Wrist Care: Preventing Carpal Tunnel Syndrome

Carpal tunnel syndrome is a specific group of symptoms including tingling, numbness, weakness, or pain in the fingers, thumb, or hand and sometimes spreading up the arm. These symptoms occur when there is pressure on the median nerve, which runs through the wrist's carpal tunnel to the hand. Long-term pressure on the median nerve can cause permanent nerve damage. See a picture of carpal tunnel syndrome anatomy.

Carpal tunnel syndrome usually responds well to preventive care and nonsurgical treatment, including rest from problem activities, ice, a wrist splint for use at night, and possibly nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation. The earlier you take action, the better the chances of relieving the symptoms and preventing permanent median nerve damage. If your symptoms continue after about 2 weeks of home treatment or are severe, talk to your doctor. He or she may prescribe specific exercises or stronger anti-inflammatory medicine. A physical therapist or occupational therapist can help you with exercises and changing your body mechanics. Surgery is usually reserved for severe, disabling carpal tunnel syndrome that hasn't responded to months of treatment.

This information focuses on things that you can control during daily activity.

Continue to Why?

When the wrists are bent, the carpal tunnel narrows and can press on the median nerve. This is especially likely when the tunnel is already narrowed by swelling.

Common movements, positions, or conditions that put pressure on the median nerve include:

• Repetitive movement of the fingers or wrist.
• Prolonged or repeated bending of the wrist, particularly using the hand to support weight or apply pressure.
• Prolonged vibrating of the hand, as when using a power tool.
• Swelling in the wrist area. This can be from carpal tunnel syndrome inflammation, which perpetuates the median nerve effects, or from fluid retention. Carpal tunnel syndrome is common during later pregnancy, when women tend to retain fluid.

Monitoring your body mechanics is key in preventing carpal tunnel syndrome.

Continue to How?

Don't wait till you have symptoms to take preventive measures. Increase your awareness of how you use your hands and equipment throughout the day, and make some changes. Many different kinds of activity can cause carpal tunnel syndrome.

Use this picture of an ergonomically correct workstation setup and posture to adjust your working environment and how you use it. You can also use this diagram to help you set up other work areas, such as where you do your hobbies or work with hand tools.

When setting up your work area:

• Center your work in front of you, as low as possible without touching your legs (your forearms are parallel to the floor or slightly lowered). If you work while standing, have your work surface at about waist height.
• Keep your hands and wrists in line with your forearms. For example, if you work at a keyboard, tilt it to help keep this alignment. See pictures of proper hand and wrist position for examples of good wrist position for manual tasks.
• Hold your elbows close to your sides.
• Avoid leaning on the heel of your hand or your wrist.
• Take little breaks every 10 to 15 minutes. Use a reminder alarm if needed.
• Do stretching exercises every 20 to 60 minutes.

Consider trying a different tool or grip. Many people benefit from using a split, V-shaped keyboard. If possible, try one for at least a week. One style may work well for you while another doesn't. When using other equipment, try changing the way you hold the tool. You may also be able to switch hands now and then when using some tools.

Consider trying wrist splints. If you have carpal tunnel symptoms and have trouble training your wrists to stay straight, try wearing wrist splints for temporary relief. Wrist splints are not meant to be worn over a long period of time. But wearing them whenever you are sleeping can help you manage carpal tunnel syndrome over the long term. See a picture of a wrist splint.

Continue to Where?

Now that you have read this information, you are ready to take preventive measures during your daily activities. If you have further questions about office ergonomics or your medical condition, contact an ergonomic specialist or your doctor.

If you would like to find more information on carpal tunnel syndrome or ergonomics, try these resources:

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