Don’t Ignore Early Signs of Carpal Tunnel Syndrome

Do you sometimes experience tingling or numbness in your hands? Feel clumsy or weak handling objects? Drop things more often than you used to?

These problems can be symptoms of carpal tunnel syndrome, signs you may want to discuss with your doctor. You may also want to take simple steps yourself to slow down the progression of this condition. If you have already developed an advanced case, though, there are effective treatments. 

“Many people first notice carpal tunnel syndrome symptoms, such as pain, numbness, or tingling at night,” says Natalia Fullerton, M.D., an orthopaedic surgeon at the University of Miami Health System. “They may wake up and shake their hands, to temporarily relieve the symptoms.”

What causes carpal tunnel syndrome?

The condition results from putting pressure on the median nerve at the carpal tunnel. This nerve runs from a spot near your armpit through your arm and travels to your hand and four of your fingers: the thumb, index, middle, and ring fingers. The carpal tunnel is a narrow, rigid passageway of ligaments and bone, through which the nerve passes at its lower end, in the wrist. 

The condition is common. It affects between 3 and 6% of adults.

“Many kinds of activities can lead to increased pressure in the carpal tunnel,” says Dr. Fullerton. The syndrome is strongly associated with certain types of repetitive motions involved in both housework and job functions, especially tasks that require repetitive awkward wrist positions. 

Activities that demand force or expose the wrist to a lot of vibration also increase the risk. 

Your job may put you at risk for developing or worsening carpal tunnel syndrome.

High-risk jobs include the following: 

• Painters
• Gardeners
• Hairdressers
• Garment workers
• Butchers and other workers who process fish or meat
• Workers who handle machines that vibrate for hours
• Warehouse workers and others who lift and carry heavy objects

Although computer work and driving are not causes of carpal tunnel syndrome, people who have the condition may experience increased symptoms of carpal tunnel when they spend long hours at a computer or behind the wheel.

The problem also arises frequently alongside conditions that cause swelling, including pregnancy. Your risk increases if you have certain diseases as well. These diseases include diabetes, renal failure, hypothyroidism, and autoimmune diseases such as rheumatoid arthritis. Genetics plays a part, too, as carpal tunnel syndrome tends to run in families. 

Women experience the most significant risk for developing carpal tunnel syndrome.

“For women, the risk for carpal tunnel syndrome is three times greater than it is for men,” says Dr. Fullerton. “The exact reason is unknown.” It’s probably a combination of hormonal factors, the fact that women have smaller carpal tunnel sizes, and the highly repetitive nature of many tasks women typically do more of, such as housework, on top of their paid employment. 

“Pregnant women are especially prone to develop this condition because of their tendency to have increased swelling,” says Dr. Fullerton. Menopause also heightens your risk.

Practice proactive prevention.

If you answered “yes,” to any of the questions at the top of this article, you might want to take steps yourself to prevent the worsening of carpal tunnel syndrome. Try these approaches:

• Practice good hand ergonomics by trying to minimize repetitive motions. Vary the way you use your hands and fingers. Try to do the offending task with the wrist in a more neutral position.
• Take frequent breaks from hand work and use the time to stretch your hands and fingers. 
• Be conscious of your hands’ positioning during sleep. “You don’t want to sleep with your wrist flexed,” says Dr. Fullerton. “Using braces to keep your wrists in a neutral, healthy position can really slow down the condition’s progression.”

 Don’t wait to protect your hands and wrists.

“It’s so much easier to treat this condition when it’s caught early, and we can use conservative measures, such as splinting,” says Dr. Fullerton. 

Some patients benefit from occupational therapy, and many insurance plans cover it. 

Over-the-counter anti-inflammatory medications can also help if your doctor gives the okay.

If carpal tunnel syndrome has advanced and such conservative measures prove inadequate, your doctor may recommend steroid injections. “The injection is only a temporary measure and is often used to ensure the diagnosis when there are other possible causes of numbness,” says Dr. Fullerton.  

The next step is surgery. “It’s a short, simple operation, done on an outpatient basis,” she says. You wear a bandage for a few days, and full recovery takes a few weeks.

If sensations in your hands and wrist are telling you it’s time to act, do so. See your doctor when symptoms are starting, rather than waiting for them to intensify. Acting early may spare you the discomfort, expense, and hassle involved with more aggressive treatment later on.  

To learn more, read this Fact Sheet from the National Institutes of Health.   

Milly Dawson is a contributing writer for UMiami Health News.

Tags: carpal tunnel syndrome, carpel tunnel, Dr. Natalia Fullerton, ortho, palm side, pressure on the nerve, transverse carpal ligament