Carpal Tunnel Syndrome
Carpal tunnel syndrome is a painful condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually, with pain, weakness, or numbness in the hand and wrist, radiating up the arm. As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In some cases no direct cause of the syndrome can be identified. Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others. The risk of developing carpal tunnel syndrome is especially common in those who preform repetitive work tasks, such as assembly line work. Carpal tunnel syndrome is also associated with pregnancy and diseases such as diabetes, thyroid disease, or rheumatoid arthritis.
Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, other nonprescription pain relievers, and oral steroids (prednisone) may ease pain. Steroid injections can also be used to alleviate the swelling and pressure on the median nerve. For more severe cases of carpal tunnel syndrome, open carpal tunnel release surgery or endoscopic carpal tunnel release may be recommended.
In general, carpal tunnel syndrome responds well to treatment, with the majority of patients recovering completely. To prevent workplace-related carpal tunnel syndrome, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible.
The National Institute of Neurological Disorders and Stroke (NINDS) conducts research on nerve-related conditions such as carpal tunnel syndrome in its laboratories at the National Institutes of Health (NIH) and also supports research through grants to major medical institutions across the country. Current studies include several randomized clinical trials to evaluate the effectiveness of educational interventions in reducing the incidence of carpal tunnel syndrome. Another clinical study is collecting data about carpal tunnel syndrome among construction apprentices to better understand specific work factors associated with the disorder and develop strategies to prevent its occurrence among construction and other workers. Scientists are also investigating the use of alternative therapies, such as acupuncture, to prevent and treat this disorder.
American Chronic Pain Association (ACPA)
Provides self-help coping skills and peer support to people with chronic pain. Sponsors local support groups throughout the U.S. and provides assistance in starting and maintaining support groups.
P.O. Box 850
Rocklin, CA 95677-0850
National Institute of Arthritis and
Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health, DHHS
31 Center Dr., Rm. 4C02 MSC 2350
Bethesda, MD 20892-2350
Centers for Disease Control and
U.S. Department of Health and Human Services
1600 Clifton Road
Atlanta, GA 30333
Occupational Safety & Health Administration
U.S. Department of Labor
200 Constitution Avenue, NW
Washington, DC 20210