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HEALTH MATTERS: Reducing the risk of carpal tunnel syndrome

By Harvey Smires, M.D. Princeton HealthCare System
    Our hands and wrists play a part in almost everything we do. A sudden injury or a painful chronic condition such as carpal tunnel syndrome can turn even basic daily tasks into monumental challenges.
    One of the most common causes of hand and wrist pain, carpal tunnel syndrome occurs when the median nerve, which runs from the forearm to the hand, becomes squeezed or pinched.
    In many cases, this is often a result of genetics and gender. The carpal tunnel — a narrow passageway located in the palm-side of the wrist — is simply smaller in some people than it is in others, making it harder for the nerve to pass through. This is especially true in women.
    But in other instances, carpal tunnel syndrome has been associated with overuse injuries caused by repetitive hand motions — from gripping a golf club or tennis racket to working on an assembly line or typing on a computer.
    Other causes of carpal tunnel syndrome include wrist injuries and certain diseases that cause swelling or put extra pressure on the nerves, including rheumatoid arthritis, diabetes, and thyroid disease. In addition, pregnant women are also prone to carpal tunnel syndrome during the last few months of pregnancy.
    Symptoms of carpal tunnel syndrome often come and go at first and include:
    • Numbness, tingling and pain in the hand.
    • Electric shock-like sensations, mostly in the thumb, index and middle finger.
    • Weak grip and clumsiness or tendency to drop things.
    These symptoms typically start out gradually and may at first just wake you up at night. This is because most people sleep with their wrists curled, putting pressure on the median nerve. Without treatment, however, symptoms may get progressively worse and eventually impact your ability to grasp objects like a phone or a steering wheel.
    If you are experiencing symptoms of carpal tunnel syndrome, consult your doctor for proper diagnosis and treatment.
    At University Medical Center of Princeton, board- certified orthopedic specialists may order an electromyogram (EMG) and a nerve conduction study (NCS) to confirm the diagnosis and check for other possible nerve problems.
    Treatment options for carpal tunnel syndrome include braces and splints to keep the wrists in a neutral position, anti-inflammatory medicine, and steroid injections. If non-operative approaches don’t bring relief, surgery to make more room for the nerve may be necessary.
    Though carpal tunnel syndrome can be difficult to prevent, there are several things you can do to help reduce your risk and protect your wrists and hands from painful injury.
    • Stay neutral. Avoid bending your wrists up or down for extended periods of time. Instead, keep your wrists straight — or in a neutral position — as much as possible, including when typing or when lifting weights.
    • Relax your grip and be gentle. Whether holding onto a pen or pressing down on computer keys, try to relax your hands and fingers and move gently. Too often we use more speed and force than necessary to complete a job, putting a greater strain on the wrist. In addition, avoid grasping items with only your thumb and forefinger, which puts an extra burden on your wrist. Try to use your whole hand to pick up objects.
    • Give yourself a break. Rest your hands regularly. If possible, switch hands for routine activities and alternate between easy and hard tasks. Taking breaks is especially important if you work with equipment that vibrates or requires you to exert extra force.
    • Sit up straight. Poor posture can cause your shoulders to roll forward, shortening your neck and shoulder muscles and compressing the nerves in the neck. This can lead to painful problems in your wrists, hands and fingers.
    • Stretch. Keeping your wrists, hands and fingers limber can help your avoid injury. Here’s a simple exercise: Curl your fingers into a fist and bend your wrist toward the palm. Then straighten your fingers and gently stretch your wrist back the other way. Repeat these motions about ten times. Moreover, exercises to strengthen your arms can help take stress off your wrists.
    • Stay warm. Your hands are more likely to hurt and become stiff if they are cold. If you can’t control the temperature in your workplace, wear fingerless gloves, which keep your wrists and hands warm, while still allowing you to maneuver.
    By paying attention to how you use your wrists, hands and fingers and taking care not to abuse them, you can help reduce your risk for carpal tunnel syndrome and avoid injury.
To find a physician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Harvey Smires, M.D., is board-certified in orthopedic surgery and is a member of the medical staff at University Medical Center at Princeton.