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 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.

  • 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 sometimes 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.

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 on things 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, 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 do 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 do 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 an ergonomically correct workstation setup and posture. You can adjust your working environment and how you use it. You can also use a similar setup for 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. For example, if you work at a keyboard, tilt it to help keep this alignment. Use proper hand and wrist position 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 needed.
  • 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 now and then when using some tools.

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. These 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.

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 hard. 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 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 learn more about carpal tunnel syndrome or ergonomics, try these resources:

Organizations

National Institute of Neurological Disorders and Stroke
NIH Neurological Institute
P.O. Box 5801
Bethesda, MD  20824
Phone: 1-800-352-9424
Phone: (301) 496-5751
TDD: (301) 468-5981
Web Address: www.ninds.nih.gov
 

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.


American Academy of Orthopaedic Surgeons (AAOS)
6300 North River Road
Rosemont, IL  60018-4262
Phone: (847) 823-7186
Fax: (847) 823-8125
Email: orthoinfo@aaos.org
Web Address: www.orthoinfo.aaos.org
 

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.


American College of Rheumatology
2200 Lake Boulevard NE
Atlanta, GA  30319
Phone: (404) 633-3777
Fax: (404) 633-1870
Web Address: www.rheumatology.org
 

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.

The ACR website offers patient information fact sheets about rheumatic diseases, about medicines used to treat rheumatic diseases, and about care professionals.


American Occupational Therapy Association
4720 Montgomery Lane, P.O. Box 31220
Bethesda, MD  20824-1220
Phone: (301) 652-2682
Fax: (301) 652-7711
TDD: 1-800-377-8555
Web Address: http://www.aota.org
 

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.


American Society for Surgery of the Hand (ASSH)
6300 North River Road
Suite 600
Rosemont, IL  60018-4256
Phone: (847) 384-8300
Fax: (847) 384-1435
Email: info@assh.org
Web Address: www.assh.org
 

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.


To learn more about carpal tunnel syndrome, see:

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Herbert von Schroeder, MD, MSc, FRCSC - Hand and Microvascular Surgery
Last Revised October 2, 2012

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