Since so many of us now spend the majority of our workdays sitting in front of a computer, we hear a lot about overuse and repetitive stress injuries. They loom in our conscious like a grim inevitability. Computer vision syndrome. Bursitis. Blackberry thumb. But no workplace injury gets as much attention as carpal tunnel syndrome.
Sometimes it feels like everyone is supposed to be on the lookout for the symptoms of carpal tunnel syndrome, no matter what he or she does for a living. Supposedly, typing can cause it and next year we’ll probably start hearing that checking your iPhone too often can cause it, too. But not every twinge of discomfort or pain is really carpal tunnel syndrome. In fact, the condition happens far less often than people think.
Wrist Woes
Carpal tunnel syndrome develops when the main nerve in the wrist is compressed and compromised. In medical jargon, it’s called an entrapment neuropathy, a condition where nerves are squashed or damaged. The median nerve runs from the forearm through the wrist, sending impulses to move the hand and fingers as well as transmitting sensory information back up to the brain. The nerve travels through an area of bone and cartilage in the wrist to get from the arm to the hand, and when that tunnel of cartilage starts pressing down on the nerve because of swelling or injury, it prevents it from sending and receiving information correctly.
The first symptoms are usually light burning, numbness, or itchiness on the hand and fingers, especially the thumb, index, and middle fingers. Sometimes people feel the need to “shake out” their hands to try to relieve the pressure. As the condition progresses, the pain becomes worse and begins to radiate up the arm to the shoulder. The pain and discomfort usually get worse after repetitive motions or heavy exertion and is often worse at night or after sleeping. Ultimately, those who suffer from carpal tunnel syndrome may have permanent numbness and weakness in their hands, to the point where it’s difficult to hold or carry objects or even make a fist. In some severe cases, people lose the ability to tell hot from cold by touch.
Luckily, true carpal tunnel syndrome is far less common than most people think. Even though it’s often associated with office workers, a 2001 study by the Mayo Clinic found that seven hours of daily computer use doesn’t raise a person’s risk for the condition at all. According to the National Institute of Neurological Disorders and Stroke, carpal tunnel syndrome is usually the result of a genetic predisposition. People whose wrists and bone structure are naturally smaller are more susceptible to the compression of the median nerve that causes the syndrome. It’s also possible to develop carpal tunnel syndrome after an unrelated injury to the wrist, because swelling can cause enough compression to affect the nerve. Pregnant women often develop carpal tunnel symptoms because of the pressure of fluid retention, but it usually goes away after childbirth. Women in general are three times more likely than men to develop carpal tunnel problems, according to the National Institutes of Health. There are jobs that are more closely associated with carpal tunnel syndrome, but they are invariably jobs that require true repetitive and forceful wrist or hand motions, like jobs involving vibrating power tools, repetitive assembly line work, and carrying heavy objects.
Tendon Tension
So what’s an office worker with wrist pain to do? There are many repetitive stress injuries caused by typing and normal daily activities and a much more likely diagnosis is tendonitis. Repetitive movements can stress the tendons that attach hand and arm muscles to the bone. When tendons are overworked, they can accumulate tiny rips, tears, and irritations. Tendonitis in the wrist can mimic many of the symptoms of carpal tunnel syndrome, so it’s no surprise that the two conditions are often confused. Tendonitis can also cause wrist pain, aching, numbness, and loss of strength and agility. The swelling from tendonitis can even sometimes end up actually causing carpel tunnel problems, since the swelling can put pressure on the medial nerve.
