Carpal Tunnel Syndrome: Causes, Symptoms and Treatments - Urban Hyve

Sitting for prolonged hours at a computer causes CTS or the Carpal Tunnel Syndrome. The condition is typically associated with numbness, stiffness and/or pain in your fingers. In today’s computer-driven workplace environment, Carpal Tunnel Syndrome is commonly caused by too many hours spent typing on a keyboard or manipulating a mouse.

Understanding Carpal Tunnel Syndrome 

 

The Carpal Tunnel is a small passage made of tissue and bones in your wrist. Carpal Tunnel Syndrome is caused when the median nerve in the carpal tunnel is pressed or squeezed.  The median nerve is responsible for the sense of feeling, touch and movement in the fingers and palm.

When the surrounding tendons in the carpal passage become inflamed or swollen, they press on the median nerve causing pain and numbness.


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If you’d like to read up some more information on what CTS is, we can recommend the following resources:

Causes of Carpal Tunnel Syndrome

There are several causes known to trigger CTS:

  • Genetic family history of CTS
  • Rheumatoid arthritis 
  • Diabetes and obesity
  • Forceful or repetitive  use of fingers and hands such as typing or sewing (especially when the worker is forced to unconsciously flex the fingers or wrist towards the forearm)
  • Pregnancy: Pregnant women are known to be more prone to developing CTS
  • Women, in general, have a smaller carpal tunnel compared to men and are more likely to develop CTS between the ages of 30 to 60
  • Accidents or injuries to the wrist

The groups primarily at risk from CTS are workers who need to type frequently (secretaries, typists and computer data entry professionals), factory workers and cashiers.

If chronic, CTS may even make simple daily tasks such as typing a shoelace or unscrewing a bottle top painful and difficult. In fact, Carpal Tunnel Syndrome has been identified as one of the primary causes for absenteeism from work.

The company loses thousands of dollars due to being short-handed as well as having to pay out medical claims while workers have to endure health risks and pain.

Symptoms of Carpal Tunnel Syndrome

Although the symptoms of Carpal Tunnel Syndrome typically begin with a nagging ache in the wrist area, it can rapidly escalate to a point where the pain becomes intense and unrelenting.

The following symptoms are commonly associated with CTS:

  • Numbness or tingling in your fingers: Carpal Tunnel Syndrome begins with a mild tingling or numb sensation that people experience during typing, driving (holding the steering wheel) or even during the act of picking up a mug of tea. As CTS progresses, workers often experience decreased grip ability.
  • The pain is usually felt in the thumb, index or middle fingers but does not extend to the little finger. During initial stages, the pain may be felt spasmodically but as the CTS progresses, you may experience constant pain in the wrist area.
  • Radiating pain: As Carpal Tunnel Syndrome develops, patients often feel a sharpshooting pains radiating out into their forearm or into their fingers and palms. You could also find yourself dropping objects frequently due to an increasing weakness in your wrist.
  • Symptoms are often experienced on both hands: Although one palm may be more severely affected, you may experience pain or numbness in both hands, especially on the palm side.
  • Ghost swelling: Patients suffering from CTS also complain of a feeling that their wrist or palms have swelled when there appears to be no visible swelling. This is typically a sign of advanced Carpal Tunnel Syndrome and requires immediate medical attention.
  • Burning, weakness and tingling: Advanced signs of CTs may include a burning sensation and atrophy of wrist tissues (wearing out of affected tissue)
  • Discoloration of the wrist area in chronic cases of CTS

Carpal Tunnel Syndrome symptoms often manifest themselves during the night resulting in disrupted sleep cycles and exhaustion during work. This is because fluid tends to accumulate around the stressed wrist area when the palm is flat during sleep hours.

CTS symptoms are often intensified by extending or flexing the wrist to perform activities.

The following resources can provide you with more information on the causes, symptoms and signs of Carpal Tunnel Syndrome.

 

Diagnosis of Carpal Tunnel Syndrome

 

Carpal Tunnel Syndrome is diagnosed in several ways depending on the severity and frequency of symptoms.

  • A physical examination: Your doctor will tap your wrist or ask you to bend your palm to isolate the area of pain and to determine the severity of the condition. He might also tap or gently apply pressure to identify areas of pain.
  • X-ray of the affected muscles: Your doctor may recommend an X-ray to test the affected carpal tissue.
  • Nerve testing with electromyograms: A tiny needle is inserted into your affected muscle area and a small, controlled electric impulse is given to test the muscle reaction at rest and after bending or tapping to determine extent of damage. This form of electrical testing is called an electromyogram and this is a modern method of diagnosing Carpal Tunnel Syndrome.
  • The Phalen Maneuver: This involves testing of the pressurized median nerve by asking the patient to fully extend the arm to exert force on the affected carpal tissue. The doctor may also the patient to place the backs of the palms to test the reaction on the affected area. The Phalen maneuver is typically used to test reaction during one minute of flexing or extending the palm.
  • Tinel test: The Tinel test involves tapping or controlled percussion over the affected carpal passageway or just near it to determine reaction and intensity of pain induced.
  • Elevation of the hand: The hand elevation test is conducted by asking you to raise your hands above your shoulders extending straight up. This test is again conducted for a time-duration of one minute to determine if symptoms of CTS are induced in the wrist areas.

If you’d like more information on the methods of diagnosis of Carpal Tunnel Syndrome, you can refer to the following recommended resources:

Treatment and solutions for Carpal Tunnel Syndrome 

 

The choice of treatment for CTS will depend on the severity of the symptoms experience by the patient. Treatments may be broadly categorized into surgical and non-surgical solutions that help alleviate symptoms.

Non-surgical solutions 

  • Wrist splints: The splint is worn on the wrist area to keep the median nerve in the right position especially during sleep. The splint usually resembles a hand-glove without the finger portions attached.

These splints typically come as reversible splints and can be worn on both hands and also during daytime. But wearing a wrist splint during work hours should be done only under medical advice as this could produce extra strain when you try and type over the pressure.
Your doctor may also recommend customizable wrist splints made out of lightweight materials.

  • Anti-inflammatory medication such as corticosteroids: Anti-inflammatory medications known as corticosteroids may be recommended in case of painful symptoms. These medications may be introduced as tablets, injections or sometimes in the form of inhalers.
  • Hand exercises: You can extend your hands in front of you stretched in an upward position and hold the position for a count of 5.  Another form of hand exercise is to make fists with both your hands and slowly bend them inward toward your forearm and hold the position to a count of 5.

In case, the symptoms are chronic in nature, then your doctor may recommend surgery on the carpal ligament to alleviate the symptoms and resolve the problem.

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Ergonomic solutions to prevent and minimize Carpal Tunnel Syndrome  

Reorganizing your workspace may help reduce and prevent the occurrence of carpal tunnel syndrome drastically, saving you hundreds of valuable dollars in employee absenteeism.

Ergonomic workstations 

 

Ergonomic keyboards and mouse controls: Ergonomically designed keyboards include heated keyboards and mouse controls that help maintain warm temperature that reduces wrist aches and numbness.

Ergonomic keyboards minimize the need to constantly put pressure on your wrist areas by helping you place your wrist in line with your forearm. Another excellent solution is to use a touchpad instead of a mouse. Touch pads help you enter data without having to continuously manipulate a mouse with your hands.
Adjustable keyboards that can be detached are a great investment as they can be manipulated to suit each individual worker’s convenience.

Wrist rests: Strategically placed wrist rests can help alleviate pain by allowing the wrist to rest comfortably during typing and even for taking short breaks. In fact, it is a good idea to take short and frequent breaks from continuous typing to rest your strained wrists on a padded wrist rest. Invest in high quality wrist-rests that provide adequate cushioning and avoid choosing cheaper ones with sharp materials jutting out of the edges.

Optimum chair position: Effective ergonomic solutions involve placing your chair to avoid having to bend your wrist upwards for typing on the screen. Keep your desk that contains your keyboard at a level slightly lower than your chair to avoid having to stretch your hand. Your chair must also be equipped with broad and comfortable arm rests to minimize strain on the hands during typing.

Recommended resources for ergonomic solutions for Carpal Tunnel Syndrome:

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