Carpal tunnel Syndrome

If, for you, working nine to five means tapping a computer keyboard, punching cash-register keys, working a jackhammer, or doing any other repetitive motion with your hands, you may be at risk for a painful condition called carpal tunnel syndrome (CTS). CTS is a collection of symptoms that can include tingling, numbness, burning, and pain from the wrist to the fingers. By far the most common cause of CTS is repetitive motion with the hands. For this reason, CTS is considered a “cumulative trauma disorder.” However, medical conditions such as rheumatoid arthritis, hypothyroidism (low levels of thyroid hormone), pregnancy, and overweight can also cause symptoms of CTS.If you suffer from CTS, you’re not alone. According to the United States Bureau of Labor Statistics, cumulative trauma disorders, including CTS, currently account for more than half of all occupational illnesses reported in the United States today. To understand why CTS occurs, it helps to take a look inside the wrist. The carpal tunnel is a narrow passageway that runs through the wrist. It is only about the size of a postage stamp, but it is crowded with nerves, blood vessels, and nine different tendons, packed in like strands of spaghetti, that control finger movement. Repetitive motions or medical conditions can cause the tendons to swell, decreasing blood flow and compressing the median nerve, which supplies the thumb, index finger, and middle finger. This compression can cause the numbness, pain, tingling, and burning we call carpal tunnel syndrome. If left unchecked, muscle wasting and permanent damage to nerves can result.

For most people, the key to beating this syndrome is prevention-making changes before CTS becomes a problem. If you’re already experiencing the tingling, numbness, and pain associated with CTS, you may be able to prevent further damage and promote healing by making a few simple changes in your lifestyle. The tips that follow can help you keep your hands and wrists healthy and help reduce symptoms of CTS. If your symptoms are severe or if they don’t resolve after two weeks of self-care, however, see your doctor.

Stay in shape. You’ll be less likely to suffer injury your body’s circulation and repair systems work well, says Mark Tager, M.D., president of Great Performance, Inc., a company in Beaverton, Oregon, specializing in occupational health. He suggests practicing good nutrition, getting adequate sleep, taking frequent exercise breaks, and avoiding smoking (cigarette smoking cuts down circulation to all areas of the body).

Take mini breaks. Fatigue in the joints or muscles is a warning sign to change your pattern of working, says Michael Martindale, L.P.T., a physical therapist at the Sports Medicine Center at Portland Adventist Medical Center in Oregon. “The body is trying to tell you something,” he say & “It’s up to you to listen and take a break.”

“Get up and change your activity,” advises David Rempel, M.D., assistant professor of medicine and director of the Ergonomics Laboratory at the University of California at San Francisco. “A 1-to 2-minute break every 20 or 30 minutes is a good idea. Then take a longer break every hour.”

Don’t snooze and lose. Some people are bothered more by CTS symptoms at night. Many doctors believe this is because the fluid in the body is redistributed when you lie down, so more of it accumulates in the wrist. In addition, many people unwittingly cause wrist-nerve compression by sleeping with one hand tucked under their head, Tager. He suggests altering your sleep position keep your wrist from being bent or compressed.

Take some weight off. Excess weight can compress the nerves in the wrist, says Tager. He advises keeping your weight within five to ten pounds of your ideal weight by eating a low-fat diet and, getting plenty of exercise.

Rotate jobs. Experts at the National Safety Council suggest that you rotate between jobs that use different muscles and avoid doing the same task for more than a few hours at a time.

Rempel offers the following example: “If your job is to tie a knot in a rope, and the guy down the line cuts the rope, see if you can modify your job so that either you switch tasks frequently Of you combine tasks so you’re not just doing the same thing over and over.”

If your job doesn’t allow rotation, talk with your supervisor or union about a change. Rotation reduces job stresses and minimizes production lossesKeep it in “neutral.” “Work with your body and your wrists in a comfortable, neutral position,” advises Rempel. For wrists, a “neutral” position is straight, not cocked. Check the height of your computer screen (it should be at eye level). Rearrange the level of your key¬≠board or workstation so that you don’t have to strain, reach, or bend your wrists. Your wrists should always be in a straight line with your forearms. And be sure your work is within your “comfort zone” (not too close or too far away).

Get the right grip on it. Most of us have a tendency to grip with only the thumb, index, and middle fingers, which can increase pressure on the wrist. If you have to grip or twist something, such as the lid of a jar, Tager suggests you use your whole hand.

Alternate hands. Whenever possible, Martindale suggests, give your dominant hand a break.

Watch those pressure points. Too often, typists rest their wrists on the sharp edge of a desk or tabie as they work, which can cause excess pressure on the wrists, says Rempel. Adjust your workstation, if necessary, to keep your wrists off the edge.

Soften up and slow down. It’s often powerful movements done at high speed that cause carpal tunnel problems. Martindale suggests slowing down and applying only the force needed.

Decrease bad vibes. People who use vibrating tools, such as sanders and jackhammers, for extended periods are at risk for wrist problems. If you are one of these folks, take frequent breaks and, when possible, operate the tool at the speed that causes the least vibration.

Go “ergo.” Often, CTS can be prevented or treated by adopting tools and workstations that have been “ergonomically” redesigned to cause less stress on the body. Some tools have been designed to work with less force, while others now feature better grips and handles. Some knife manufacturers, for example, have redesigned knives for meat packers that require less wrist bending. Other companies have created aids such as wrist rests for computer users that can prevent or reduce CTS problems.

Look for items that can ease the strain on your wrists and hands, but be wary of miracle machines and gadgets. “Some of the ergonomic aids can be really helpful,” says Rempel. “But I tell people to be careful about devices that make medical claims that say they’ll cure CTS.”

Watch for symptoms, and take action. Pay attentior to early warning signs of CTS, such as morning stiffness in the hands or arms, clumsiness, inability to make a fist, or thumb weakness, and take preventive and self-care action immediately, says Tager.

Ice it. If you’re having CTS symptoms, use ice to reduce swelling and inflammation. Place an ice pack on the wrist and forearm for 5 to 15 minutes two or three times a day, advises Rempel. At the same time, however, be sure to take steps to eliminate the cause of the trauma to your wrist.

Take the heat off. Heat can worsen CIS. “Heat may be good for loosening sore muscles, but you should never use heat with a nerve problem,” says Rempel. “Heat causes the tissue to swell, which can make the problem worse.”

Nix flimsy splints. Wrist splints prescribed by physicians can help CTS; too often, however, people who develop CTS symptoms rush to the pharmacy for a wrist splint as a home remedy. Rempel says these splints can do more harm than good. “The wrist splints you buy at the pharmacil are pretty flimsy,” he says. “They often allow the wrist to move. If people put them on and don’t take them off for long periods of time, they can cause muscle shrinking (atrophy).”

Reach for over-the-counter relief. For minor pain and swelling, take aspirin or ibuprofen.


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