Q: I use a computer all day at work and am worried about getting carpal tunnel syndrome. What can I do to reduce the risk?
A: Carpal tunnel syndrome is caused by a “pinched” nerve in the palm where the arm meets the hand.
The nerve (the median nerve) becomes pinched because the tendons that flex the fingers become swollen and put pressure on the nerve. Much like if you sit in a chair too long and your leg “falls asleep,” the fingers supplied by the median nerve also “fall asleep.” This typically involves the thumb, index, long and ring fingers. Pain at the site of compression is also typical.
The causes of carpal tunnel syndrome are many and related to general health, specific hand trauma and one’s own anatomy. Some of the most common health-related causes are diabetes, hypertension, obesity and general deconditioning. Autoimmune disorders such as rheumatoid arthritis and even thyroid disease can contribute significantly to nerve compression and nerve function.
After diagnosis, a trial of splinting and nonsteroidal anti-inflammatory medication (like ibuprofen) is in order. Attention to and treatment of primary health-related causes is also important. If conservative management does not lead to improvement in symptoms, a diagnostic nerve conduction velocity is ordered. This is a test of one’s nerve “wiring.” It will tell the hand surgeon if there is slowing of the speed at which the median nerve works at the carpal tunnel. If that is the case, and the patient’s examination is consistent with carpal tunnel syndrome, then a carpal tunnel release will be prescribed.