Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is one of the most common conditions that can affect individuals working in office environments. It’s a neurological health issue that has become increasingly prevalent in modern times. This syndrome can range from being a minor problem to requiring treatment that includes surgical intervention.

Carpal Tunnel Syndrome occurs when pressure is applied to the median nerve which is responsible for the sensory functions of the fingers (thumb and the first three fingers) as well as the motor functions of the hand muscles. This nerve passes through a narrow passage in the wrist surrounded by bones and ligaments, known as the carpal tunnel.

Causes

Carpal Tunnel Syndrome doesn’t often have a single cause, as a combination of risk factors may contribute to its occurrence and an increased risk of irritation or damage to the median nerve. Some of these key factors include:

Wrist fractures, injuries or bleeding within the carpal tunnel, leading to deformities in bone structure and changes in its interior space, thus exerting pressure on the median nerve.

Carpal Tunnel Syndrome is generally more common in women, possibly due to the relatively smaller size of the carpal tunnel in females compared to males.

Changes in bodily fluids and fluid retention can lead to increased pressure within the carpal tunnel and irritation of the median nerve. This condition can manifest during pregnancy and menopause.

Occupational factors can play a role, as certain jobs involve repetitive movements. For example, hairdressers or those using vibrating hand tools that require prolonged and repetitive wrist bending, as well as individuals in occupations that subject their wrists to incorrect postures for prolonged periods, such as typing on a computer keyboard or using a computer mouse, embroidery, musicians, and playing handball.

Obesity is a risk factor associated with Carpal Tunnel Syndrome.

Medical conditions that may increase the chances of developing this condition, such as:

Diabetes, which can damage nerves, including the median nerve.

Inflammation and swelling resulting from rheumatoid arthritis.

Thyroid disorders and kidney failure.

Symptoms

In the presence of any of such risk factors, the following symptoms of Carpal Tunnel Syndrome may appear:

Tingling or numbness: Typically starting at night, sensations of pain and tingling manifest in the thumb, index, and middle fingers. These symptoms can cause the patient to wake up multiple times during the night. They can also occur during the day, for instance, while driving, holding a phone, or reading a newspaper.

Weakness in the hands and arms: Numbness in the hands or weakness of the thumb’s gripping muscles, which are controlled by the median nerve, might lead to difficulty in holding objects.

Finger pain: this pain may radiate to the hands or arms.

Left untreated, these symptoms could be exacerbated, leading to complications including permanent nerve damage and muscle atrophy. In such severe cases, surgical intervention is needed. This procedure involves cutting the ligament that forms a cover for the carpal tunnel and widening the tunnel to relieve pressure on the nerve.

Prevention

Pressure on the hands and wrists can be alleviated through these methods:

keep your hands and wrists in the proper position during work and avoid excessively bending your wrists upwards or downwards, keeping them in a moderate and relaxed position.

Sit properly; improper posture causes the shoulders to hunch forward, tensing the neck and shoulder muscles causing pressure on nerves in the neck, which can affect the wrists, fingers, and hands.

Take short and frequent breaks whenever possible during work. During these breaks, stretch and gently bend your hands and wrists, or rotate them in different directions for a minute every 10 to 15 minutes, while avoiding repetitive movements for prolonged periods.

Switch tasks whenever possible, especially if using a vibrating device or one requiring force.

Use appropriate tools at work to avoid exerting pressure on the wrist and the median nerve. For instance, choose an appropriate computer mouse or ensure that the keyboard is at elbow level or slightly lower, so your hand is not elevated or causing pressure on the wrist and median nerve.

Keep your hands warm, as a cold work environment increases the chance of hand pain and stiffness. If temperature control in the workplace is not possible, using gloves can help maintain warmth.

Use a brace or splint to immobilize the wrist and restrict movement.

Avoid sleeping on the affected hand to help alleviate pain.

Engage in physical exercise, especially stretching exercises.

By: Dr. Badreyya Al-Harmi, Consultant Public Health, Emirates Public Health Association

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