Carpal Tunnel Syndrome

In the past 10 years, the number of people suffering from carpal tunnel syndrome, a condition that causes symptoms ranging from painful tingling in the hands, to clumsiness and lack of usefulness in the hands, has increased dramatically. The National Institute for Occupational Safety and Health (NIOSH) points to automation and job specialization which require people to do repetitive tasks with few manipulations thousands of times each day, as one of the possible reasons for a dramatic increase in hand and wrist pain. 

Below is an overview that may help in better understanding carpal tunnel syndrome, its causes and its treatment.

What is Carpal Tunnel Syndrome?
What are the Symptoms?
What Causes Carpal Tunnel Syndrome?
Prevention
Treatment

What is Carpal Tunnel Syndrome?
To understand what carpal tunnel syndrome is, it is first important to understand the basic anatomy of the wrist. The carpal tunnel is named from the 8 carpal bones in the wrist that form a tunnel like structure. This tunnel is filled with tendons that control the movement of the fingers. It is also a pathway for the median nerve to reach the sensory cells in the hand. Repetitive flexing and extending of the wrist can cause the protective sheaths of each tendon to thicken. Carpal tunnel syndrome results from pressure on the median nerve caused by these swollen tendon sheaths. 

What are the Symptoms?
Carpal tunnel syndrome may first occur as painful tingling in the hands at night. The pain may be significant enough to disturb sleep. There may also be a feeling of uselessness in the fingers that is sometimes described as a swollen feeling, even though there is no apparent swelling. Symptoms may progress to the point where the hands feel tingly and painful during the day. There may also be a decreased ability and power to squeeze. There may be an inability to distinguished between hot and cold touch, and the hands may appear clumsy in performing simple tasks such as tying shoes or picking up small objects. 

What Causes Carpal Tunnel Syndrome?
Swelling of the tendons in the carpal tunnel cause carpal tunnel syndrome, but there are many things that can cause the tendons to swell. This swelling can result from repetitive and forceful movement of the wrist. NIOSH indicates that job tasks involving highly repetitive manual acts, or necessitating wrist bending or other stressful wrist postures, are connected to the incidents of carpal tunnel syndrome and related problems. Using vibrating tools may also be a contributing factor. The common factor in most job associated cases of carpal tunnel syndrome, however, is repetitive use of small hand tools. 

Prevention
NIOSH focuses on relieving awkward wrist positions and repetitive hand movements, and reducing vibration from hand tools, in its efforts to control carpal tunnel syndrome. This could involve the redesign of tools or tool handles so the wrist is in a more natural position during use and modifying layouts of work stations. Other ways of preventing carpal tunnel syndrome could include altering the way certain tasks are performed, frequent rest breaks, and rotating workers into different tasks. 

Treatment
Treatment of carpal tunnel syndrome may include anti-inflammatory drugs and hand splinting to reduce tendon swelling in the carpal tunnel. Steroid injections are very helpful. Ultimately, surgery may also be necessary to release the compression on the median nerve.