Carpal Tunnel Syndrome

by Steve Neville

As technical writers, we generally have safe jobs. There aren't many workplace hazards that befall us when we're putting together a new manual or updating some online help. One problem that technical writers do sometimes struggle with is Carpal Tunnel Syndrome, or CTS.

What is the Carpal Tunnel?

CTS attacks an important but overlooked part of our anatomy -- our carpal tunnel. The carpal tunnel is a small passage just inside our wrist. This passage consists of the wrist bones on the bottom, and a ligament (the transverse carpal ligament) on the top. If you put your hand out, palm up, and feel your wrist you can feel the outside of the carpal tunnel. On the bottom, you can feel your wrist bones, and on the top you can feel the softer ligament. Running through this tunnel are arteries and veins that supply blood flow to your fingers, tendons that allow your fingers to bend, and the median nerve that provides feeling to your thumb, index, and middle finger.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is quite simply the swelling of the carpal tunnel, in the form of the transverse carpal ligament. The expansion of this ligament compresses the median nerve inside the tunnel. This is primarily caused by repetitive stress on the wrist. Common occurrences are from assembly work and typing. CTS isn't new, as the American Physiotherapy Association has heard cases of meat packers as far back as 1860 who complained of similar symptoms. These symptoms include: numbness in the hand and thumb, and wrist tingling pain. Doctors often hear patients complain about a 'funny feeling' in their hands.

How do I get treated?

When detected early, the first step is to undergo strategies to prevent the symptoms from getting worse (see the following section for more information). Advanced stages may require you to wear a splint that keeps the wrist straight. Cortisone injections to reduce the swelling have been used with some success. Finally, sufferers can undergo carpal ligament release surgery. This is day surgery, undertaken with local or general anesthesia, where doctors cut the ligament to help release the pressure on the nerve. Although a very safe procedure, it comes with the usual risks of any surgery, along with time off work while you are recovering.

How do I prevent it?

Carpal Tunnel Syndrome can be kept under control and prevented, if you take certain steps. If you must undergo repetitive motion stress, there are a few ways to make your life a little better. Kinesiologists recommend the following four steps:

1. Take frequent breaks -- Every 30-50 minutes, take a short break to rest your wrists. During the break, really rest the wrist joint and step away from your workstation.
2. Use a stress ball -- These round foam balls are great at not only exercising your wrist and fingers, but post-surgery they are excellent at rebuilding hand strength.
3. Do stretches -- One good stretch is to put your arm straight out in front of you at about chest height with your palm down. With the other hand, grasp the fingers of your outstretched hand then gently but securely pull your hand back. You are trying to make your palm vertical, with the arm and hand appearing to make a 'stop' gesture. Only pull back far enough to feel the stretch. Hold for about 15 seconds. Repeat with opposite arm.
4. Get ergonomic devices for your work area -- Anything that promotes your working with a straight (not bent wrist) is extremely helpful. Whether they are gel pads at your mouse or keyboard, or grip extenders, these items help alleviate the stress on your wrists. Some people opt to choose a trackball or thumbwheel instead of a mouse. Either device can be helpful for some, but for others, they find that the isolated pressure on the thumb and inside of the hand can make their symptoms worse.

Sources and Useful Links

Medical Source -- www.yourmedicalsource.com

National Institute of Health -- www.nlm.nih.gov

American Physiotherapy Association -- www.apta.org