Carpal Tunnel Syndrome: Separating Fact from Fiction

Editor’s Note: Today’s post is written by Betsy Schack, OTR/L. Betsy is an occupational/hand therapist at Athletico Skokie and Athletico Park Ridge.

Have you ever woken up in the middle of the night and felt like your hand was just put in a pile of fire ants? You wake up and shake your hand furiously, but the burning does not go away. What you’re experiencing could be carpal tunnel syndrome (CTS). Read more about what causes CTS and how you can not only prevent it but fix it before it becomes worse.

Fact or Fiction:

1.  I don’t have a physically demanding job where I use my hands a lot, so there is no way I can get CTS.

FICTION: Carpal tunnel syndrome can occur in anyone regardless of age or activity level. To understand this, you must understand the anatomy associated with carpal tunnel syndrome and the causes behind it.

Photo credit: American Society for Surgery of the Hand

If you turn your hand so your palm is facing up, you will find the crease where your hand meets your wrist. About one thumb width above this crease lies the carpal tunnel through which 9 tendons pass on their way to your hand. These tendons are attached to muscles that are responsible for flexing your fingers and the tip of your thumb. Stuck between these tendons and a tough, unforgiving structure called the transverse carpal ligament is the median nerve. The median nerve travels all the way down from your neck to your hand and provides sensation to your thumb, index, middle, and half of your ring finger, as well as movement signals to muscles in your hand. It can get pretty crowded in the small carpal tunnel space, especially if there is swelling present, and often times the median nerve gets compressed. This is carpal tunnel syndrome.

2. I don’t do a lot of typing, so I probably won’t get carpal tunnel syndrome.

FICTION: While carpal tunnel syndrome can be caused by excessive typing, it can be caused by any repetitive action of the hand, including prolonged gripping or pinching, jobs that involve repetitive vibration to the hand (jackhammer or drilling), or even the position you sleep in. Anything that causes inflammation to the tendons that run through the carpal tunnel in the wrist can cause compression of the median nerve including fractures/dislocations of the wrist, swelling, and systemic disorders (diabetes, rheumatoid arthritis, hypothyroidism).

3. I have heard that wearing a wrist brace at night could help my carpal tunnel syndrome.

FACT: Keeping the wrist in a neutral or straight position will put less pressure on the carpal tunnel and, therefore, put less compression on the median nerve. Wearing a wrist brace ensures that the wrist stays in a neutral position, which is important especially when we sleep because we tend to want to curl up and keep our wrist in a flexed position. The wrist brace can also be worn throughout the day with activity to make sure the wrist is in the optimal position that puts the least amount of compression on the nerve.

4. I should wait until the pain in my hand gets really bad before going to see the doctor because there is nothing that they can do about it now.

FICTION: If you suspect that you may have carpal tunnel syndrome it is recommended that you don’t let it go untreated. Prolonged compression of the median nerve can cause permanent damage to your hand, including weakness in the hand and muscle atrophy in the thumb. If you have carpal tunnel, you may begin to drop things because your hand does not have the strength to hold onto them. Conservative treatment such as occupational/hand therapy and wrist brace wear are more effective when you have mild to moderate carpal tunnel syndrome. For this reason, you should have your symptoms evaluated by a medical professional to avoid more extensive damage by leaving them untreated. Besides brace use and therapy, other treatment techniques for carpal tunnel include cortisone injection to the carpal tunnel to decrease inflammation and surgery. Your doctor may want you to have what’s called an EMG nerve conduction test to determine how much compression is on the median nerve to determine what your best treatment option is.

If you or someone you know has any further questions about carpal tunnel syndrome, feel free to set up a complimentary injury screening at your nearest Athletico offering occupational/hand therapy.