Preventing Carpal Tunnel Syndrome

I.T. professionals are at risk of contacting carpal tunnel syndrome from repetitive hand strokes from hitting the keys. It is one of the most notorious occupational disorder of most workers of different fields according to occupational safety and health research centers. Carpal tunnel syndrome (CTS) affects the hand, wrist and arm. It is characterized with intermittent numbing, tingling sensation in the hands, arms and sometimes the forearm and the shoulder. Carpal tunnel is a space formed by the bones and ligaments of the wrist. The median nerve runs in this space and is compressed at the wrist leading to CTS. I'm going to describe 3 types of carpal tunnel syndrome (CTS).

• Work-related CTS are common among people who work with repetitive hand or arm strokes like those working with vibrating machines (e.g. jackhammer), carpentry, computers and mechanics. Any activity with repetitive grasping and manipulation can lead to CTS.
• Trauma-related CTS is secondary to fractures of the arm bone, dislocation of the wrist bones, strong trauma to the hands regardless of mechanism of injury, pressure of the median nerve from a tumor growth or hematoma and also deformities from abnormal healing of old bone fractures.
• Systemic disease-related CTS may be due to hypothyroidism and osteoarthritis. Osteoarthritis can lead to structural deformities of the wrist joint leading to median nerve compression. Hypothyroidism can lead to obesity and gradually to arthritis which then contributes to the nerve compression. Diabetes is often linked with CTS due to peripheral neuropathy that has a similar symptoms with CTS.

Aside from the Phalen's Test that I posted earlier, we have the Tinel's Test and Durkan's Test. Tinel's is performed by lightly tapping the area over the nerve to elicit a 'pins and needles' sensation in the area of the nerve's control or distribution. Durkan's or the carpal compression test is done by applying a firm pressure on the palm over the nerve area for 30 seconds to elicit the symptoms. More test should be considered before CTS is confirmed since corrective surgery of the wrist with a misdiagnosis of CTS will likely fail. Prevention should be directed to a modification on occupational modalities that can lessen the likelihood of having CTS like applying ergonomic work tools and lifestyle adjustment. For people who work with keys or keyboards hit them lightly and take at least a 15-20 minute hand break which includes gentle stretching and bending exercises of the wrist, hands and fingers. Avoid too much bending of the wrist and taking breaks reduces the risk of CTS. Warm compresses will improve blood flow and alleviates discomfort and nerve compression from repetitive strokes. Paraffin wax for the hands has benefits over CTS just ensure safety by testing the temperature to prevent burns. A basin of warm water will do. While soaking the hands do open and close exercise. Protect hands from too much cold. Repetitive exposure to cold contributes to vasoconstriction thus limiting blood flow delaying the distribution of the essential nutrients for the nerve. Vitamin B from whole grains, beans and peas, protein-rich foods and green leafy vegetables will help maintain nerve function and prevent degeneration of it.