Carpal Tunnel Syndrome: Symptoms, Management and Prevention

For academics and students, indeed for anyone who spends long hours on a computer, the risk of developing a repetitive strain injury (RSI) is quite real. Add to those long hours in front of your monitor the time that you spend holding a book, scrolling on your phone and performing any other of the countless daily activities that put strain on your wrist, and you can understand why your wrists in particular may sometimes feel tight and painful. Perhaps more surprising is that this pain may indicate that you are developing carpal tunnel syndrome.

What is carpal tunnel syndrome?

The carpal tunnel is, as the name suggests, a tunnel, formed by the bones and ligaments of your wrist. Through this tunnel feed several tendons and the median nerve, which controls motor and sensory supply to parts of the forearm and hand. The problem is that tendons are prone to inflammation, which, in the tight space of the carpal tunnel, can result in compression of the median nerve and significant pain in the hand and forearm.

The components of the carpal tunnel: ligaments and the median nerve

What are the early warning signs of carpal tunnel?

Before listing symptoms, it is important to note that in its early stage, carpal tunnel can be managed effectively, significantly delaying the advancement of the syndrome.

Early signs that you may be developing carpal tunnel include: 

• Tingling or numbness in your palm or fingers (often in your dominant hand)
• Weakness in your hand or wrist
• Darting pains in the wrists
• Referred pain in the arm and shoulder.

The pain will often be worse at night, and can often be lessened by shaking your hand.

What can you do to delay onset?

If you are already experiencing some of these symptoms, it is time to act. As mentioned above, carpal tunnel is a manageable condition. It is not curable, however, a combination of rest, gentle exercise and, if necessary, a split may help you to avoid a worsening of your symptoms.

Rest

As much as possible, rest. This is harder than it sounds. So much of our daily life is spent using our wrists, especially in this age of smartphones. However, as with any inflammation, rest is essential for recovery.

Exercise

Use the following three exercises to gently stretch out your wrist. You should feel the stretch in your wrist and forearm.

Exercise 1: Gently pull your fingers backwards, feeling the stretch in your palm, wrist and forearm.

Exercise 2: Gently bend your wrist forwards, feeling the stretch in your wrist and forearm.

Exercise 3: Gently pull your wrist backwards by the thumb, feeling the stretch in your wrist and palm.  

Use a splint

If rest and gentle exercise does not seem to be enough, a wrist splint may be needed. This is a kind of brace that serves to stabilise and support the wrist, helping you to rest it.

What can you do to prevent developing carpal tunnel? 

Whether you have experienced the symptoms outlined above or not, some minor lifestyle and equipment changes can reduce the severity of your symptoms, or prevent you developing them altogether. Specifically, you need to reduce the strain on your wrist that can lead to inflammation by improving your posture, taking regular breaks and limiting the impact on your wrist of your daily activities.  

Pay attention to your posture

Your posture plays an important role in preventing and managing carpal tunnel. Poor posture contributes to carpal tunnel syndrome by placing indirect pressure on the median nerve, and by directly affecting the positioning of the wrist and hand and thus the inflammation of the tendons in the carpal tunnel.

It is recommended that you follow these practices of good posture:

• Your spine should be against the back of your chair, and your shoulders should be relaxed.
• Your elbows should rest along the side of your body, with your wrists straight.
• Your feet should be flat, either on the floor or on a footrest.
• If referring to materials while typing, these should be at eye level.
• Try to keep your neck flexible, rather than rigid.

Obviously, achieving this ideal posture may require some modification of the environment in which you work. A height-adjustable chair, footrest, wrist rest and platform on which to sit your monitor to bring it to eye level are essential for any computer desk set up. Spare some consideration for your poor wrists when you next flop down on the couch with your laptop.

Take regular breaks

Regular breaks are very important to prevent tendon inflammation. Use this time to gently stretch out your wrists, as suggested above. Avoid using your time away from the keyboard to scroll around on your smartphone (which uses your wrist!), or hold a book to read (which uses your wrist!). Some other useful ways to spend your break include:

• Shaking out your limbs
• Leaning back in your chair
• Squeezing your shoulder blades together
• Breathing deeply to relax.

Exert less force

Finally, wrist inflammation is made immeasurably worse by the strain of repeated impact, such as when hitting that stubborn space bar on your aging keyboard. Every effort must be made to reduce the force you are exerting when using your wrist. Some ways to do this include:

• Choose a keyboard that requires minimal pressure to press the keys.
• Replace your mouse with a trackball, which requires less pressure to scroll.
• Support your wrist by using a wrist rest. A rolled-up face washer positioned under your wrist works quite well.
• Choose an easy-grip pen with good ink flow.

By reducing the pressure on the ligaments in your wrist, you are allowing any inflammation to go down, and preventing a worsening of the problem (and thus the pain). By making these changes long term, as adjustments to your lifestyle and equipment use, you may be able to significantly reduce the effect that this painful repetitive strain injury can have on your daily life.

References

University of Maryland Medical Centre. 2012. ‘Carpal Tunnel Syndrome’. Last reviewed 26 May. http://umm.edu/health/medical/reports/articles/carpal-tunnel-syndrome.

Better Health Channel. 2012. ‘Carpal Tunnel Syndrome’. Last updated July. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/carpal-tunnel-syndrome.

Health Direct. 2014. ‘Carpal Tunnel Syndrome Symptoms’. Last reviewed October. https://www.healthdirect.gov.au/carpal-tunnel-syndrome-symptoms.