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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Dr. Pooja Raval`, M.P.T.  (Neuro)

Carpal Tunnel Syndrome (CTS) is one of the highly prevalent and often debilitating conditions affecting the hand and wrist. It is commonly associated with activities that involve repetitive motions, and desk work is a prime example. The condition is often characterized by pain, numbness, and tingling (pins and needles type of sensation) in the palm; sometimes leading to weakness of fingers, resulting in a weak grip and affecting day-to-day activities that require gripping and fine movement of fingers. 

The carpal tunnel houses the median nerve and tendons responsible for controlling finger movement and sensation of the palm (from half of the ring finger to the thumb region). When there is increased pressure on the median nerve at the wrist, it can lead to a range of symptoms, but before moving forward to symptoms, let’s discuss the causes of Carpal Tunnel Syndrome. 

Causes of Carpal Tunnel Syndrome:

  1. Repetitive Movements: One of the primary causes of CTS is repetitive hand and wrist movements, and activities such as typing, using a mouse, or assembly line work can lead to the compression of the median nerve within the carpal tunnel.
  2. Prolonged Pressure: Continuous pressure on the wrist, either from resting the wrist on a desk or using tools that vibrate, can contribute to the development of CTS.
  3. Pregnancy: Hormonal changes during pregnancy can result in fluid retention, which may contribute to the compression of the median nerve, making pregnant women more susceptible to CTS.
  4. Obesity: Being overweight or obese is a risk factor for Carpal Tunnel Syndrome. Excess body weight can increase pressure on the median nerve, leading to symptoms of CTS.
  5. Medical Conditions: Certain medical conditions, such as diabetes, rheumatoid arthritis, and thyroid disorders, can increase the risk of developing Carpal Tunnel Syndrome.

How Desk Work Contributes to Carpal Tunnel Syndrome:

  1. Keyboard and Mouse Usage: Continuous typing and mouse usage can strain the tendons and compress the median nerve, especially if the wrists are in awkward positions for extended periods.
  2. Poor Posture: Incorrect posture at the desk, including slouching or leaning on the wrists, can contribute to increased pressure on the carpal tunnel.
  3. Inadequate Ergonomics: Lack of proper ergonomic equipment, such as an adjustable chair and keyboard, can lead to prolonged and uncomfortable hand positions, contributing to the development of CTS

Symptoms of Carpal Tunnel Syndrome:

CTS manifests with a range of symptoms that can vary in severity. Common signs include:

  1. Pain or discomfort in the hand and wrist that may radiate up the arm.
  2. Numbness and tingling in the thumb, index, middle, and ring fingers.
  3. Weakness in the hand in untreated long-term cases, resulting in difficulty in gripping objects.

Diagnosis often involves a medical history review, physical examination, and, in some cases, nerve conduction studies. X-rays and other imaging studies may be used to rule out other conditions that can mimic the symptoms of Carpal Tunnel Syndrome, such as arthritis or fractures. Tinel's Sign and Phalen's Maneuver - these physical tests involve tapping on the median nerve or flexing the wrist to reproduce symptoms, aiding the diagnosis of Carpal Tunnel Syndrome.

Treatment Options:

1. Conservative Measures:

  • Rest and Immobilization: Avoiding activities that exacerbate symptoms and using splints or braces to immobilize the wrist can provide relief.
  • Physical Therapy: Stretching and strengthening exercises prescribed by a physical therapist can help alleviate symptoms and prevent a recurrence. 
  • Ergonomic Changes: Modifying workstations to ensure proper wrist positioning and using ergonomic tools can reduce strain on the median nerve.

2. Medications:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These medications can help alleviate pain and inflammation associated with CTS.
  • Corticosteroid Injections: Injections of corticosteroids into the carpal tunnel can provide temporary relief by reducing inflammation.

3. Surgical Interventions:

  • Carpal Tunnel Release: In cases where conservative measures are ineffective, surgical intervention may be recommended. Carpal tunnel release involves cutting the ligament to relieve pressure on the median nerve.

4. Lifestyle Modifications:

  • Weight Management: For individuals with obesity-related CTS, weight loss can significantly reduce symptoms and improve overall hand function.
  • Activity Modification: Adjusting hand and wrist movements to minimize repetitive stress can be beneficial in managing and preventing Carpal Tunnel Syndrome.

Preventive Measures for Desk Workers:

  1. Ergonomic Workspace: Ensure your desk, chair, keyboard, and mouse are ergonomically designed to support a neutral wrist position.
  2. Regular Breaks: Take short breaks to stretch and rest your hands and wrists, reducing the strain from continuous desk work.
  3. Wrist Exercises: Perform regular wrist exercises and stretches to maintain flexibility and prevent stiffness.
  4. Proper Posture: Maintain good posture while sitting at the desk to reduce unnecessary strain on the wrists and hands.

Conclusion:

Carpal Tunnel Syndrome is a multifaceted condition with various contributing factors. Understanding its causes, recognizing symptoms, and exploring diagnostic and treatment options are crucial for effective management. From conservative measures to surgical interventions, the approach to treating CTS is tailored to the individual's unique circumstances. By promoting ergonomic practices and incorporating regular breaks and exercises, desk workers can create a healthier and more comfortable workspace, reducing the likelihood of Carpal Tunnel Syndrome.

About Ergophyx 

Ergophyx, spearheaded by Dr. Maitri Shukla and Dr. Pooja Raval, is dedicated to enhancing the health and wellness of industrial and corporate employees in Gujarat. Despite the longstanding recognition of Work-Related Musculoskeletal Disorders (WMSD), insufficient efforts have been made to address them. Ergophyx's mission is to mitigate WMSD by implementing targeted workplace wellness programs. Through this initiative, They aim not only to alleviate employee discomfort but also to enhance productivity and overall business performance. With a team of dedicated physiotherapists, they prioritize employee well-being, striving to eradicate WMSD and promote a healthier, more vibrant workforce.

Dr. Pooja Raval; co-founder of Ergophyx; has a work experience of more than 12 years. She has been a clinician for more than 9 years and spent 3 years in academics. She has had her physiotherapy department in a multispecialty hospital for 5 years.

Dr. Pooja Raval
MPT (Neuro) GPC-3546
Co-Founder Of Ergophyx


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