If you put in long hours at a repetitive hand-intensive task—working on an assembly line or in the garment industry, typing or computer keyboarding, or knitting or playing piano—you could develop carpal tunnel syndrome, or CTS. Deriving its name from the Greek karpos, or wrist, CTS is a painful disorder of the wrist and hand that results from compression of the median nerve at the wrist by surrounding tissue or excess fluid.
The carpal tunnel is the passageway, composed of bone and ligament, through which a major nerve system of the forearm passes into the hand. These nerves control the muscles in this area, as well as the nine tendons that allow your fingers to flex. The wear and tear of repeated movement thickens the lubricating membrane of the tendons and presses the nerves against the hard bone. This process, called nerve entrapment, can be caused not only by repetitive strain, but by bone dislocation or fracture, arthritis, and fluid retention (as may occur in pregnancy)—anything that narrows the tunnel and compresses the nerve.
Thousands of cases of CTS are diagnosed each year, and women are far more susceptible to it than men because women tend to do the kinds of industrial, office and domestic jobs that promote CTS. In addition, their carpal tunnel space is smaller by nature.
Symptoms of Carpal Tunnel Syndrome
- Carpal tunnel causes burning, tingling, and numbness in your hands, especially in the thumb and first three fingers. Usually symptoms first occur early in the morning or at night, and may also awaken you at night. Nocturnal awakening occurs in up to 95 percent of all patients. Flexing your hand in your sleep or sleeping on it may aggravate the discomfort.
- Weakness in the hands and fingers may make it difficult to pick up or hold onto objects. Carpal tunnel syndrome usually affects the dominant hand and begins with pain and tingling or numbness.
- Sensation of swelling in the fingers without any visible swelling
What Causes Carpal Tunnel Syndrome?
CTS is brought on by repetitive work or movement. In addition to the examples mentioned above, carpenters and dentists, people working with electric drills or other vibrating instruments, and indeed anyone who works with his or her hands for long hours can get CTS. Tennis and squash players are also candidates, as are people who frequently work out with handweights, rowing machines or other exercise equipment involving repetitive hand movements.
What If You Do Nothing?
In some instances the symptoms of carpal tunnel syndrome disappear without any treatment. Usually, however, if you do nothing to alleviate the problem, the tingling and numbness can progress to a weakened grip and severe pain in the forearm or shoulder. By all means get medical advice before this happens.
Home Remedies for Carpal Tunnel Syndrome
Symptoms of mild CTS may improve with the following measures.
- Elevate. When you lie down, elevate your arm with pillows.
- Try ice. Icing the wrist for 20 minutes at a time can offer temporary pain relief.
- Take over-the-counter anti-inflammatory pain relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling.
- Avoid smoking. This may help prevent the constriction of the small blood vessels of the hand, which can aggravate the condition.
- A wrist splint may help. For mild CTS symptoms, a splint that keeps your wrist and fingers in a neutral position can help ward off pain that occurs at night from bending your wrist in your sleep. Your doctor or a physical therapist can advise you about obtaining a splint and how often to wear it.
- Be wary of other CTS devices. The marketplace is full of devices—braces, wristrests, wrist trolleys, fingerless gloves—that supposedly head off CTS or help correct it. But there’s little, if any, evidence that any of them are worth much.
- Exercise. Stretching and strengthening exercises can be helpful.
Carpal Tunnel Syndrome Prevention
A few simple precautions can help minimize the risk of CTS.
- Don’t flex. When working with your hands, keep your wrists straight. Flexing and twisting them stresses the carpal tunnel.
- Think before lifting. Lift objects with your whole hand—or better yet, with both hands—to reduce stress on the wrist.
- Adjust your keyboard. If you work at a computer keyboard, make sure your fingers are lower than your wrists; don’t rest the heels of your hands on the keyboard.
- Give your hands a rest. Take breaks frequently when working with your hands. Working too rapidly may contribute to the problem.
- Type with a soft touch. Don’t pound the keys, which aggravates pressure on the wrist.
- Stop when it hurts. If your hands hurt while you’re exercising or playing a racket sport, stop. If you carry handweights while running or exercising, make sure they aren’t too heavy.
- Don’t grip the steering wheel. Hold it gently to reduce pressure on your wrists.
- Share work tasks. If the work you do is stressing your hands, see if you can rotate tasks or share work with someone else.
- Wear splints to help keep the wrists straight.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician if carpal tunnel syndrome symptoms become bothersome, begin to interfere with normal daily activity, of if you find yourself having to take aspirin or other painkillers to keep working. The syndrome is much easier to treat and much less likely to cause long-term problems when it’s diagnosed early.
What Your Doctor Will Do
After taking a thorough history, your doctor will perform a physical exam that will include one or more tests to assess the extent of pain in your wrist. Your hand and wrist may also be x-rayed. Although CTS is usually not difficult to diagnose, you may be referred to a neurologist for testing the nerves’ ability to transmit impulses. If your condition is mild, wearing a splint at night may be all you need. If that doesn’t work, your doctor may suggest anti-inflammatory drugs, such as aspirin or ibuprofen, or injections of cortisone.
If nerve injury or muscle damage progresses, surgery may prove advisable. Surgery is usually successful in restoring full hand function unless the condition has been present for several years.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media