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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.

Modern carpal tunnel release is performed under local anesthesia as an outpatient. The operation takes about 15 minutes. After surgery, weightlifting restrictions may be in place for four to six weeks as the short incision in the palm heals.

If you are worried about getting carpal tunnel syndrome from computer use, stop worrying. Large epidemiological studies have proved that clerical workers (computer operators) are no more at risk of developing carpal tunnel syndrome than everyone else.

Mark Brzezienski, M.D., is a partner at The Plastic Surgery Group, a professor of plastic and orthopedic surgery at the University of Tennessee Health Science Center and a member of the Chattanooga-Hamilton County Medical Society.

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Mark Brzezienski, M.D.
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