Wrist care: Preventing carpal tunnel syndrome

Introduction

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 of developing 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.

Key points

  • Many health conditions and diseases make you more likely to get carpal tunnel symptoms. But if you exercise, stay at a healthy weight, control other health conditions such as arthritis and diabetes, and avoid smoking, you can help prevent carpal tunnel syndrome.
  • Arranging your activity and work space using ergonomic guidelines can help prevent carpal tunnel syndrome. Office ergonomics focuses on how a workstation is set up, including the placement of your desk, computer monitor, paperwork, chair, and associated tools, such as a computer keyboard and mouse. The same ideas can help you arrange your position for other daily activities.
  • Proper body mechanics are key to preventing carpal tunnel syndrome.
  • Evaluate your daily routine for activities that increase your risk of carpal tunnel syndrome.
  • Take frequent breaks from activities to rest, stretch, change positions, or alternate with another activity.
 

Carpal tunnel syndrome is a specific group of symptoms including tingling, numbness, weakness, or pain in the fingers, thumb, or hand and occasionally spreading up the arm. These symptoms occur when there is pressure on the 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 and 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 specifically on factors that you can control during daily activity.

Test Your Knowledge

Carpal tunnel syndrome may be painful, but it can't cause permanent damage.

  • True
    This answer is incorrect.

    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 weakness.

  • False
    This answer is correct.

    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 weakness.

  •  

Continue to Why?

 

When the wrists are bent during activities such as typing or needlework, the carpal tunnel narrows and can press on the median nerve. This is especially likely when the tunnel is already narrowed by swelling.

Common movements, positions, or conditions that put pressure on the median nerve include:

  • Repetitive movement of the fingers or wrist.
  • Prolonged or repeated bending of the wrist, particularly using the hand to support weight or apply pressure.
  • Prolonged vibrating of the hand, as when using a power tool.
  • Swelling in the wrist area. This can be from carpal tunnel syndrome inflammation, which perpetuates the median nerve effects, or from fluid retention. Carpal tunnel syndrome is common during later pregnancy, when women tend to retain fluid.

Monitoring your body mechanics is key in preventing carpal tunnel syndrome.

Test Your Knowledge

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 mechanics.

  • True
    This answer is correct.

    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 perform other manual tasks that can also affect the median nerve.

  • False
    This answer is incorrect.

    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 perform other manual tasks that can also affect the median nerve.

  •  

Continue to How?

 

Don't wait 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 syndrome.

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.

When setting up your work area:

  • Center your work in front of you, as low as possible without touching your legs (your forearms are parallel to the floor or slightly lowered). If you work while standing, have your work surface at about waist height.
  • Keep your hands and wrists in line with your forearms. If you work at a keyboard, tilt it to help keep this alignment. See pictures of proper hand positioning for keyboard use and proper hand and wrist position for mouse and trackball use for examples of good wrist positions for manual tasks.
  • Hold your elbows close to your sides.
  • Avoid leaning on the heel of your hand or your wrist.
  • Take little breaks every 10 to 15 minutes. Use a reminder alarm if necessary.
  • Do stretching exercises every 20 to 60 minutes.

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 periodically when using some tools.

If you've developed 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 wrist splint.

Test Your Knowledge

I don't have any hand pain, numbness, or weakness, so I don't need to bother about doing activities the "right" way.

  • True
    This answer is incorrect.

    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.

  • False
    This answer is correct.

    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.

  • True
    This answer is correct.

    Although it might seem like a lot to think about at first, taking preventive steps against carpal tunnel syndrome isn't too difficult. After you have new habits, they're easy to keep.

  • False
    This answer is incorrect.

    Although it might seem like a lot to think about at first, taking preventive steps against carpal tunnel syndrome isn't too difficult. 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, the following resources are available:

Organizations

National Institute for Occupational Safety and Health (NIOSH)
395 E Street SW
Suite 9200
Washington, DC  20201
Phone: 1-800-CDC-INFO (1-800-232-4636)
(202) 245-0625
(513) 533-8328 (outside the U.S.)
Fax: (513) 533-8347
E-mail: cdcinfo@cdc.gov
Web Address: www.cdc.gov/niosh
 

The National Institute for Occupational Safety and Health (NIOSH) conducts research and makes recommendations for the prevention of work-related injuries and illnesses. NIOSH also provides information to the public.


American Physical Therapy Association
1111 North Fairfax Street
Alexandria, VA  22314-1488
Phone: 1-800-999-APTA (1-800-999-2782)
(703) 684-2782
Fax: (703) 684-7343
TDD: (703) 683-6748
Web Address: www.apta.org
 

The American Physical Therapy Association is a national organization representing nearly 70,000 physical therapists, physical therapist assistants, and students. Its goal is to foster advancements in physical therapist education, practice, and research. The APTA also provides information and education to the public about physical therapy and how it is used to treat certain conditions.


Occupational Safety and Health Administration (OSHA), U.S. Department of Labor
200 Constitution Avenue
Washington, DC  20210
Phone: 1-800-321-OSHA (1-800-321-6742)
TDD: 1-877-889-5627 toll-free
Web Address: www.osha.gov
 

The Occupational Safety and Health Administration (OSHA) provides information about hazards at the workplace and about worker safety.


You can find more information about carpal tunnel syndrome in these topics:

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Last Updated: October 29, 2008

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