USC Health Now

Many people have experienced pain in their hands or wrists after a long day at the computer or doing repetitive tasks. But how do you know when it’s something more serious, like carpal tunnel syndrome? Here, a USC expert gives tips on recognizing carpal tunnel and treating hand and wrist pain.

by Katie Neith

Carpal tunnel syndrome (CTS)—a condition that causes pain, tingling, numbness and other problems in the hand—affects an estimated 3-7 percent of the population, according to the American College of Rheumatology. Nonetheless, it is often the name given to any pain or pressure in the hands and wrists.

Knowing the Difference

“CTS occurs when there is pressure on the median nerve as it crosses the wrist into the hand through an area called the carpal tunnel. Also passing through this tunnel are numerous tendons,” explains Lisa Deshaies, occupational therapist and adjunct clinical faculty in the Division of Occupational Science and Occupational Therapy at the USC School of Dentistry.

“Many things can cause pressure on the nerve including illnesses, such as diabetes, rheumatoid arthritis and hypothyroidism; pregnancy; wrist injuries; tumors; repetitive wrist and/or finger motions; and prolonged vibration over the nerve, from tool use for example,” says Deshaies, who is also a certified hand therapist. “But some of these activities can also lead to tendonitis or tenosynovitis.”

Tendonitis is the inflammation of the tendons passing through the carpal tunnel. Tenosynovitis is the inflammation of the tendons and their surrounding fluid-filled sheaths, called synovium, in the hand and wrist area.

Both tendonitis and tenosynovitis cause pain, while CTS is characterized by other symptoms including changes in sensation, such as feeling numbness or tingling in the hand involving the thumb, index and middle finger, and changes in strength such as the hand feeling weak or frequently dropping objects, says Deshaies.

According to the American College of Rheumatology, middle-aged and older individuals are more susceptible to CTS than younger people, and women are three times more likely to experience it than males.

Preventing Pain

“The best way to prevent carpal tunnel syndrome or tendon inflammation is to avoid aggravating wrist positions—like extreme wrist flexion or extension—or modify forceful or repetitive activities that could irritate the nerve or tendons over time,” says Deshaies. “This can be done through frequent rest and stretch breaks, using different tools or changing the setup of a workstation.”

The U.S. Department of Labor’s Occupational Safety and Health Administration offers online ergonomic tools for specific occupations. Ergonomics is the applied science of equipment design intended to maximize productivity by reducing operator fatigue and discomfort. Look for tips that may apply to you at: www.osha.gov/SLTC/ergonomics/

Treating Tension

If you think you may have CTS, the best course of action is to see a physician who can help determine if you are experiencing CTS or if another condition is causing your symptoms, says Deshaies.

She says that conservative, non-surgical treatment for CTS often includes wearing a wrist splint, taking anti-inflammatory medication and resting, including avoiding activities that are causing symptoms.

“It is also important to do gentle exercises for your fingers and wrist so they do not become stiff,” Deshaies says.

A specialist, such as an occupational therapist, can also help by analyzing the activities that aggravate your wrist and help you modify your performance or environment, such as your computer workstation, to minimize the pressure on your nerve, Deshaies points out.

For more information on occupational therapy, carpal tunnel and ergonomics, visit the consumer section of The American Occupational Therapy Association at www.aota.org/Consumers.aspx.