Light at the End of the (Carpal) Tunnel

August 8, 2019

Clinical Contributors to this Story

Salem Samra, M.D. contributes to topics such as Surgery of the Hand.

We rely on different tools each day to complete various tasks. But we don’t often consider how the constant use of these tools can lead to pain.

“Forceful or repetitive hand movements over time can cause tingling, numbness and pain in the arm, wrist or first three digits [the thumb, pointer and middle fingers]. These are the main symptoms of carpal tunnel syndrome,” says Salem Samra, M.D., a hand and plastic surgeon affiliated with Bayshore Medical Center.

Carpal tunnel syndrome happens when the median nerve, which runs down the arm to the hand through a tunnel in the wrist, gets trapped. This entrapment occurs when the median nerve gets squeezed against the ligament that forms the “roof” of the tunnel. Excessive, forceful or repetitive motion of the fingers can lead to swelling of the contents of the carpal tunnel and pinching of the nerve. Some other causes of carpal tunnel syndrome can be related to chronic illnesses, like rheumatoid arthritis or diabetes, which can also cause swelling in tissues and joints.

A wide variety of work tasks can lead to carpal tunnel syndrome. Assembly jobs like sewing, meat or poultry packing, or small equipment manufacturing have the highest numbers of affected workers. People who use keyboards and electronic devices can also be affected. In fact, a 2017 study reported in Muscle & Nerve showed that university students who used handheld electronic devices for five or more hours a day were more likely to report wrist or hand pain, and testing showed they had physical changes in the transverse carpal ligament that could lead to median nerve entrapment.

Facts About Carpal Tunnel

  • Carpal tunnel syndrome is three times more common in women than men, and it usually only affects adults.
  • Pregnant women have a higher risk of developing carpal tunnel syndrome. Experts think it may be related to pregnancy hormones that cause swelling.
  • Long-term use of vibrating hand tools, such as sanders, drills or clippers, can also contribute to carpal tunnel syndrome.

Prevention of Carpal Tunnel

If you can, make changes in your workplace to help prevent carpal tunnel syndrome, and do them before you start to experience symptoms. If you use a keyboard and mouse, work with these tools at the lowest possible level that keeps the wrists in line with the forearms (called a “neutral position”). If your work includes repetitive tasks, take five-minute breaks every 20 to 60 minutes to stretch your wrists. The same advice applies if you hold tablets, phones or game controllers for long periods.

Treatment for Carpal Tunnel

If you are affected by carpal tunnel syndrome, some home treatments can help. Wearing a wrist brace or splint, particularly at night, helps keep the wrist properly aligned and lessens pressure on the nerve. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs can reduce swelling and relieve pain. Ice packs can help, too.

If the problems continue, speak to your health care provider. He or she may recommend a nerve conduction test to verify that carpal tunnel syndrome is, in fact, the problem. Steroids, either oral or by injection, may be called for.

If none of these treatments give sufficient relief, and symptoms keep you from working or doing other activities, surgery might be required. A hand surgeon, who could be an orthopedic or plastic surgeon, will discuss the best surgical plan for you, whether that is a traditional approach through the palm of the hand or a minimally invasive technique.

The bottom line: Do what you can to prevent carpal tunnel syndrome. “If symptoms start, take care of carpal tunnel syndrome early because long-term pressure on the nerve can lead to permanent nerve damage,” Dr. Samra says.

Learn how our orthopedics teams are helping patients achieve smooth, pain-free movement.

Dr. Samra practices in Holmdel and Old Bridge. To make an appointment, call 732-729-2100.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.