Pain, stiffness, discomfort in wrists can be signs of carpal tunnel syndrome

5:00 AM, Feb 25, 2019

No matter what kind of work you do, chances are you do at least part of it with your hands. High impact work or repetitive motion can lead to a common hand condition: carpal tunnel syndrome.

Carpal Tunnel Syndrome is very common; there are about 500,000 carpal tunnel surgeries done every year.

Pain, stiffness, and discomfort in the wrists can be debilitating and a cause for concern.

“Carpal Tunnel Syndrome is a syndrome that affects the hand. It causes pain, numbness and tingling. The most classic symptom people start noticing initially is when they are driving, or texting in these days, and their fingers start to go numb,” said South Texas Bone and Joint Orthopedic Surgeon Dr. Ryan Thomas.

And while repetitive activities like typing and texting won’t cause carpal tunnel, they can make the symptoms more noticeable.

“If you notice your fingers going numb, when that is a occurring then you probably do have some carpal tunnel, and certainly if it wakes you up from sleep.  As it gets a little more advanced, you may notice some weakness in your hand as well as you might start dropping things,” said Thomas.

Most of the time, a doctor can diagnose this condition based on a patient’s symptoms and a physical exam. Other times, patients may need to undergo further testing.

“Typically the thumb, index, and long finger are mostly where people notice it first. The small finger, the other half of the ring finger innervated by the ulnar nerve which is the funny bone at your elbow and so that is usually not affected with carpal tunnel,” said Thomas.

Dr. Ryan Thomas says the good news is, that in milder cases, it can be treated by using a wrist splint at night and taking over the counter anti-inflammatory medication. If it goes untreated, it can lead to long-term problems.

“If you compress that nerve for a long time, you can damage that nerve permanently. That means your fingers go numb, and they stay that way. And so if carpal tunnel is left unchecked for a long time, it can cause permanent damage,” said Thomas.

Carpal tunnel is more common in women than men, by about three to one. It’s also more common during times of hormonal change – particularly during pregnancy and menopause. People who are obese, sedentary, and those who smoke are also more likely to suffer from carpal tunnel.

Symptoms:

Carpal tunnel syndrome symptoms usually start gradually. The first symptoms often include numbness or tingling in your thumb, index and middle fingers that comes and goes.

Carpal tunnel syndrome may also cause discomfort in your wrist and the palm of your hand. Common carpal tunnel syndrome symptoms include:

  • Tingling or numbness. You may experience tingling and numbness in your fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not your little finger. Sometimes there is a sensation like an electric shock in these fingers.The sensation may travel from your wrist up your arm. These symptoms often occur while holding a steering wheel, phone or newspaper. The sensation may wake you from sleep.

    Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.

  • Weakness. You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.

When to see a doctor:

See your doctor if you have persistent signs and symptoms suggestive of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.

Causes:

Carpal tunnel syndrome is caused by pressure on the median nerve.

The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).

Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.

There is no single cause in many cases. It may be that a combination of risk factors contributes to the development of the condition.

Risk factors:

A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase your chances of developing or aggravating median nerve damage. These include:

  • Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.People with smaller carpal tunnels may be more likely to have carpal tunnel syndrome.
  • Sex. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men.Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don’t have the condition.
  • Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to your median nerve.
  • Inflammatory conditions. Illnesses that are characterized by inflammation, such as rheumatoid arthritis, can affect the lining around the tendons in your wrist and put pressure on your median nerve.
  • Obesity. Being obese is a significant risk factor for carpal tunnel syndrome.
  • Alterations in the balance of body fluids. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy generally resolves on its own after pregnancy.
  • Other medical conditions. Certain conditions, such as menopause, obesity, thyroid disorders and kidney failure, may increase your chances of carpal tunnel syndrome.
  • Workplace factors. It’s possible that working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage.However, the scientific evidence is conflicting and these factors haven’t been established as direct causes of carpal tunnel syndrome.

    Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.

Prevention:

There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists with these methods:

  • Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink.
  • Take frequent breaks. Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force.
  • Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. Keep your keyboard at elbow height or slightly lower.
  • Improve your posture. Incorrect posture rolls shoulders forward, shortening your neck and shoulder muscles and compressing nerves in your neck. This can affect your wrists, fingers and hands.
  • Change your computer mouse. Make sure that your computer mouse is comfortable and doesn’t strain your wrist.
  • Keep your hands warm. You’re more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.

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