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Bone, Muscle, and Joint Problems

Carpal Tunnel Syndrome

Prevention - Home Treatment - When to Call a Health Professional

The carpal tunnel is a narrow passageway between the bones and ligaments in your wrist. The median nerve, which controls sensation in the fingers and some muscles in the hand, passes through this tunnel along with some of the finger tendons. Carpal tunnel syndrome (CTS) develops when there is pressure on the median nerve where it goes through the carpal tunnel.

Doing activities that use the same finger or hand movements over and over again can cause CTS. Other

causes include being overweight, a cyst (ganglion) on the tendon sheath in the wrist, or rheumatoid arthritis. Previous wrist injuries, pregnancy, diabetes, thyroid disease, and taking birth control pills also may increase your risk for CTS.

Pressure on the median nerve causes the following symptoms of CTS:

  • Numbness or tingling in the fingers of one or both hands, except for the little finger.

  • Numbness or pain in your hand or wrist that wakes you up at night.

  • Numbness or pain that gets worse when you use your hand or wrist, especially when you grip an object or bend (flex) your wrist.

  • Occasional aching pain in your arm from your hand to your shoulder.

  • A weak grip.

    Pain and tingling in the hand may be caused by pressure on a nerve in the wrist.

Prevention

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  • Stop any activity that you think may be causing finger, hand, or wrist numbness or pain. If your symptoms improve when you stop an activity, resume that activity gradually and with greater efforts to keep your wrist straight or only slightly bent.

  • Use your whole hand (not just your fingers and thumb) to grasp objects.

  • Reduce the speed and force of repetitive hand movements such as typing.

  • Switch hands and change positions often when you are doing repeated motions.

  • Take frequent breaks and rest your hands.

  • If you are not able to change positions or equipment at work often enough to prevent numbness or pain, wear a wrist splint that will reduce the stress on your fingers, hand, or wrist.

  • Pay attention to your posture. When you are typing, make sure your fingers are lower than your wrists (using a keyboard wrist support may help). When your forearms are hanging by your sides, keep your shoulders relaxed.

  • Keeping your arm, hand, and finger muscles strong and flexible and maintaining good overall fitness will also help prevent the symptoms of carpal tunnel syndrome.

  • Avoid using too much salt if you tend to retain fluid.

Home Treatment

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  • Follow the Prevention tips above.

  • Use aspirin or ibuprofen to relieve pain and reduce swelling.

  • Apply ice or a cold pack to the palm side of the wrist. See Ice and Cold Packs.

  • Avoid sleeping on your hands. Wear a wrist splint at night to relieve pressure on your wrist.

  • Do simple range-of-motion exercises with your fingers and wrist to prevent stiffening. Stop if you have pain.

  • Other lifestyle changes such as losing weight, quitting smoking, reducing the amount of alcohol you drink, and controlling diabetes may help relieve symptoms of CTS that are related to swelling.

  • Vitamin B6 has not been shown to be an effective treatment for CTS.

When to Call a Health Professional

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  • If tingling, numbness, weakness, or pain in your fingers and hand has not gone away after 2 weeks of Home Treatment.

  • If you have little or no feeling in your fingers or hand.

  • If you cannot do simple hand movements, or you accidentally drop things.

  • If you cannot pinch your thumb and first finger together or your pinch is weak.

  • If you cannot use your thumb (no thumb strength).

  • If you have problems at work because of pain in your fingers or hand.

    If you are considering surgery to treat carpal tunnel syndrome, gather as much information as possible about the risks and benefits of surgical treatment. Getting all the facts and thinking about your own needs and values will help you work with your doctor to make a wise health decision.

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