This strange-sounding problem has nothing to do with the kind of tunnels you drive
through. When someone has carpal (say: KAR-pul) tunnel syndrome,
or CTS, the "tunnel" of bones and
ligaments in the wrist has narrowed. This narrowed tunnel pinches a nerve, causing
a tingly feeling or numbness in a person's hand, especially in the thumb and first
three fingers.
Someone with carpal tunnel syndrome may have trouble typing on the computer
or playing a video game. In fact, repetitive motions (doing the same thing again and
again) from those activities may be to blame for causing the carpal tunnel syndrome
in the first place.
Where Is This Tunnel?
Take a look at the palm of your hand. Under the skin at your wrist is the tunnel
we're talking about. Nine tendons (tough bands of tissue that join a muscle with some
other part of the body) and one nerve pass through this tunnel from the forearm to
the hand. The bottom and sides of the carpal tunnel are formed by wrist bones, and
the top of the tunnel is covered by a strong band of connective tissue called a ligament.
The tendons that run through the tunnel connect muscles
to bones and help you use your hand and bend your fingers and thumb. The nerve that
passes through the carpal tunnel to reach the hand is the median
(say: MEE-dee-un) nerve.
It's pretty tight inside the carpal tunnel. In fact, there's barely enough room
for the tendons and the nerve to pass through it. If anything takes up extra room
in the canal, the median nerve gets pinched, which causes numbness and tingling in
the area of the hand where the nerve spreads out. Swelling can happen when someone
does the same thing over and over, like typing. This swelling can pinch the nerve.
Who Gets It?
Millions of Americans have CTS. Kids can get it, too, but it's not as common. Most
people who get CTS are over 30, and more women than men have it. In fact, three times
as many women as men have CTS. Computer operators, assembly-line workers, and hair
stylists are at risk because they repeat the same hand movements over and over again.
What Causes It?
Anything pressing on the median nerve can cause CTS. The tendons passing through
the carpal tunnel can become swollen from doing the same movement over and over, like
typing on a computer or playing video games or a musical instrument for long periods
of time. It's more common in gymnasts, particularly those who do a lot of handstands,
and in people who play racquet sports, like tennis.
Broken or dislocated wrist
bones or even sprains that cause swelling around the
carpal tunnel may lead to CTS, too. Medical problems that increase someone's risk
of getting CTS include arthritis,
thyroid problems, and diabetes.
CTS is also more common during pregnancy and in people who are overweight.
How Is It Diagnosed and Treated?
Did you ever wake up and your hand is still asleep — all numb and giving
you pins and needles? Sometimes, with CTS this tingling starts in the palm of the
hands and fingers, especially the thumb, and the index and middle fingers.
A brace or splint can help mild cases of CTS. It is usually worn at night and keeps
a person's wrists from bending. Keeping the wrist straight opens the carpal tunnel
so the nerve has as much room as possible. Resting the wrist will allow the swollen
tendons to shrink. Medicines like ibuprofen can also help
reduce the swelling.
In more severe cases, your doctor may recommend cortisone (say:
KOR-tih-zone) to reduce inflammation and swelling in the carpal tunnel. This medicine
is given by a shot, or injection. When the symptoms of CTS have improved, the doctor
may suggest the person do wrist exercises and make changes that can prevent further
problems, such as repositioning the computer and keyboard.
If none of these treatments help, the person may need surgery to release the pressure
on the median nerve. This surgery takes less than an hour and usually doesn't require
a stay overnight in the hospital. Very few people are permanently injured by CTS.
Most can get better and take steps to prevent the symptoms from returning.
CTS Prevention
Though not many kids get CTS, it's a good idea to develop good habits now that
can prevent this problem in adulthood. When you spend a lot of time on the computer
or when you text, be sure to take breaks and not overdo it. Just getting up to stretch
or do something else for a while can help. You might even set an alarm clock or a
kitchen timer to go off every hour or so to remind you to take your breaks.
At the computer, be sure your work area is comfortable. Use a chair that can be
adjusted for your height so that you aren't sitting down too low or up too high. Your
chair, computer screen, and keyboard should all be in line. And try to follow these
rules while sitting:
- Hold your elbows at your sides with your wrists in front to set the keyboard height.
- Keep your forearms and wrists straight and don't bend your wrists up.
- If you use a wrist pad, don't press into it when you type.
- Place things you use a lot within close reach, with no item farther than an arm's
length away.
When you take these steps, you're treating your wrists just right. And if you ever
get CTS, remember that there's always light at the end of the carpal tunnel.
Date reviewed: January 2015