HealthTips: Carpal tunnel syndrome

RECOGNIZING CARPAL TUNNEL

If you're performing jobs or participating in activities that require repetitive hand movements, you might be at risk for developing carpal tunnel syndrome. The condition, caused by inflammation and irritation in the narrow groove formed by eight small bones and tissue in the wrist, affects an estimated 3.7 percent of the U.S. population, or some 8.1 million individuals. Those most susceptible to the potentially debilitating ailment include mechanics, cashiers, carpenters, grocery store checkers, manufacturing or assembly-line workers, violinists, gardeners, golfers and knitters. Heavy computer use and typing also are suspected of bringing on CTS, which is characterized by:

-- An ache in the wrist that may move into the hand or forearm;

-- Swelling in the wrist and hand;

-- Numbness, burning or tingling in the hand and fingers;

-- Increased pain when moving the hand or wrist;

-- Weakness in the thumb and first three fingers;

-- Loss of strength and difficulty gripping objects;

-- Pain in the wrist, palm or forearm;

-- Pronounced pain and/or numbing during sleep;

-- Muscle atrophy.

According to the Department of Health and Human Services, women are three times as likely as men to suffer from CTS, perhaps because their wrist bones tend to be smaller, creating a tighter space through which the nerves and tendons must pass. Their genetic makeup may also increase the likelihood of musculoskeletal injuries, and their hormonal changes during pregnancy and menopause may make them more susceptible. CTS also can be brought on or exacerbated by a misalignment of the carpal bones and wrist, trauma to the wrist, arthritis, gout, neck and shoulder problems and tumors.

PREVENTING CARPAL TUNNEL

Government and other scientists recommend taking steps to prevent carpal tunnel syndrome, including:

-- Change your work environment to lessen the stress and strain on the wrist and hand. Make sure the workspace and equipment are at the right height and distance for the hands and wrist. For computer users, the keyboard should be placed high enough to permit the wrist to rest comfortably without bending. For most people, the workspace should be some 27 to 29 inches above the floor. Keep your elbows close to your sides as you type to reduce the strain on your forearm. Maintain good posture and wrist position.

-- Take a 10-to-15-minute break every hour to give your hands and wrists time to rest and recover.

-- Vary your tasks, avoiding repetitive motions, or at least breaking them up each hour with movements that work different muscles.

-- Relax your grip, unwind your muscles and practice gentle, loose hand and wrist motions to avoid stress and tension that can strain and irritate muscle.

-- Exercise, flexing and bending the wrists and hands in the opposite direction from the repetitive movement. A sample: after typing, make a tight fist, hold, stretch the fingers, hold, repeat several times.

-- Keep your hands warm, even if you have to wear fingerless gloves during work.

TREATING CARPAL TUNNEL

If you develop carpal tunnel, see a doctor to avoid permanent damage to the nerves and muscles of the hand and thumb. Treatment options include:

-- Physical therapy to strengthen the wrist and hand; yoga, ultrasound, chiropractic manipulation and acupuncture to reduce symptoms; massage to relieve pain, slow CTS progression and boost grip strength, according to a report by University of Miami School of Medicine researchers published in the Journal of Bodywork and Movement Therapies.

-- A wrist splint, worn round-the-clock or only at night within three months of symptoms to support and brace the wrist until the nerves and tendons recover.

-- An occasional rest from the repetitive motion to reduce or eliminate mild symptoms.

-- Temporary use of nonsteroidal anti-inflammatory drugs -- aspirin, ibuprofen and other non-prescription pain relievers -- to help control discomfort. In severe cases, it may take a cortisone injection or corticosteroids pill to reduce swelling. Diabetics should be aware long-term corticosteroid use can make controlling insulin levels more difficult.

CTS surgery, one of the most common procedures performed in the United States, is usually reserved for severe cases after other treatments have failed for at least six months.

LEARNING ABOUT CARPAL TUNNEL

For more information on carpal tunnel syndrome, contact the:

-- National Women's Health Information Center, 800-994-9662;

-- National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, 301-495-4484, 877-226-4267 or www.niams.nih.gov;

-- National Institute of Neurological Disorders and Stroke, 301-468-5981, 800-352-9424 or www.ninds.nih.gov;

-- National Institute for Occupational Safety and Health, 513-533-8471, 800-356-4674 or www.cdc.gov/niosh/pubs.html;

-- American Academy of Orthopaedic Surgeons, 847-823-7186, 800-346-2267 or www.aaos.org;

-- American Chronic Pain Association, 916-632-0922 or www.theacpa.org;

-- American Society for Surgery of the Hand, 404-523-8821 or www.hand-surg.org.

UPI Consumer Health welcomes comments on this column. E-mail: lwasowicz@upi.com