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Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually, with pain, weakness, or numbness in the hand and wrist, radiating up the arm.
As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In some cases no direct cause of the syndrome can be identified. Most likely the disorder is due to a congenital predisposition – the carpal tunnel is simply smaller in some people than in others. However, the risk of developing carpal tunnel syndrome is especially common in individuals performing assembly line work.
Initial treatment generally involves resting the affected hand and wrist for at least two weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease pain. Cool (ice) packs and prednisone (taken by mouth) or lidocaine (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide immediate, temporary relief.
Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely. To prevent workplace-related carpal tunnel syndrome, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible.
The National Institute of Neurological Disorders and Stroke (NINDS) conducts research on nerve-related conditions such as carpal tunnel syndrome in its laboratories at the National Institutes of Health (NIH) and also supports research through grants to major medical institutions across the country. Current studies include several randomized clinical trials to evaluate the effectiveness of educational interventions in reducing the incidence of carpal tunnel syndrome.
Another clinical study is collecting data about carpal tunnel syndrome among construction apprentices to better understand specific work factors associated with the disorder and develop strategies to prevent its occurrence among construction and other workers. Scientists are also investigating the use of alternative therapies, such as acupuncture, to prevent and treat this disorder.