Carpal Tunnel Syndrome

| Posted On Aug 26, 2014 | By:

Carpal tunnel.shutterstock_114444253You start to wake up in the middle of the night with hand numbness.  Then, after spending several days doing house renovations with power tools, you begin to experience numbness and burning sensations in your thumb and fingers.  Finally, you begin to notice you are having difficulty holding objects.  This is one of many scenarios that could indicate you have developed carpal tunnel syndrome (CTS).

The carpal (relating to the 8 bones that form the wrist) tunnel is a confined space through which the median nerve (which runs from the forearm into the palm of the hand) and 9 tendons pass. Carpal tunnel syndrome is associated with any condition that causes increased pressure on the median nerve. This pressure, in turn, can cause numbness, tingling, burning sensations, pain, weakness, and/or swelling of the thumb, index, middle and ring fingers. Chronic CTS can lead to weakness and atrophy of the thenar muscles at the base of the thumb.

Carpal tunnel diagram

What are the causes?

The majority of the time, the cause of carpal tunnel syndrome is not fully known.  Some possible causes or risk factors include:

What are the treatment options?

It’s very important to address and treat CTS promptly. Continuing pressure on the nerve can impede its proper functioning.  If the pressure is not relieved, it can cause chronic numbness and weakness in the fingers and thumb which may require more invasive treatment, such as surgery, to correct.

How can I avoid developing carpal tunnel syndrome?

  1. If you work at a computer, make sure the computer workstation you use has excellent ergonomics, and take breaks every 15-30 minutes (I have a smiley face on the corner of my screen frame to remind me).  Consider using a wrist rest and mouse pad.  Keyboard alternatives include a digital pen, dictation, or a voice recognition program.

Carpal Tunnel Computer Workstation Ergonomics

  1. If you do a lot of repetitive work at your job, if possible, consider alternating hands, taking regular breaks, or modifying how you use your hands and wrists.  Sometimes, this can be quite difficult given the nature of your job.  If you work in a factory situation, consider rotating the specific job you do.
  2. Do regular stretching exercises (see exercises at end of this article).
  3. Avoid holding any object (from a book to tools) in one position for a long time.
  4. It is important to know the symptoms of CTS and be ready to take action as soon as the symptoms begin, including reducing activities that trigger the symptoms.

Carpal tunnel syndrome can be quite debilitating, especially if it is in your dominant hand.  I encourage you to learn to recognize the beginning symptoms of CTS.

If you have symptoms that last for more than a few weeks or are severe, you should see your medical care provider to get a professional diagnosis of your condition as other problems can mimic CTS.  (Other conditions with similar symptoms can be cervical radiculopathy, thoracic outlet syndrome, Raynaud’s disease, or diabetic neuropathy.)  You want to seek medical help sooner rather than later because the longer you have CTS symptoms, the longer it generally takes for the symptoms to resolve once your problem is diagnosed.

Stretching exercises for carpal tunnel syndrome

Here are some examples of typical exercises for CTS.  Your doctor or occupational therapist will tell you when you can start these exercises and which ones will work best for you.

When you no longer have pain or numbness, you can do exercises to help prevent CTS from coming back.  Remember: do not do any stretch or movement that is uncomfortable or painful.

For more information about wrist care and preventing carpal tunnel syndrome symptoms, please visit the Healthwise® Knowledgebase.

Warm-Up Stretches

Prayer Stretch

CTS.Prayer Stretch

Wrist Flexor Stretch

CTS.Wrist Flexor Stretch

Wrist Extensor Stretch

CTS.Wrist Extensor Stretch

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About Scott Gilbert, PA-C

Scott Gilbert, PA-C, joined the Orthopedics and Sports Medicine Department of Atrius Health in 2001. Scott sees patients, provides orthopedic consultation and does post-surgery follow-up care in the office for a broad array of concerns and injuries. He can empathize well with his patients: as an avid sports enthusiast, he has participated in many sporting activities, from a wide variety of more traditional competitive team and individual sports (soccer, cross-country running, basketball, swimming, triathlons) to outdoor pursuits including high altitude mountaineering, rock and ice climbing, kayaking, cross-country skiing, and long-distance cycling. He now loves spending time with his wife and 2 children in the out-of-doors and coaching.