Members of faculty of the Hand Program at Beth Israel Deaconess Hospital–Needham are national leaders in investigating new ways to treat this increasingly common condition. They have published dozens of research articles.
Carpal tunnel syndrome is caused by a compressed nerve in the wrist, which subsequently causes symptoms in the hand. Pressure on the median nerve, which is inside a narrow passage in the wrist called the carpal tunnel, causes the nerve to malfunction. This nerve provides feeling to the thumb, index and middle fingers, and half the ring finger. It also controls several muscles in the hand, the most important of which allows the thumb to touch the little finger. Compression occurs when the tissues in the carpal tunnel swell up.
Carpal tunnel syndrome is a repetitive strain injury. Although there are many causes for carpal tunnel syndrome, by far the most common is doing repetitive motions as part of your job. Fragmentation of work to the point that one person does one task over and over has been blamed for the increase in cases of carpal tunnel syndrome in recent years. There are approximately one million new cases every year.
Anything that causes irritation, inflammation, fluid retention, or an abnormal growth in or around the carpal tunnel can cause carpal tunnel syndrome, including
It is possible to develop carpal tunnel syndrome with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing carpal tunnel syndrome. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
The vast majority of carpal tunnel syndrome cases are work related. People whose occupations involve repetitive work with the hands, such as keyboard operators, factory workers, typists, barbers, musicians, and vehicle drivers, are at increased risk. In addition, people who use vibrating tools, such as jack hammers, chain saws, chippers, grinders, drills, and sanders, for long periods everyday may be at increased risk.
Wrist injuries, such as burns, broken bones, compression, or crush injuries, may increase your risk of developing carpal tunnel syndrome.
Having the following medical conditions may increase your risk of developing carpal tunnel syndrome
Carpal tunnel syndrome is most often diagnosed between the ages of 40-60.
Women are diagnosed with carpal tunnel syndrome three times more often than men.
Inheriting a narrowed carpal tunnel increases your chances of developing carpal tunnel syndrome.
Carpal tunnel syndrome causes symptoms in one or both hands that, more rarely, may also extend up the arm. Symptoms are caused by compression of the median nerve in the carpal tunnel. This nerve supplies feeling to the thumb, index, middle, and half the ring finger. It also innervates the muscles that move the thumb toward the little finger and move the index finger around in a circle.
The doctor will ask about your symptoms and medical history, and examine your neck, arms, wrists, and hands. The physical exam will include tests of strength, sensation, and signs of nerve irritation or damage.
The physical exam may include
Other tests may include
The treatment and management of carpal tunnel syndrome requires that pressure in the carpal tunnel be reduced. There are several ways to do this. As with all health problems, the safest and simplest treatments are tried first. If your carpal tunnel syndrome is due to another treatable condition, such as diabetes or a hormone disorder, that condition may be treated first to see if the carpal tunnel syndrome resolves.
To treat carpal tunnel syndrome directly, the options are
Carpal tunnel syndrome is most often caused by activity associated with repetitive hand motion on the job. Those most at risk, such as keyboard operators, factory workers, typists, musicians, barbers, and bus drivers, can do much to prevent development of carpal tunnel syndrome. Ergonomic specialists can help you set up your workplace to be as comfortable and efficient as possible.
You may reduce your chances of getting carpal tunnel syndrome by taking these steps
According to a report published by the American Academy of Orthopaedic Surgeons, a simple warm-up routine may greatly reduce the incidence of carpal tunnel syndrome. The warm-up routine is as follows
A simple change in how your wrists are positioned during sleep may reduce your risk of getting carpal tunnel syndrome. Sleep with your wrists cocked upward instead of bent downward to minimize pressure in the carpal tunnel.