What is Carpal Tunnel Syndrome and What To Do About It

Carpal Tunnel Syndrome is one of the most common upper extremity musculoskeletal disorders. Here’s what to do about it…

In the United States, carpal tunnel syndrome (CTS) has an incidence of 1 -3 people per 1000 people per year. CTS occurs ten times more often in women than men.¹ It’s one of the most common upper extremity musculoskeletal disorders.

In this post we will discuss:

Symptoms of CTS
Some Common Causes of Carpal Tunnel Syndrome
Activities That Can Aggravate Carpal Tunnel Symptoms
Prevention and Symptom Maintenance
How Occupational Therapy Can Help Relieve Your Symptoms

Symptoms Of Carpal Tunnel Syndrome

Hand, wrist, or forearm pain
Numbness or tingling thumb, index, middle, and ring fingers of one or both hands
Hand weakness
Difficulty with finger coordination

Causes

Carpal Tunnel Syndrome occurs when the small passageway called the carpal tunnel compresses the median nerve. The median nerve runs the forearm length to the palm and provides feeling to the palm, the thumb, middle, and ring fingers. Compression of the median nerve in the carpal tunnel can be caused by swelling from a wrist fracture, arthritis, or repetitive everyday activities.

How Your Work Commute May Be Aggravating Carpal Tunnel Symptoms

If you commute into New York City from anywhere in the Tri-State area, you may spend a significant amount of time gripping the steering wheel, typing on your computer while on the train, or resting your head on your bent wrist to take a nap. Once you arrive at work, you may spend a full-day typing, writing, or repeatedly grasping and moving items.

The cumulative effect of one or more activities can compress the median nerve and cause CTS. If left untreated, CTS can cause permanent nerve damage.

Gripping a Steering Wheel Tightly During A Stressful Commute Can Compress The Median Nerve.

Prevention and Symptom Maintenance

Although refraining from using your hands may not be an option, there are ways to prevent Carpal Tunnel Syndrome. One way is by making minor environmental changes to your daily routine. Some of those small changes include:

Creating an ergonomic workspace that reduces pressure on the median nerve. You can find more information about workspace ergonomics here.²
Taking rest breaks that include hand and wrist stretches are the most effective.
Alternate tasks to reduce repetitive movements
Using a pillow to neutrally position your wrists while sleeping in the bed or using a neck pillow while sleeping on the train.

How Occupational Therapy Can Help With Carpal Tunnel Syndrome

Another option is to wear splints to keep the wrists in a neutral position. Research shows that splinting can significantly relieve CTS symptoms after weeks of use.^3. Research has also indicated that wearing a splint only at night is as effective as whole-day splinting⁴. Certified hand therapists (CHTs), and occupational therapists (OTs) that specialize in hand therapy, can recommend and customize wrist splints for daily use.

Susanne Corrales, Occupational Therapist, shows her patient how to prevent Carpal Tunnel Syndrome when typing. Susanne provides patient education to her patients, along with her hand therapy services.

Although OTs “play a key role in the conservative care of CTS with the goal of preventing surgery”⁴, OTs can also provide other non-surgical and post-surgical interventions, such as recommending adaptive equipment. Adaptive equipment recommendations can include:

Ergonomic pens
Keyboard wrist cushion
Enlarged handled eating and cooking utensils
Equipment to modify leisure items such as golf clubs and baseball bats.

Conclusion

The threat of CTS doesn’t have to keep you from engaging in activities you need and want to do. Using preventative measures will help keep your median nerve healthy. However, if you find that prevention hasn’t worked, healthcare providers such as doctors and occupational therapists are qualified to assist you with your next intervention phase.

Citations

Sevy JO, Varacallo M. Carpal Tunnel Syndrome. [Updated 2022 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieved September 8, 2022 from: https://www.ncbi.nlm.nih.gov/books/NBK448179/
https://www.aota.org/~/media/Corporate/Files/Practice/Manage/Home-Office-Ergonomics-Tips.pdf
O’Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003;2003(1):CD003219. DOI: 10.1002/14651858.CD003219. PMID: 12535461; PMCID: PMC6486195.
Huisstede, B. M., Hoogvliet, P., Randsdorp, M. S., Glerum, S., Middelkoop, M. van, & Koes, B. W. (2010, July 1). Carpal tunnel syndrome. part I: Effectiveness of nonsurgical treatments–A systematic review. Archives of Physical Medicine and Rehabilitation. Retrieved September 8, 2022, from https://www.archives-pmr.org/article/S0003-9993(10)00229-7/fulltext
Julianna E. Dole, Nancy Baker, Shawn C. Roll; Carpal Tunnel Treatment Options: Developing Consolidated Guidelines for Best Practice—A Meta-Synthesis . Am J Occup Ther August 2021, Vol. 75(Supplement_2), 7512510275p1. doi: https://doi.org/10.5014/ajot.2021.75S2-RP275