If you spend a lot of time doing
activities that involve forceful or repetitive hand or wrist movement or use of
vibrating equipment, you have an increased risk for
carpal tunnel syndrome. These activities can include
driving, working with small instruments, knitting, or using a sander. You can
reduce your risk—and any hand pain or weakness you may already have—by taking a
few simple steps.
Carpal tunnel syndrome is a specific group of symptoms including
tingling, numbness, weakness, or pain in the fingers, thumb, or hand and
sometimes spreading up the arm. These symptoms occur when there is pressure
median nerve, which runs through the wrist's
carpal tunnel to the hand. Long-term pressure on the
median nerve can cause permanent nerve damage. See a picture of
carpal tunnel syndrome anatomy.
Carpal tunnel syndrome usually
responds well to preventive care and nonsurgical treatment, including rest from
problem activities, ice, a wrist splint for use at night, and possibly
nonsteroidal anti-inflammatory drugs (NSAIDs) for pain
inflammation. The earlier you take action, the better
the chances of relieving the symptoms and preventing permanent median nerve
damage. If your symptoms continue after about 2 weeks of home treatment or are
severe, talk to your doctor. He or she may prescribe specific exercises or
stronger anti-inflammatory medicine. A physical therapist or occupational
therapist can help you with exercises and changing your body mechanics. Surgery
is usually reserved for severe, disabling carpal tunnel syndrome that hasn't
responded to months of treatment.
This information focuses
on things that you can control during daily activity.
Carpal tunnel syndrome may be painful, but it can't
cause permanent damage.
Carpal tunnel syndrome can be mild and
temporary, usually when the cause is temporary. But continuing an activity that
puts pressure on the median nerve can lead to permanent nerve damage and hand
Continue to Why?
wrists are bent, the carpal
tunnel narrows and can press on the
median nerve. This is especially likely when the
tunnel is already narrowed by swelling.
positions, or conditions that put pressure on the median nerve include:
Monitoring your body mechanics is key in preventing carpal
Even if you don't use tools such as vibrating
equipment or a keyboard very much, it's smart to be careful about your body
How often or how long you do a task is only
part of what can cause a repetitive motion injury such as carpal tunnel
syndrome. If your hands aren't aligned with your arms while you work, even
doing a task for a short time can be a problem. And getting carpal tunnel
symptoms by using poor body mechanics for one task adds to your risk of having
pain and weakness if you do other manual tasks that can also affect the
Continue to How?
till you have symptoms to take preventive measures. Increase your awareness of
how you use your hands and equipment throughout the day, and make some
changes. Many different kinds of activity can cause carpal tunnel
Use this picture of an
ergonomically correct workstation setup and posture to
adjust your working environment and how you use it. You can also use this
diagram to help you set up other work areas, such as where you do your hobbies
or work with hand tools.
Consider trying a different tool or grip. Many people benefit from using a split, V-shaped keyboard. If
possible, try one for at least a week. One style may work well for you while
another doesn't. When using other equipment, try changing the way you hold the
tool. You may also be able to switch hands now and then when using some
Consider trying wrist splints.
If you have carpal tunnel symptoms and have trouble
training your wrists to stay straight, try wearing
wrist splints for temporary relief. Wrist splints are
not meant to be worn over a long period of time. But wearing them whenever you
are sleeping can help you manage carpal tunnel syndrome over the long term. See
a picture of a
I don't have any hand pain, numbness, or weakness, so
I don't need to bother about doing activities the "right" way.
Carpal tunnel syndrome can sneak up on you.
After it starts, pain and inflammation can take patience and time to treat. To
prevent problems, your smartest choice is to build good habits now.
After I've made the right adjustments to my activity
or work area, all I have to do is watch my posture, take occasional breaks, and
stretch a few times a day.
Although it might seem like a lot to think
about at first, taking preventive steps against carpal tunnel syndrome isn't
too hard. After you have new habits, they're easy to keep.
Continue to Where?
Now that you have read this
information, you are ready to take preventive measures during your daily
activities. If you have further questions about office ergonomics or your
medical condition, contact an ergonomic specialist or your doctor.
If you would like to find more information on carpal
tunnel syndrome or ergonomics, try these resources:
The National Institute of Neurological Disorders and
Stroke (NINDS), a part of the National Institutes of Health, is the leading
U.S. federal government agency supporting research on brain and nervous system
disorders. It provides the public with educational materials and information
about these disorders.
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
The American College of Rheumatology (ACR) and the
Association of Rheumatology Health Professionals (ARHP, a division of ACR) are
professional organizations of rheumatologists and associated health
professionals who are dedicated to healing, preventing disability from, and
curing the many types of arthritis and related disabling and sometimes fatal
disorders of the joints, muscles, and bones. Members of the ACR are physicians;
members of the ARHP include research scientists, nurses, physical and
occupational therapists, psychologists, and social workers. Both the ACR and
the ARHP provide professional education for their members.
website offers patient information fact sheets about rheumatic diseases, about
medicines used to treat rheumatic diseases, and about care
The American Occupational Therapy Association (AOTA) is the
nationally recognized professional association of approximately 35,000
occupational therapists, occupational therapy assistants, and students of
occupational therapy. AOTA's mission is to advance the quality, availability, use,
and support of occupational therapy through standard-setting, advocacy,
education, and research on behalf of its members and the public.
ASSH is a professional organization of hand surgeons
that provides education to the public about hand problems, such as Dupuytren's
disease, carpal tunnel syndrome, and tennis elbow. ASSH also provides education
about surgery, preventive tips to keep your hands safe, and an online tool to
find a hand surgeon.
You can find more information about carpal tunnel
syndrome in these topics:
Return to topic:
October 2, 2012
Kathleen Romito, MD - Family Medicine & Herbert von Schroeder, MD, MSc, FRCSC - Hand and Microvascular Surgery
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