We hear about Carpal Tunnel Syndrome everyday. The moment your hand falls asleep and you get the pins and needles in your fingers, somebody is bound to suggest that it is CTS. However, this is because most people do not have a clear understanding of what Carpal Tunnel Syndrome is. Understanding the physiognomy is important if you want to understand CTS.

The wrist is the slimmest part of the human body. Slim wrists have been considered a sign of beauty for centuries, but people with smaller wrists, it is now known, are at higher risk for CTS.

The carpals are the bones you feel when you touch your wrist. In the wrist is the carpal tunnel, which is enclosed by the carpals on three sides, and on the fourth side, by a transverse carpal ligament. Within this narrow space, is not only the median nerve, but also nine flexor tendons. These tendons help you bend your wrist. As you can imagine, it’s a pretty tight squeeze. If for some reason the carpal tunnel is too small, or if the tendons within the tunnel become larger, your median nerve will be compressed.

It is through the median nerve that you get sensation in your thumb, forefinger, middle finger, and part of your ring finger. When the median nerve is compressed, sensation to these fingers will begin to reduce. You will begin to feel a sort of numbness, or a tingling – rather like your hand is falling asleep.

When you bend your wrist, to form a right angle, the carpal tunnel becomes much narrower. And when you stop to think about it, you will see that most activities, from playing the guitar to typing to having your lunch to pushing a swing, require your wrist to bend. Keeping it bent for prolonged periods of time – like when you type for a long time – compresses the median nerve, and causes the symptoms of CTS. If you do this repeatedly, you could be left with a clear cut case of Carpal Tunnel Syndrome.

Another possibility is that repeated stress on your wrist can injure the tendons in the carpal tunnel. This makes the already narrow space even narrower, and can cause the median nerve to be compressed. This is why anti-inflammatory medicines give relief – once the tendons are back to normal, the carpal tunnel is back to normal, too.

In some cases, there might be a tumour in the wrist. This could also cause compression to the median nerve.

Some other reasons that might result in the inflammation of your tendons are hypothyroidism, pregnancy and diabetes. In such cases, the underlying causes need attention, though anti-inflammatory medicines could still help.

Knowing the facts about Carpal Tunnel Syndrome is important, because a lot of other things, like tendonitis or even bursitis, are ignored after wearing a wrist splint because everybody seems to assume that ay pain in the arm anywhere is CTS. While wearing a wrist splint might not do much harm, it won’t cure anything, either.

Prevention is always better than cure, but if you do have Carpal Tunnel Syndrome, there are different treatments you can try.

The most tempting option when your wrist hurts would be to pop a couple of pain killers and get on with your work. However, while pain killers will help the pain subside for a while, it will just hit you again once the effect wears off. Anti-inflammatory medicines will be of more help.

The pain in the wrist and palm is because your median nerve in the wrist is compressed. The median nerve passes through the carpel tunnel, which is the area in your wrist surrounded on three sides by the carpals and on one by ligaments. There are nine tendons in this tunnel, so, especially for people with small wrists, it can be a tight squeeze for the nerve. In some cases, a tumour in this region, usually benign, is the reason why the median nerve is compressed. In most cases, though, inflammation of the tendons is the real reason why the median nerve gets compressed. This means that anti-inflammatory medicines can relieve much of the pain and discomfort, together with proper rest and support for the wrist.

A wrist splint is also a good idea for people who might just be beginning to recognize the symptoms of CTS. Some people also seem to get relief when cold and hot compresses are alternately applied. If the hot compress gives more relief, though, chances are that it is not CTS at all. CTS has got so much publicity lately that all pain or tingling in the palm is mistakenly thought to be CTS. Plain old tendonitis could be your problem, too.

There are certain schools of thought that consider that stress is the main cause for most Repetitive Strain Injuries. While stress is probably not the cause for CTS, it is true that high stress levels can aggravate the condition. This is why exercises like Yoga, which not only keep you fit, but also helps you calm your mind, help people suffering from CTS.

The last resort is usually surgery. The success rates for surgery are uncertain. While over 90% people felt much better after the surgery according to some studies, over 70% reported recurrence according to others. Surgically relieving the pressure on the median nerve, though, is the last option for people with severe CTS. After the surgery, of course, the patient has to be careful – take plenty of breaks, not strain the wrist too much, maintain correct posture, use ergonomic chairs and other instruments. With such precautions, CTS can definitely be held at bay.

There are also plenty of people who swear by alternative medicines of many sorts, though they have not gained any significant recognition, nor have they been investigated properly.

Dealing with CTS requires some major lifestyle changes, and it can take time to work out a strategy. For short-term management of the condition, though, localized steroid injections can help. This is strictly a short-term remedy, though.

Once those lifestyle changes have been effected, CTS can be beaten and you can go on to lead a full life, as long as you are willing to take a few precautions.

A glove is made to fit a hand. It’s not meant to fit any hand, though. It fits the hand it was made for. Ergonomics is the theory that makes sure that work places and the work itself fit the people who do the work exactly that way.

Ergonomics as an applied science is very important in the work place, especially with the rising incidence of Repetitive Strain Injuries, like Carpal Tunnel Syndrome. Designing the work environment using ergonomics is one of the first steps in eliminating, or at least reducing the occurrence of Carpal Tunnel Syndrome and other RSIs.

Let us take something as simple as the chair you sit in. If it is designed according to the principles of ergonomics, when you sit in it, you will be able to achieve the 90-90-90 posture without even trying. That is, your ankle will be bent at 90 degrees, which will mean that your feet are flat on the floor. Your knee will be bent at 90 degrees, as well, which means that the length of the seat should be right. Your hip will also be bent at 90 degrees, with the back rest having the option of reclining to 120 degrees, which is the optimum way of supporting your back while keeping your posture correct. When you keep your arms on the arm rest, your elbow should also be bent at 90 degrees. This will protect your back, your shoulders, your neck and your arms from any musculo-skeletal injuries that might result in chronic pain for you.

Similarly, an ergonomic keyboard will reduce the chances of injury to your wrist. An ergonomic keyboard is one where you will not have to stretch or flex your wrists to type. When you flex your wrist over prolonged periods of time, you will be increasing the chances of the occurrence of Carpal Tunnel Syndrome.

Engineering Psychology is the branch of ergonomics that makes any kind of equipment more user-friendly, minimizing chances of injury. This can refer to anything from making software more interesting to repositioning the handle on a power tool.

Macroergonomics, on the other hand, is a larger field that deals with organizational factors – improving the work place and relationships within the work place by changing the environment. The environment in this case refers to both people around you and the things you see.

Seating Ergonomics is a whole different field, because the way a person should sit will be different depending on the job he is supposed to do. Correcting seating arrangements is a major way to reduce RSIs.

Work places are beginning to be designed according to these principals, to ensure both short term and long term safety for employees. These measures can also drastically cut down the amount of money companies pay out in damages, while keeping their employees healthy and able to lead full lives.

Your first day on the job – the first time you are sitting down at the computer you will spend a good part of your life staring at. Did anybody tell you that you might be courting Carpal Tunnel Syndrome, though? Every job, no matter how safe it seems, has its risks, even desk jobs. However, there are some things you can do to minimize your risks.

1. Get the right chair. You might not have much choice there, of course, but on most office chairs, the height can be adjusted. Get the height right. You ought to be able to keep your feet flat on the floor with your knees bent at right angle.
2. Make sure your computer keyboard is at the right height. When you sit down comfortably and settle down to type, your forearms must be parallel to the floor. That is, the keyboard must be at about the same level as your elbow.
3. Once you have settled down, double check. When you use the keyboard, do you have to flex your wrists? If you do, you have to adjust the heights again.
4. Make sure your back has the right support. This will help you maintain a good posture. If your back is not straight, your shoulders will droop. If your shoulders droop, your lower arm and wrist will be affected, and you might have Carpel Tunnel Syndrome before you know what’s happening to you.
5. Your monitor must be placed so that you don’t have to bend your neck all the time to look at it. You should be able to see the monitor fine when you look straight.
6. Use a supported mouse pad. Using the mouse, with all the clicks and double clicks, can be quite hard on the wrists. Using a supported mouse pad can keep away Carpal Tunnel Syndrome. When you use a mouse pad, the tendons in your carpel tunnel will not be under severe strain, and thus will not compress your median nerve, which is how you get CTS in the first place.
7. Even after you take car of all of those details, take frequent breaks. Every fifteen to twenty minutes, take a break and do some gentle stretches. Walk around a bit if you can, but even if you can’t, something as simple as stretching one arm horizontally across your chest while pulling it towards your chest with your other arm can help you keep your muscles loose and thus keep away Repetitive Strain Injuries like CTS.
8. Most work places with computers have the temperature turned down fairly low. This can be hard on your wrists, but wearing fingerless gloves is a good way to counter this.
9. If you feel that you might be experiencing any numbness or tingling in your palm, consult your doctor immediately. Something as simple as wearing a splint or a wrist brace can take care of it if you realize it this early.

All jobs include repetitive tasks. This means that everybody could be at risk for CTS. This is something that can be prevented quite easily if you pay proper attention to certain elementary forms of safety at work – just as easily as it could take your self-reliance away from you if you don’t take these measures.

If you lift heavy boxes all day long every day, you know what will happen – your back will be too stiff for you to stand up straight. And that is if you’re lucky. If you’re not, you will be stuck with a bad back until you get proper treatment, and even then, it might not get better. If that can happen to your back because of strain, consider what can happen to a part of your body that is so much more delicate, like your wrist.

No part of your body can take repeated strain and still function properly. Repetitive Strain Injuries or Cumulative Trauma Disorders, or CTDs, are serious problems facing the work force today.

Cumulative Trauma Disorders affect people from all walks of life, but the people who are the most susceptible to these disorders are those who work in assembly lines, those who work on computers, musicians and people who do hard labour. There are many Cumulative Trauma Disorders that affect these people – Focal Dystonia, Cubital Tunnel Syndrome, Radial Tunnel Syndrome and Intersection Syndrome, to name but a few. The most common Cumulative Trauma Syndrome that affects people today, though, is Carpal Tunnel Syndrome.

Whichever CTD you have, there will be warning signs that can help save you a lot of pain and discomfort if you can learn to distinguish them.

• Tingling or numbness
• Pain, especially during the night, maybe bad enough to wake you up in your hand, wrist shoulder, arm or neck
• General weakness, difficulty in gripping things

If you feel that you have any of these symptoms, there is a chance that you might have a CTD, but it will still be its early stages, when it can easily be tackled.

Once you know that you have a CTD, you have to give your arm, in the case of CTS, as much rest as possible. If you can’t give it complete rest, wear a brace and take frequent breaks.

It’s also a known fact that psychological factors contribute towards CTDs. If you are a lot of stress, or if you are not entirely satisfied with your job, for example, your CTD could be aggravated. In fact, there are a few schools of thought that consider stress to be the main cause of CTDs. Excess psychological strain can, at the very least, make you more susceptible to these strain injuries – heavy boxes are not the only kind of load you might be carrying that might be affecting your health and your performance.

A workplace and surroundings designed with the principles of ergonomics in mind – making sure that the environment and the job fit the person who is doing the job, thus ensuring that the person does the job with the maximum effect and with the least harm – is one of the best ways to counter strain injuries of many kind, as well as to prevent strain injuries in the first place.

Before we can look at preventive measures for Carpal Tunnel Syndrome, we need a basic understanding of what Carpel Tunnel Syndrome or CTS is. The Carpel Tunnel is the passage in the wrist created by bones on three sides and ligament on the fourth. Through this tiny space, nine tendons pass, as well as the median nerve. It stands to reason that any inflammation of any sort in the carpal tunnel will cause the median nerve to be compressed. The median nerve goes on to the thumb, forefinger middle finger and ring finger. This is the reason for the burning, tingling feelings and for the numbness and the pain.

So the first thing to do to prevent Carpal Tunnel Syndrome is to avoid causing any kind of strain to your wrist. This is easier said than done, though. Most jobs now require people to sit in front of a computer for hours on end. Manual labour, too, has become easier with power tools. These power tools vibrate, though, and this vibration is very hard on the wrist. If you have no choice but to strain your wrist in your line of work, there are certain things you can do to minimize your risk.

• The best thing you can do is make sure you take adequate breaks. A break every twenty minutes or so can do wonders. This is especially important if you have any tingling or pins and needles sensation in your palm, because these are the first signs of Carpal Tunnel Syndrome.
• Fix your posture. This has been talked about so many times that it has become quite stale. A good posture seems to be the one-shot remedy for so many things that it wouldn’t be much of a surprise if somebody said that it could fix a broken neck, too. But the fact remains that good posture is essential in preventing Carpal Tunnel Syndrome. Ensuring that your wrist does not bend too much for too long, keeping your forearms parallel to the floor while typing and therefore not applying too much pressure all help prevent the onset and/or aggravation of Carpal Tunnel Syndrome
• Keep your wrist warm. You can’t always control the temperature you work in, but you can make sure that you keep your wrist warm with a fingerless glove. This can also act as a support for your wrist, making sure that you don’t bend it too much.
• If you have trouble with hypothyroidism, diabetes or have had some sort of injury in your wrist that might have causes inflammation in the area or tendonitis, you will be more susceptible to CTS. Treating these causes before the onset of CTS is important.
• Don’t stay in one position for too long, whether you are standing or sitting. Walk around, do a few stretches, roll your shoulder, loosen up – do whatever works for you.

Even if you feel that you might have CTS, your best chance to get rid of it for good is if it is diagnosed early enough to give you as many options as possible.

Are Computers Responsible for CTS?

Computers have long got the rap as one of the leading causes of Carpal Tunnel Syndrome. There are always studies that both support and negate this statement, but it has become one of the leading reasons for missing work.

Carpal Tunnel Syndrome is caused by the compression of the median nerve in the carpal tunnel, which is in your wrist, due to various reasons.

Common sense tells you that people who use their wrists and hands the most are at more risk for CTS and other Repetitive Strain Injuries. While the first thing that pops into your mind might be people who sit at a computer all day or use a typewriter, people who are more at risk are ones who do heavy lifting and other such heavy labour.

Musicians are others who are at risk – playing percussion instruments, string instruments or the piano puts a lot of strain on the wrist.

Statistics among Computer Users

Those who work on computers come next. Among this group, people who type over sixty words per minute and exert more pressure while typing are at more risk than others. Projections show that among people who work on computers, the percentage of people who suffer symptoms of CTS could go up from 10% before the turn of the century to 50% by 2010. Even now, in studies, an average of 30% of people complained of suffering from symptoms that indicate Carpal Tunnel Syndrome and other related Repetitive Strain Injuries, or RTIs.

Avoiding RTI While Working on Computers

There are ways to avoid such Repetitive Strain Injuries while working at the computer, though. Proper posture is the first step. When you sit in front of the computer, pay attention to how you sit and see if there are things you must change. First of all, when you type for prolonged periods of time, you have to see if your wrist is bent most of the time. If it is, you are putting yourself more at risk for Carpal Tunnel Syndrome. Making sure that the keyboard is at the same level as your elbow makes a lot of distance. This way, your forearm will be parallel to the floor, and your wrist will not be bent.

Ensure that you are sitting straight. This might sound a bit like a Finishing School for Young Ladies, but especially when you are sitting in front of a computer, making sure that your hip is bent at 90 degrees – that is, making sure that your back is straight – and keeping your feet flat on the ground is very important. This means that your chair should be at the right height and the computer’s keyboard and monitor should also be at the right height for you.

Even if you have no tingling, numbness or pain, the best way to prevent CTS is to take short breaks, at least once every twenty minutes. Do gentle wrist exercises at this time. CTS is easiest to cure, with less chance of recurrence, in its early stages. If you begin to exhibit the symptoms, wear either a splint or a fingerless glove, if you cannot type with a splint. Take frequent breaks, correct your posture and use an ice pack and anti-inflammatory medicine if it hurts, but see your doctor as soon as you can.

Most of the things we do are repetitive. Typing on a keyboard is repetitive, playing a musical instrument is repetitive, writing is repetitive – even eating is a repetitive action. When repetitive actions are not performed in a properly controlled environment and in the right way, you put yourself at risk for Repetitive Strain Injuries.

The most common of Repetitive Strain Injuries is Carpal Tunnel Syndrome. You are at risk for CTS if you use your wrists and hands a lot, for repetitive tasks. Guitar players, assembly line workers, typists, computer workers and people who do heavy labour are the most at risk for CTS.

Repetitive Strain Injuries usually affect the arm and upper back. A person need not be suffering from only one condition. One can very often lead to others. For instance, CTS starts with slight tingling and numbness in the thumb. Next, that tingling and numbness spreads to the forefinger, middle finger and parts of the ring finger. After that, it affects the whole palm, and the tingling and numbness becomes more acute pain, especially at the wrist. Flexing and stretching the wrist becomes painful, and keeping it bent for even one minute can make the whole hand go numb.

After this stage, the pain and numbness might spread to the lower forearm. If left untreated at this stage, the whole arm, shoulder and upper back might become painful. All these are symptoms of Repetitive Strain Injuries, but the classic symptoms of Carpal Tunnel Syndrome are numbness and tingling in the thumb, forefinger, middle finger and parts of the ring finger, and pain in the wrist.

Quite often, people suffer from a combination of Repetitive Strain Injuries. While the causes can be isolated in most cases, some cases have idiopathic causes.

One tell-tale symptom of Repetitive Strain Injuries is increased numbness or pain during the night. The trouble is that people more often than not brush this off as sleeping in the wrong position or an arm ‘going to sleep’ because of lack of blood circulation. This is how it feels, but it is often a lot more serious than your arm deciding to take a nap.

The good news is that with a few lifestyle changes, Repetitive Strain Injuries can easily be handled. Something as simple as using a mouse pad that gives you extra support, or using a speech recognition software instead of using the keyboard much if you have a lot of writing to do can make a lot of difference.

Getting your posture right can give a lot of relief, as well, especially for upper back and shoulder pain. Using chairs that are the right height for you, that let you keep your feet flat on the ground with your legs bent at ninety degrees at the knee, and using the right desk that lets you keep your forearm parallel to the floor are also things that can relieve much of the pain for Repetitive Strain Injuries.

Carpal Tunnel Syndrome is one of the many kinds of Repetitive Strain Injuries that can leave a person unable to perform the required tasks at their workplace adequately. CTS is one of the leading causes for lawsuits for compensation from employers. Many cases are fair and just. Carpal Tunnel Syndrome can leave a person not only unable to perform his or her job, but also unable to take care of himself/herself at home.

Something as simple as tying your shoelaces can become an arduous task. You could have chronic pain that increases during the night, keeping you awake. You might have swelling on your wrist. You might not be able to feel whether something is hot or cold. You might lose your sense of touch. You might lose the strength in your hand, as well – gripping something, chopping vegetables, washing dishes, doing the laundry can all become next to impossible. Even holding a fork and knife can become painful and difficult.

As such, Carpel Tunnel Syndrome is considered to be a disability that can not only keep you from making your living, but can also gravely bring down the quality of your life. Many people with CTS also show signs of depression and say that they have a constant feeling of hopelessness, when confronted with the difficulty they face while doing the simplest of tasks that everybody takes for granted.

This means that if you got this affliction because of conditions at your work, you are legally entitled to compensation. For this, you have to prove that you do have occupational CTS. Other causes of CTS have to be eliminated. They included congenital reasons, pregnancy, wrist size, acute trauma to your wrist, certain kinds of oral contraception, diabetes, hypothyroidism and obesity. Even if you do have one or more of these conditions, you have to be able to show that conditions at work and lack of information provided at work aggravated your condition.

If you can do that, once you have been examined by an approved physician, you will be entitled to pain compensation, time off for rehabilitation, proper treatment and retraining once you are back on your job. You can also ask for job rotation, proper work environment that follow principles prescribed by ergonomics and frequent short breaks.

However, the catch is that if you do not have occupational CTS and that can be proved, you might not be eligible for some or any of these benefits. CTS became part of the get rich fads in the nineties, and the people who genuinely face these problems every day are the ones who have had to pay for this.

Studies have shown that over 90% of employees who suffer from CTS got their pain compensation, time off as well as retraining and improved conditions once they returned to work, but the risks of CTS because of the repetitive actions involved in the performance of their jobs were not mentioned at any time during their employment. In some cases, treatment, even surgery, was not successful enough to enable them to get back to work, and in these cases, law suits for compensation were filed. Most of these cases get settled out of court.

Before we can look at preventive measures for Carpal Tunnel Syndrome, we need a basic understanding of what Carpel Tunnel Syndrome or CTS is. The Carpel Tunnel is the passage in the wrist created by bones on three sides and ligament on the fourth. Through this tiny space, nine tendons pass, as well as the median nerve. It stands to reason that any inflammation of any sort in the carpal tunnel will cause the median nerve to be compressed. The median nerve goes on to the thumb, forefinger middle finger and ring finger. This is the reason for the burning, tingling feelings and for the numbness and the pain.

So the first thing to do to prevent Carpal Tunnel Syndrome is to avoid causing any kind of strain to your wrist. This is easier said than done, though. Most jobs now require people to sit in front of a computer for hours on end. Manual labour, too, has become easier with power tools. These power tools vibrate, though, and this vibration is very hard on the wrist. If you have no choice but to strain your wrist in your line of work, there are certain things you can do to minimize your risk.

• The best thing you can do is make sure you take adequate breaks. A break every twenty minutes or so can do wonders. This is especially important if you have any tingling or pins and needles sensation in your palm, because these are the first signs of Carpal Tunnel Syndrome.
• Fix your posture. This has been talked about so many times that it has become quite stale. A good posture seems to be the one-shot remedy for so many things that it wouldn’t be much of a surprise if somebody said that it could fix a broken neck, too. But the fact remains that good posture is essential in preventing Carpal Tunnel Syndrome. Ensuring that your wrist does not bend too much for too long, keeping your forearms parallel to the floor while typing and therefore not applying too much pressure all help prevent the onset and/or aggravation of Carpal Tunnel Syndrome
• Keep your wrist warm. You can’t always control the temperature you work in, but you can make sure that you keep your wrist warm with a fingerless glove. This can also act as a support for your wrist, making sure that you don’t bend it too much.
• If you have trouble with hypothyroidism, diabetes or have had some sort of injury in your wrist that might have causes inflammation in the area or tendonitis, you will be more susceptible to CTS. Treating these causes before the onset of CTS is important.
• Don’t stay in one position for too long, whether you are standing or sitting. Walk around, do a few stretches, roll your shoulder, loosen up – do whatever works for you.

Even if you feel that you might have CTS, your best chance to get rid of it for good is if it is diagnosed early enough to give you as many options as possible.