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 JULY 30, 2003 What Is Carpal Tunnel Syndrome? What Is Carpal Tunnel Syndrome? Carpal tunnel syndrome (CTS) is a condition brought on by a pinched nerve at the wrist. CTS is classified as a cumulative trauma disorder, which is a disorder caused by repeatedly performing stressful motions with the hands or holding the hand in the same position for long periods of time. It specifically affects the sensitive nerves and blood supply that feeds the hands and wrists, causing numbness, tingling and pain in the arm, hand, and fingers. The syndrome gets its name from the space in the wrist where the median nerve and nine tendons pass from the forearm into the hand. This tunnel is formed on three sides by the carpal bones of the hand and the strong, broad carpal ligament on top. The median nerve supplies sensation to the thumb, index, and ring fingers. The tendons that course through the tunnel flex the fingers and lie underneath the median nerve within protective sheaths. With repetitive motion of the fingers, hand, and wrist, the lining of the tendons within the carpal tunnel may swell up. In addition, the ligament that forms the roof of the carpal tunnel may become thicker and broader. Eventually, the tendons and the ligament press on the median nerve. Anyone who has persistent pain in the hand and wrist should consult a physician for a diagnosis. Who Gets Carpal Tunnel Syndrome? Carpal tunnel syndrome affects men and women of all ages and often strikes workers whose tasks require repeating the same motion in the fingers and hand for long periods of time. Meatpackers complained of pain and loss of hand function as long ago as the 1860s. Today, CTS has surfaced among assembly line workers, jackhammer operators, typists, computer operators, file clerks, secretaries, assemblers, manual laborers, or any occupation that entails the use of the hands and wrists, including athletes and physicians. Approximately one out of every 1,000 workers develops CTS. For some unknown reason, women suffer three times the rate of CTS as men do. Older people also are more likely than younger ones to complain of CTS, possibly because nerve velocity slows down as people age. Medical illnesses may also cause swelling in the wrist and lead to CTS. These include arthritis, thyroid disease, diabetes mellitus, menopause, and pregnancy. Exercises Hand and wrist exercises can help reduce the risk of developing CTS. Isometric and stretching exercises can strengthen the muscles in the wrists and hands, as well as the neck and shoulders, improving blood flow to these areas. Excessive use of the hands can cause the forearm muscles to tighten, increasing pressure on their tendons as they pass through the wrist. Stretching these muscles will reduce the tension on the tendons. Wrists. Make a loose fist, palm up, and use the other hand to press gently down against the clenched hand. Resist the force with the closed hand for five seconds. Keep the wrist straight. Repeat with the palm down and with the thumb side of the fist up. With the fist down, press against the knuckles of the closed hand. Resist for five seconds with the palm up, palm down, and with the thumb side of the fist up. Repeat this series of exercises five times. Fingers and Hand. Clench the fingers of one hand into a fist tightly, then release, fanning out the fingers. Do this five times. Repeat with the other hand. Forearms. Place the hands together in front of the chest, fingers pointed upward. Keep the palms flat together and raise the elbows to stretch the forearm muscles. Stretch for 10 seconds. Then gently shake the hands limp for a few seconds to loosen them. Repeat frequently when the hands or arms tire from activity. Neck and Shoulders. Sit upright and place the right hand on top of the left shoulder. Hold that shoulder down and slowly tip the head away to the right. Keep the face pointed forward, or even turned slightly toward the right. Hold this stretch gently for five seconds. Repeat on the other side. Stand in a relaxed position with the arms at the side. Shrug the shoulders up, then squeeze the shoulders back, then stretch the shoulders down, then press them forward. The entire exercise should take about seven seconds. |
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