailment and occurs in up to 95 percent of all patients. Flexing your hand in your sleep or sleeping on it may aggravate the discomfort.
  • Weakness in the hands and fingers that may make it difficult to pick up or hold on to objects. Carpal tunnel syndrome usually affects the dominant hand and begins with pain and tingling or numbness.
  • A sensation of swelling in the fingers without any visible swelling.

What causes it

As an occupational injury, CTS is brought on by repetitive work or movement. In addition to the examples mentioned above, carpenters and dentists, people working with electric drills or other vibrating instruments, and indeed anyone who works with his or her hands for long hours can get CTS. (CTS belongs to a larger category of work-related injuries known as repetitive strain injury, which has a long history and can be found in many jobs and professions.) Tennis and squash players are also candidates, as are aerobic dancers using hand weights and people who frequently use rowing machines or other exercise equipment.

What if you do nothing

In some instances the symptoms of carpal tunnel syndrome disappear without any treatment. Usually, however, if you do nothing to alleviate the problem, the tingling and numbness can progress to a weakened grip and severe pain in the forearm or shoulder. By all means get medical advice before this happens.

Home remedies

Symptoms of mild CTS may improve with the following measures. In addition, observe the preventive steps noted below.


When you lie down, elevate your arm with pillows.

Try ice

Icing the wrist for 20 minutes at a time can offer temporary pain relief

Take over-the-counter anti-inflammatory pain relievers

Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling.

Avoid smoking

This may help prevent the constriction of the small blood vessels of the hand, which can aggravate the condition.

Be wary of CTS devices

The marketplace is full of devices special braces, backrests, wristrests, forearm supports, wrist trolleys, and fingerless gloves that supposedly head off CTS or help correct it. But there’s no evidence, except testimonials, that any of them are worth much. Some experts think that some of the wrist devices actually decrease circulation to the wrist, or restrict movement in such a way as to transfer your problems from wrist to shoulder.


A few simple precautions can help minimize the risk of CTS.

Don’t flex

When working with your hands, keep your wrists straight. Flexing and twisting them stresses the carpal tunnel.

Think before lifting

Lift objects with your whole hand or better yet, with both hands to reduce stress on the wrist.

Think comfort

Make sure your work station is comfortable. If you’re working at a computer keyboard, make sure your fingers are lower than your wrists; don’t rest the heel of your hands on the keyboard.

Give your hands a rest

Take breaks frequently when working with your hands. Working too rapidly may contribute to the problem.

Type with a soft touch

Don’t pound the keys, which aggravates pressure on the wrist.

Stop when it hurts

If your hands hurt while you’re using a rowing machine, for instance, or while playing a racket sport, stop. Pain is always a signal to stop. If you carry hand weights while running or exercising, make sure they aren’t too heavy.

Don’t grip the steering wheel

Hold it gently to reduce pressure on your wrists.

Share work tasks

If the work you do is stressing your hands, see if you can rotate tasks or share work with someone else.

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