What Is Carpal Tunnel Syndrome?

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It’s no secret that we spend a lot of time sitting in front of the computer. A recent survey found the typical office worker will spend 1,700 hours a year in front of a computer screen. (1) That comes out to be 6.5 hours a day. That is a lot of time sitting, browsing, and typing. We’ve already talked about the detrimental effects of sitting, but what about typing? Excessive typing, especially typing with bad posture, can lead to something called carpal tunnel syndrome. 
What is carpal tunnel syndrome? Carpal tunnel syndrome is a condition that causes numbness, tingling, and pain in the hand and sometimes arm. This can eventually lead to muscle weakness and atrophy in the hand. In order to better understand this condition, it helps to know the anatomy of the carpal tunnel.  
The carpal tunnel is a narrow passageway in the wrist in which nine tendons and one nerve cross through. The floor and walls of this tunnel is made up of the small wrist bones, also known as the carpal bones. The roof of the tunnel is made from a thick ligament called the transverse ligament that holds the contents of the tunnel in. Below is a picture of the carpal tunnel. 

The problem with this tunnel is its rigidity. This area does not expand and stretch well in order to increase the size of the tunnel. Therefore, “overcrowding” in the carpal tunnel can lead to increased pressure in the structures that pass through the carpal tunnel, especially the median nerve.  
The median nerve originates from the neck and travels through the arm, down the forearm, and into the hand via the carpal tunnel. This nerve provides feeling in the thumb, index, middle, and ring fingers. This nerve also controls the muscles around the base of the thumb which is crucial for grip and hand dexterity.  
“Overcrowding” in the carpal tunnel can happen due to swelling. The nine tendons that cross the tunnel are surrounded by tissue called the synovium. The synovium’s role is to provide lubrication to the tendons that cross the tunnel, making it easier to move the fingers. However, the synovium can become irritated and swell taking up space in the carpal tunnel and leading to increased pressure on the median nerve. This pressure “chokes” the median nerve leading to the symptoms of pain, numbness, tingling, and eventual weakness in the hand.  
What are some of the risk factors for developing carpal tunnel syndrome?  

  • One obvious risk factor is the size of the carpal tunnel. Some people are just born with small carpal tunnels decreasing the space for the median nerve.  
  • Repeating the same hand and wrist motions over a long period of time may aggravate the synovium in the wrist, causing swelling and putting pressure on the median nerve. Sounds a lot like typing, doesn’t it? 
  • Doing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can increase pressure on the nerve. Sound familiar? 
  • Different co-morbidities are also associated with increased risk of carpal tunnel syndrome such as rheumatoid arthritis, diabetes, and thyroid disorders.

How can you prevent carpal tunnel syndrome? 

  • It is a good idea to periodically stretch the hand and wrist. Also, changing the task is a good idea to prevent any type of repetitive strain on the hand or wrist. 
  • Be aware of your wrist and hand form. You want to avoid excessive wrist flexion or extension. 
  • Set up the environment. Make sure the computer screen, keyboard, and mouse are at the proper height and distance. Your posture will affect the functioning of the hand and wrist. 
  • Strengthening postural muscles will help you maintain good posture while at work, reducing stress on the wrist.

If you have already been diagnosed with carpal tunnel syndrome, it is a great idea to apply the tips mentioned above. In addition to that it is also a good idea to apply the following: 

  •  Wear a brace or splint at night. This will help to keep the wrist in a neutral position while you sleep, lessening the pressure in the carpal tunnel and helping to decrease the inflammation. 
  • You can also take anti-inflammatories to help decrease the pain and reduce inflammation. 
  • Make an appointment with a physical therapist. They will teach you proper mechanics, mobilize the median nerve, decrease pain, and assist you in making lifestyle changes.

Let’s keep our hands and wrists healthy this year! 
 
(1) Bailey, Grant. “Office workers spend 1,700 hours a year in front of a computer screen.” The Independent, 23 July 2018, http://www.independent.co.uk/news/uk/home-news/office-workers-screen-headaches-a8459896.html