Carpal Tunnel Syndrome: Can We Prevent It?

The cause of carpal tunnel syndrome (CTS) is commonly associated with repetitive motions or, working long hours with fast hand movements such as on an assembly line, food packing line, waitress work, or on a computer keyboard and mouse.  However, there are many other possible causes that are less commonly discussed such as pregnancy (caused by generalized water retention), birth control pills (same reason), obesity (same reason), rheumatoid arthritis, hormonal disorders such as diabetes, thyroid disease, and menopause and others.  Of course, if one combines a fast repetitive job with a hormonal disorder, the chances are increased even more for developing CTS. Essentially, any condition that results in an increase in swelling within the carpal tunnel (wrist), will potentially cause CTS so injuries like sprains/strains, fractures, sports injuries, tendonitis and so forth are all potential causes of CTS.  Common symptoms of CTS include: numbness in the 2nd to 4th fingers/hand, pain in the same location, waking up at night needing to shake or “flick” the fingers, driving related numbness, weakness in the grip, difficulty buttoning a shirt, and performing fast repetitive tasks (sewing, crocheting, knitting, cooking) or awkward wrist position tasks (auto mechanic, waitress, musicians, electricians, plumbers, carpenters).

Knowing the cause is important when considering CTS prevention. It is also important to realize the pressure within the carpal tunnel doubles in people without CTS and increases six times in people with CTS when we flex or extend our wrist up or down so sleeping with the wrist straight REALLY HELPS!  This is why patients wear a wrist “cock-up splint” so they don’t accidentally bend their wrist when sleeping.  Night splints like this are also very effective so the swollen tendons and/or other structures in the carpal tunnel can properly “rest.” If a person has a history of CTS that comes and goes, depending on how active they are, wearing a night splint as a prevention approach is appropriate. The use of a wrist splint during the day is often NOT a good idea if it impedes one’s ability to do their normal or needed tasks.  This is because we will irritate the forearm where the splint hits when we flex / extend the wrist and localized bruising can result (sometimes increasing the symptoms of CTS).  Using a splint on long drives can also be helpful as driving frequently irritates CTS.

Mayo Clinic offers the following as a list of precautions that may help in reducing the onset, or if present, the frequency/intensity of CTS symptoms:

1.                  Reduce your force and relax your grip

2.                  Take frequent breaks

3.                  Watch your form

4.                  Improve your posture

5.                  Keep your hands warm

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Though these strategies can help, make sure you properly manage any existing “other problems” listed in the middle of the 1st paragraph.  Also, as discussed in prior Health Updates, chiropractic management offers a great non-surgical solution to the management of CTS and should FIRST be utilized before considering surgery!