Carpal tunnel syndrome can cause wrist pain and numb fingers, and is popularly associated with the workplace. There is some question, however, as to whether or not the syndrome is actually related to occupation.
"There are multiple studies that show for, and against, certain occupations causing the syndrome. Predispositions for the syndrome are diseases like diabetes and thyroid disease; age and obesity," Dr. Troy Pierce, orthopaedic surgeon for The Bone & Joint Center.
Carpal tunnel happens as a result of pressure on the main nerve that goes to the hand and fingers, Pierce explained. The nerve, which runs in a tight tunnel at the wrist, shares the space in the tunnel with tendons. When the tendons become inflamed or swollen, they crowd the nerve and put pressure on it. That's when the wrist pain and numb fingers begin.
"People will complain of dropping things, and some thumb weakness. Symptoms are usually worse at night. When we lay down our hands, they tend to swell more," Pierce said.
Carpal tunnel is fairly common among individuals over age 30.
"Some studies show that 5 percent of people will have some percentage of carpal tunnel in their lifetime," Pierce said. "It happens in people in their 30s through the end of life. It's very rare to see it earlier."
Catch it early
As with most conditions, carpal tunnel is more easily cured in its earlier stages. Pierce said that more than 70 percent of mild to moderate cases can be cured with the use of night-time splints and cortisone injections into the tunnel to shrink swollen tendons.
"In the mild to early stages, you'll get occasional numbness of the thumb, index finger and long finger associated with repetitive activity, and some night-time symptoms," Pierce said. "In moderate stages, you'll notice it with most activities and most nights."
In severe stages, Pierce said, the fingers are numb all the time and the muscles in the thumb are wasting.
"It's surprising. There's a lot of stoic, self-employed people in North Dakota that put off going to the doctor, and sometimes they will present on an initial visit with severe carpal tunnel," Pierce said. "All of the severe cases will require surgery. Putting it off any longer would result in permanent nerve damage and muscle weakness."
The surgery, called carpal tunnel release, is a 10-minute outpatient procedure.
"We go down to the roof of the tunnel and release the ligament which makes up the roof of the tunnel, to allow the tunnel to expand," Pierce said. "It releases pressure on the nerve. Most people notice dramatic symptom relief immediately."
Prevention
Pierce said management of diabetes and thyroid disease is important to preventing carpal tunnel, as is losing weight and wearing splints at night when symptoms begin. Some occupational changes can also help.
"There are some ergonomic changes in your occupation that can be done to help alleviate stress on the tendons and wrists," he said. "For example, if you do a lot of typing or mousing during the day, a standard mouse is worse for carpal tunnel. You should get a mouse where the wrist is stationary, and you just move the thumb. For typing, there are more ergonomical keyboards and different pads for the wrist."
"Taking frequent breaks is important," he added. "Vary your activity so you're not doing one constant activity for hours on end."
Pierce said individuals should seek treatment for carpal tunnel if they are beginning to notice symptoms on a daily basis.
"If you're noticing weakness, especially in the thumb muscles, and if your fingers wake you up frequently at night with numbness, or if you notice numbness during the day with activities, you should seek treatment," Pierce said.
