Do you use your hands as part of your job? Chances are you do. Whether you perform your job duties in a storefront, an office, or out in the field, you will likely find yourself needing to repeat one movement over and over. The more time you spend performing repetitive tasks – such as typing, pushing, or grasping – the higher your risk for developing Carpal Tunnel Syndrome (CTS).
CTS Definition and Anatomy:
Photo credit: Carpal Syndrome Vs Repetitive Strain Injury | CPR First Aid
The carpal tunnel is an open space in the wrist. It is made up of the bones at the base of the hand along with a rigid ligament. This ligament contains a major nerve called the median nerve, plus nine tendons that bend the fingers.
CTS is a common nerve condition that occurs when the median nerve is under pressure. This nerve provides feeling to the thumb, and index, middle, and part of the ring finger. When the nerve is squeezed, pressure increases in the carpal tunnel, which can lead to a lack of blood flow to the nerve
Mechanism of injury:
CTS results from prolonged periods of increased pressure within the carpal tunnel. Any condition that reduces space within the carpal tunnel can cause CTS.
When using our hands for extended periods of time, the tendons controlling the fingers can swell as they become irritated from overuse. This swelling is what narrows the space within the carpal tunnel, applying pressure to the median nerve.
Contributing factors:
- Environmental:
- Repetitive tasks
- Sustaining a wrist injury that causes swelling
- Continued use of vibrating machinery
- Awkward arm positions sustained for long periods
- Poor ergonomic set up
- Medical:
- Hormonal imbalancesChronic conditions such as autoimmune diseases, diabetes, or arthritisFluid retentionCertain medications
- Ganglion cysts
CTS is more common in women than men. One possible explanation for this is that women’s wrists tend to be smaller on average, meaning there is less space in the carpal tunnel to begin with.
Signs & symptoms of CTS:
Individuals with CTS may notice some or all of the following symptoms present in their wrist, hand, and/or fingers:
- Pain
- Numbness
- A “pins and needles” sensation
- Weakness/loss of grip strength
- Loss of dexterity
- Decreased muscle mass
- The feeling and/or appearance of swelling
- “Ape hand” deformity
CTS symptoms tend to begin gradually and often worsen when doing aggravating movements. Some may find that their symptoms worsen as the day goes on.
Treatment options
Treatments for CTS vary greatly depending on the duration and severity of symptoms. Many people experience no long-term symptoms while others find relief from at-home remedies, and others still require medical intervention. Some ways to find relief are:
- Resting
- Stretching
- Applying a cold compress/ice
- Forearm massages
- Taking medication to relieve pain (NSAIDs)
- Wearing a wrist splint
- Physical Therapy
- In severe cases of nerve damage/chronic pain, some individuals may require surgery
Prevention:
- Limit the amount of time your wrist spends in unnatural positions
- Minimize the amount and duration of repetitive movements
- Take regular breaks
- Stay warm – pain and stiffness can worsen when you’re cold
- When typing, use all your fingers and press he keys lightly
- Strengthen the muscles in your wrist/hand with exercises
- Stretches may help prevent soreness as well as helping treat it
- Use as loose of a grip as possible
- Prioritize having an ergonomically supportive work environment
- Pay attention to your form when you are lifting, grasping, writing, typing, etc.
Common job duties that can contribute to CTS
| Job tasks and corresponding occupations associated with CTS | |
| Job Tasks | Occupations |
| Grasping and tugging fabric, pulling cloth | Production sewer, tailor, garment worker |
| Milking cows, handling equipment | Agricultural worker |
| Handling objects on conveyor belts | Assembly-line worker |
| Pushing down a ratchet, using a screwdriver, power tools | Mechanic |
| Using keyboard and mouse, filing | Clerical worker/secretary/office worker |
| Hand weeding, power tools | Gardener |
| Using spray gun | Painter |
| Knitting and sewing, holding brushes | Crafts-person |
| Scrubbing | Janitor, personal support worker, kitchen and restaurant worker |
| Playing stringed instruments or using a bow | Musician |
| Using laser scanner at checkout | Cashier |
| Cutting, de-boning | Butcher/poultry-processing worker |
| Assembling small parts | Electronic industry worker |
| Turning keys | Locksmith |
| Wearing poorly fitting gloves which apply external pressure | Agricultural workers, mechanics, factory workers, those working in cold temperatures |
| Pressing a tool into the palm | Painter, carpenter, stablehand |
| Pounding safety lever or stamping machine | Receipt processor |
| Gripping the steering wheel | Truck driver |
| Forceful hand motions | Massage Therapist |
REFERENCES:
Tips for Preventing Carpal Tunnel Syndrome at Work | Joint Replacement Institute
Preventing Carpal Tunnel Syndrome in the Workplace: Elite Sports Medicine + Orthopedics: Orthopedics
Carpal_Tunnel_Syndrome_advice_leaflet_Sept_2022.pdf
Wrist Care: Preventing Carpal Tunnel Syndrome
Carpal Tunnel Syndrome: Symptoms, Causes & Treatment
10 Tips for Avoiding Carpal Tunnel Syndrome in the Workplace
How to Prevent Carpal Tunnel Syndrome at Work | Douglas J. Abeles M.D. & Associates