HEALTHY AND ACTIVE | My wrist hurts — do I have carpal tunnel syndrome?

Does clapping for the Seahawks hurt your wrist and make your fingers tingle? Do you have to shake your hand to get it to “wake-up” after keyboarding? This wrist pain and hand numbness might be the signs of carpal tunnel syndrome. 

Carpal tunnel syndrome is a condition where the tendons or nerve running through a tunnel-like formation (called the carpal tunnel) in the wrist become inflamed. This nerve, the median nerve, controls sensation to all fingers except the small (“pinky”) finger and controls the motion of many of the muscles in the thumb and hand. 

Swelling within the carpal tunnel places pressure on the median nerve and interferes with its ability to function. Waking up with numbness in the thumb and nearby fingers is often the first sign of this condition. Pain on the palm side of the wrist that radiates through the forearm and shoulder may also occur.

The symptoms associated with carpal tunnel syndrome can progress over weeks and months and make daily activity at home and work uncomfortable. Hand weakness and numbness when raking leaves last weekend can progress to an inability to handle a carving knife by Thanksgiving. 

Women between 40 and 60 years of age have the highest incidence of carpal tunnel syndrome, although it is a condition that affects both sexes of all ages and activity levels. 

Your doctor can diagnosis this condition for you and may have specific nerve studies completed to confirm the diagnosis. Consulting with your doctor will also help assure there aren’t other more serious conditions causing your hand pain and numbness.

Possible causes

There are many painful conditions of the wrist and hand, and although carpal tunnel syndrome is a common culprit, there are other potential diagnoses that must be ruled out. Hand and finger numbness can be caused by a pinched nerve in the neck, while numbness in the small finger is caused by a nerve that is not in the carpal tunnel (the ulnar nerve). 

Wrist pain can be caused by tendon inflammation and finger stiffness can result from arthritis, trigger finger and diseases of the tissue in the palm such as Dupuytren’s disease. 

Poor ergonomics, repeated awkward movements of the hands and forceful gripping can lead to carpal tunnel syndrome. Using a keyboard with the hands and wrists in a bent position can place pressure on the median nerve and lead to inflammation. Standing and sitting in a slouched position can place stress on the nerves of the arm and force tendons within the carpal tunnel to work harder leading to pressure on the median nerve. 

People with medical conditions such as diabetes, rheumatoid arthritis and a prior broken wrist may be more likely to develop carpal tunnel syndrome. 

Pregnancy can cause this condition, although it typically resolves postpartum.

The initial care for carpal tunnel syndrome should be to rest the hand and wrist and avoid activities that make the symptoms worse. If symptoms subside, a gradual return to activity should be attempted. Wearing a wrist support splint at night may prevent nerve damage associated with excessively bending the wrist during sleep. 

Your doctor may refer you to an occupational therapist for guidance on splinting, exercise and ergonomic instruction that can be effective in resolving carpal tunnel syndrome. Occupational therapists specialize in how the body interacts with the environment and can teach exercises to improve posture and movement and reduce the risk of other injuries. 

The goal of non-surgical care is to reduce symptoms while staying engaged in family and work life. If this conservative approach is unsuccessful, a surgical procedure may be recommended. Carpal tunnel surgery is a common procedure that usually results in a return to activity after a few weeks of recovery as the hand heals. 

The best treatment for carpal tunnel syndrome is prevention. A healthy diet with regular exercise is the place to start. Limiting time you spend keyboarding and getting an ergonomic assessment of your workstation will prevent positions and activities that can lead to nerve and tendon inflammation. 

When you type, keep your wrists straight, with your hands a little higher than your wrists. Relax your shoulders when your arms are at your sides. Keeping the wrist in a neutral position — not bent too far up or down — is the safest position to work from. 

Performing shoulder, wrist and hand stretches every hour during the workday can relieve the stress on the tendons and nerves of the arm. 

If you must perform repeated movements, switch hands occasionally if you are able and try to use your whole hand, not just your fingers, to hold an object. 

Take frequent rest breaks when engaging in activities that require using your hands a lot so that the tendons and nerve in your carpal tunnel can recover and not become fatigued. 

Pain is a sign that damage has occurred, and an aching wrist with tingling in the fingers may be a sign of carpal tunnel syndrome. Check with your doctor to get proper guidance on medical care and consider consulting with an occupational therapist to assess how your activity may be modified to help resolve that pain in the wrist. 

AARON SHAW is an occupational therapist and certified strength and conditioning specialist at MoveMend (www.MoveMend.info) in Madison Valley. To comment on this column, write to MPTimes@nwlink.com.