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Whether you work at a computer or with tools -- anywhere that requires using your hands for repetitive tasks -- carpal tunnel syndrome (CTS) is a potential hazard. It affects workers in many different industries, from office work to construction to retail. The mechanisms of the wrist and hand are much more complicated and delicate than one might think, and it can be easy to ignore signs of strain or overuse.
Understanding carpal tunnel syndrome requires understanding the anatomy of your arm and hand. The carpal tunnel is the narrow passageway on the palm side of your wrist that connects your forearm to your hand. The ligaments and bones that connect these two house the median nerve as well as the tendons that bend your fingers. The median nerve controls some of the muscles at the base of your thumb, but primarily is what provides feeling to the thumb and all your fingers except the little finger. When this nerve is squeezed, carpal tunnel syndrome can develop.
CTS is called an entrapment neuropathy, a condition in which too much pressure is placed on a peripheral nerve. The symptoms can somewhat vary in degree and usually begin gradually. They can occur in one or both hands and include:
Pressure on the median nerve causes CTS, and this pressure usually comes when the space in for the median nerve within the tunnel shrinks. Typically this is from swelling or thickening in the tunnel lining by irritated tendons, and a single cause can be hard to find. Injuries or actions that can start this process may include:
Other contributing factors may include genetic predisposition, diabetes, obesity, the development of a cyst or tumor, fluid retention during pregnancy or menopause, mechanical problems in the wrist joint, and various forms of work using the hands.
Women are 3 times more likely than men to get CTS, and this may be due to having smaller wrist bones and less space within the carpal tunnel. Many conditions that cause hormonal changes and can contribute to CTS are also suffered more commonly or exclusively by women, such as pregnancy, menopause, and hypothyroidism. Carpal tunnel incidence also increases with age, with people age 45-54 particularly at risk.
Certain industries have more prevalent rates of CTS. Although it's often associated with secretarial, data entry, and other office work, the highest rates of worker's compensation for carpal tunnel have been found in factories, particularly textile mills and clothing manufacturers. Any assembly line is subject to it, though: assemblers are 3 times more likely to get CTS than even data entry professionals.
Any occupation with these types of tasks may present carpal tunnel risks:
Preferably the best course of action with CTS is to prevent carpal tunnel before it becomes an issue. However, this is most readily available for cases stemming from the workplace and doesn't fully cover complications caused by other health issues. Still, it helps to have guidelines in place to ensure safer work practices. These might include the following:
Unfortunately, sometimes you can develop carpal tunnel syndrome despite precautions. Like the gradual onset of the syndrome, treatment is a process. It's dependent on how advanced your symptoms are, and the underlying causes. Treatments are varied and may include: