Tunnel of Pain

By Ben Sinclaire (Own work) [CC0], via Wikimedia Commons

In the 1990s, we started to see a rise in the incidence of carpal tunnel syndrome (CTS) mainly in direct correlation with the increased use of computers in the workplace. According to the National Library of Medicine, “Carpal tunnel syndrome is a condition in which there is pressure on the median nerve — the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.” Back in 1999, Carla R. McMillan wrote an article entitled Carpal Tunnel Syndrome: The Rise of an Occupational Illness, indicating that, at that time, CTS was “the fastest-growing occupational illness in the United States.”

As we’re well aware, computer usage in the workplace has not decreased one whit.  However, CTS, once a phrase we’d hear frequently in the media, seems to have fallen off the hot-topic radar. So what’s the state of CTS today? Information from the PennState Milton S. Hershey Medical Center indicates “that about 3% of women and 2% of men will be diagnosed with carpal tunnel syndrome during their lifetime. The condition peaks in women over age 55. Still, determining how many people actually have CTS is very difficult. Many people who report CTS symptoms have normal test results. Other people have abnormal test results but no symptoms.” So CTS is still pretty prevalent, and a person’s likelihood of susceptibility can be increased by factors such as work that involves force, vibration, or repetitive stress to the hands and wrists;  working in cold conditions; physical injury; medical conditions such as diabetes, hypothyroidism, rheumatoid arthritis, osteoarthritis, obesity, and pregnancy; as well as factors such as autoimmune disease, muscle and bone disease, structural abnormalities, kidney insufficiency, Down syndrome, amyloidosis (a progressive disorder of the connective tissues), acromegaly (a disease that leads to abnormally large hands and feet due to excessive growth hormone), or a tumor on the median nerve (removing the tumor often successfully treats CTS in these cases).

Perhaps the decrease of CTS in the news comes from an increase in understanding of treatment and prevention. As was always the case, the earlier the detection and treatment, the better.  They key is to try to get there before any permanent damage to the median nerve occurs. The National Institute for Neurological Disorders and Stroke (NINDS) states, “Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.” There are also drugs that can ease the pain and swelling associated with carpal tunnel syndrome, stretching and strengthening exercises can be helpful in people whose symptoms have abated, and acupuncture and chiropractic care have benefited some patients though their effectiveness remains scientifically unproven. Surgery, unfortunately, may be required in some cases, but carpal tunnel release is one of the most common surgical procedures in the United States.

The best possible way to handle CTS is prevention. NINDS suggests care in the work place such as “on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position.” They also recommend wearing fingerless gloves to help keep hands warm and flexible. “Workstations, tools and tool handles, and tasks can be redesigned to enable the worker’s wrist to maintain a natural position during work. Jobs can be rotated among workers. Employers can develop programs in ergonomics, the process of adapting workplace conditions and job demands to the capabilities of workers.” And, according to the University of Maryland Medical Center, adjusting one’s work area, tools, or performance of tasks in ways to put less stress on hands and wrists is a good start in preventing CTS, as is proper posture and exercise programs to strengthen the fingers, hands, wrists, forearms, shoulders, and neck.