Carpal tunnel syndrome (CTS) is a disorder that is classified as a repetitive stress injury (RSI). Carpal tunnel syndrome is a painful progressive condition caused by compression of the median nerve.

Carpal tunnel syndrome, as with many nerve compression disorders, is often the result of nerve compression at more than one site. This situation is referred to as a “double crush”. The median nerve can potentially be impinged upon at four common sites. These areas of possible compression include the neck, shoulder, elbow and the wrist. Therefore, carpal tunnel syndrome usually involves compression at the point where the median nerve passes through the wrist and at least mild impingement at one of the other three common areas of compression.

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The median nerve originates from nerve roots in the neck, passes by the shoulder, elbow and wrist and terminates in the hand. CTS is characterized by any one or combination of the following symptoms:

1. Hand Pain
2. Wrist Pain
3. Numbness, tingling, weakness in the thumb, pointer finger and the middle finger.
4. Radiating pain that travels from the neck to the hand, wrist and fingers.
5. Pain and weakness in the wrist, hand and arm that magnifies as the day progresses
6. Night time pain that wakes you up
7. Clumsiness of the hands

Associated Symptoms Can Include:

1. Neck Pain
2. Shoulder Pain
3. Elbow Pain
4. Forearm Pain

Symptoms usually start gradually. Pain, weakness, or numbness in the hand and / or wrist can radiate up the arm and into the neck. As the symptoms worsen, tingling and decreased grip strength may cause difficulty with tasks such as forming a fist, grasping small objects, or performing other manual tasks. If left untreated, permanent levels of permanent disability may occur.

Who Gets Carpal Tunnel Syndrome?

Anyone can get carpal tunnel syndrome. However, patients usually develops carpal tunnel syndrome as the result of long periods of exposure to a physically stressful task. While there are cases of CTS that result from car accidents (bracing yourself against the steering wheel), or experiencing a hard fall in which you catch yourself on your outstretched wrists, CTS onsets of this type are rare.

CTS is much more likely to develop from specific repeated tasks, often related to your type of employment. Professions commonly associated with CTS include but are not limited to:

• Computer operations
• Meat cutters
• Tailors
• Musicians
• Massage therapists
• Carpenters
• Gardeners
• Secretaries
• Assembly line workers

All of these professions require ongoing repetitive movements of the hand, wrist and fingers. The constant repetitive movements overwhelm the coping mechanisms that allow for normal, non-repetitive movements of these body parts. The result is irritation, inflammation, pain and disability.

What to do about Carpal Tunnel Syndrome?

Initially, treatment involves resting the affected hand and wrist and avoiding the activities that caused or may worsen symptoms. Night time immobilization of the wrist in a splint to avoid further damage from twisting or bending is often helpful. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, can ease the pain. Ice packs, prednisone and / or lidocaine (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide relief.

Stretching and strengthening exercises are very important for people whose symptoms have improved. If symptoms persist for 6 months or longer, your physician may recommend surgery to sever the band of tissue around the wrist (flexor retinaculum) to reduce pressure on the median nerve.

The recurrence rate of carpal tunnel syndrome following treatment is high. The majority of patients never recover completely. Reports show that the majority of Carpal Tunnel Release Surgeries are authorized again within 24 months of the initial procedure.

The best way to treat carpal tunnel syndrome is to prevent it. Eliminating as many repetitive tasks as possible will help stave off the onset of carpal tunnel syndrome.
The following suggestions can go a long way in preventing the onset of carpal tunnel syndrome:

1. Take frequent breaks, rest from repetitive tasks is vital
2. Use correct posture, postural stress can affect the nerves as they exit the spine
3. Eliminate repetitive over-reaching. Stretching for a mouse or phone on a regular basis generates postural stress.
4. Stretching and regular exercise are of great help
5. Ice pack application on aggravated wrists helps.
6. Rotate your job duties when possible, ie don't keyboard or mouse for hours on end if you can also be working on dictation or some other task that gives you a break from the computer.
7. Watch your posture, bad posture contributes the stresses that result in carpal tunnel syndrome.