Between constant work on our computers and non-stop texting, carpal tunnel pain seems like an inevitability. Carpal tunnel pain is related to the median nerve that runs from the tips of the fingers up to the elbow on the underside of the forearm. The median nerve controls all sensation in the hand and fingers.
The carpal tunnel itself is a protective sheath of small bones through which the median nerve and ligaments must pass. This small channel, the carpal tunnel, is not immune to overuse, misuse, or injury from repetitive motion. When the nerve is damaged or irritated, it can swell, becoming compressed in the carpal tunnel.
Signs and symptoms of carpal tunnel damage that might precede the progression to a more serious condition include:
- Numbness and tingling in the fingers and wrist
- Pain that could potentially radiate up the arm
- Weakness in the hand and fingers
- General discomfort in the affected area
- Burning sensation
The fingers most commonly affected are the thumb, middle, and index fingers.
Carpal tunnel pain can be caused by any number of things. As carpal tunnel issues arise when the nerve is compressed or constricted as it passes through the carpal tunnel in the wrist, those individuals with a smaller passageway may be genetically predisposed to issues. Other potential risk factors for developing carpal tunnel pain include:
- Age: Carpal tunnel syndrome is generally diagnosed most frequently in people between the ages of 45 and 54, with the risk increasing for both men and women as they age.
- Gender and hormones: Women who are pregnant show a higher incidence of carpal tunnel pain, possibly due to hormonal changes. Post-menopausal women may also have an increased risk as the wrist’s bony structures may actually become enlarged during this time.
- Body mass: Those with a higher body mass index (BMI) are more likely to experience carpal tunnel pain.
- Previous injury: Any previous injury to the wrist, hand, or arm puts a person at risk.
- Certain health conditions: Diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis are risk factors as all of these conditions increase inflammation in the body.
- Repetitive motion injuries: Those who are using the wrist frequently in the same manner are at risk for irritation of the median nerve from its origination point in the cervical spine to the palm of the hand and fingers.
Carpal tunnel pain is largely preventable, and minor symptoms can often be managed with minimally-invasive treatments and lifestyle changes.
If you smoke, stop
Quitting smoking today is the number one thing you can do right now that will begin to change your health immediately. Smoking affects all systems of the body, including the flow of blood and oxygen. This may explain why those with carpal tunnel pain who smoke often experience more intense symptoms that last longer. Quitting smoking is a great first step.
At work, relax
When typing, strike the keys with just enough force to make them work. Use a big pen for handwriting, and don’t squeeze it so tightly. Whether it is habit or an approaching deadline that makes us do it, we tend to use more force than is necessary for the job. Try to relax and use just the right amount.
While you are relaxing, take a break
Much of minor carpal tunnel pain can be due to the sheer amount of work we perform. Long hours at a computer or gripping a pen or pressing the keys of a cash register add up. The median nerve can become irritated. If you can, break up your work day (and repetitive tasks) with something that helps to get the whole body moving. Stretch and bend your arms and shoulders, gently working the muscles and tendons. Stand up when you do these stretches for more benefit.
Just like your mom always said: sit up straight
A long day on the job followed by a long commute results in shoulders that are rounded forward, with a neck that leads the way. Restore the natural curves of the spine by working with both feet on the floor, knees at the same level or slightly below the hips. Use a lumbar pillow to allow the low back to follow its natural curve, engage your core muscles, and move your shoulder blades onto your back. This posture may be tiring at first, especially if it has been a long time since you sat with proper form, but after a while your body will adapt.
Carpal tunnel pain treatments
If you have been diagnosed with carpal tunnel syndrome, there are other steps you and your doctor may consider. Your doctor may recommend using non-steroidal anti-inflammatory drugs (NSAIDS) in the short-term to help control inflammation.
Because of the potential for gastrointestinal side effects with long-term use, your doctor may also use a combination of the following:
- Supportive braces or splint: These braces come in many different levels of support, from soft compression to total immobilization. Braces can be worn as long as needed to help support the wrist, and they can be utilized again if symptoms flare up.
- Oral diuretics: These may help to remove any accumulated fluid in the body to relieve pressure on the median nerve.
- Corticosteroid injections: There have been recent studies that showed that 33% of patients receiving corticosteroid injections for carpal tunnel pain did not need additional treatments after two years.
- Surgery: For those patients who do not respond to lifestyle changes and minimally-invasive treatments for carpal tunnel pain, surgery may be an option. This is truly a treatment of last resort, as it involves cutting the transverse carpal ligament to relieve pressure on the median nerve. The two types of possible surgeries are open release and endoscopic. Open release is a more traditional surgery that involves making a two-inch incision, while endoscopic surgery uses a much smaller incision and a camera to locate and lacerate the carpal ligament. Although both are usually completed on an outpatient basis, endoscopic surgery is usually associated with a shorter recovery period.
Carpal tunnel pain can be both genetic and environmental; there are factors that you can control to help prevent or manage the pain. What changes can you make today?