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Here’s how to get a handle on carpal tunnel syndrome

Mechanic's hands

You’re driving with a very tight grip on the steering wheel. You’ve been clutching the handle of a heavy bag for a while. Do your hands start to tingle and go numb? You may have carpal tunnel syndrome.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a common, and sometimes painful condition that affects the hands, and can cause weakness in grip. The numbness or tingling comes from compression of the median nerve as it passes through the wrist. The median nerve supplies sensation in the thumb and first three fingers, and thumb movement. The nerve travels from the forearm into the hand, through a narrow passage inside the wrist called the carpal tunnel. Nine tendons also run through the carpal tunnel. When the tendons swell they compress the nerve.

How does the hand go numb?

Using your hand in highly repetitive forceful work engages muscles and tendons. Repetitive motions or awkward positions, or repeated tight gripping of things, over a prolonged period can cause the tendons to become inflamed. The swollen tendons can press on the median nerve and cause numbness typically on the palm side of the hand and involving all fingers except the small one.

Is it treatable?

The good news is that most cases are mild to moderate, and can be treated conservatively with night time wrist splints, or steroid injections, says Dr. Larry Robinson, who is a physiatrist or rehabilitation physician at Sunnybrook St. John’s Rehab. He is a nerve, muscle, and bone expert who treats illnesses or injuries holistically to help patients regain as much function or movement as possible.

Who is at higher risk, and why?

“Carpal tunnel syndrome has long been thought of as related to computer work, when in fact, studies show that more risk is with individuals whose work involves highly repetitive, high force hand use,” says Dr. Robinson, who is also the Chief of Sunnybrook’s St. John’s Rehab program.

Mechanics, farmers, hairdressers, cashiers, butchers, musicians and carpenters – these are examples of occupations more commonly associated with carpal tunnel syndrome. Non-work related risk factors include obesity, rheumatoid arthritis, diabetes, and pregnancy. 

Tips to minimize hand and wrist stress

Relax your grip
Avoid gripping items tightly or avoid using a stronger grip than needed, for manual tasks.

Take frequent breaks
If you are working on a big project, give your hands and wrists a break by gently stretching and bending them periodically. You might even get up and walk away for a few minutes if you can.

Avoid bending your wrist all the way up or down
A relaxed middle position is best. The tingling from carpal tunnel syndrome can feel so intense that it can awaken an individual at night. Patients also report shaking their hands for relief – or a type of movement Dr. Robinson and other experts call ‘positive flick sign’. Wearing wrist splints every night helps keep wrists ‘quiet’ and straight.

Reduce your risk
Keep diabetes well controlled, and maintain a moderate weight. Modify workplace conditions.

Contact your doctor if you have persistent pain
When carpal tunnel syndrome is being considered, there are tests available to confirm whether you have this condition. Early treatment can help avoid more symptoms and progression, which in the worst case can lead to loss of muscle function of the thumb, and long-lasting sensory loss.

Not all hand numbness is carpal tunnel syndrome
Dr. Robinson also cautions that hand numbness may be related to neuropathy or damage to the nerves causing reduced nerve stimulation, especially in patients with diabetes. Numbness can also be related to a pinched nerve in the neck, or other nerve injury.

About the author

Natalie Chung-Sayers

Natalie Chung-Sayers is Sunnybrook's Communications Advisor for the Holland Musculoskeletal Program and the St. John's Rehab Program.

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