Carpal tunnel syndrome is a common concern in the dawn of the teleworking age. It is frequently seen in those who work heavily with their hands. These days, that often includes long days on the computer, smartphone, or tablet. Carpal tunnel syndrome results from compression of the median nerve as it passes through the wrist on its way to the hand. The median nerve provides strength and sensation to much of the hand. Fortunately, carpal tunnel syndrome treatment starts at home with a few key tips.
In classic form, carpal tunnel syndrome presents with numbness and tingling in the first three fingers of the hand. It can, however, have variations in its presentation earning it the reputation as the “great masquerader.” Other common presentations include the entire hand being numb, wrist pain, and pain moving up the forearm. People often report shaking their hands to “wake” them up. Also, they report increased symptoms with driving or heavy lifting.
Let’s review a classic presentation. A 51-year-old transitions work from an ideal office set-up to a home lab-top. Over 6 months, he experiences worsening hand pain with occasional numbness in his fingers and aching pain in his forearms. His symptoms are especially severe after a long day at work on the computer. He needs frequent rest breaks and finds himself shaking his hands for relief.
Carpal tunnel syndrome, which is often bilateral, presents similarly to one other condition. Neck pain with injured or irritated nerves can also cause hand numbness and pain. In this case, there is no associated neck pain or pain radiating from the neck into the fingers. The symptoms are not aggravated with neck movement. Flexing the wrist does provoke tingling in the first three fingers of the hand which is consistent with carpal tunnel syndrome.
Carpal Tunnely Syndrome Treatment
Fortunately, carpal tunnel syndrome treatment starts at home. Initial treatment includes proper positioning, reducing strain from repetitive movements, and bracing. Proper positioning means working with the wrists in a neutral position. Neutral wrist position reduces the stress and pressure on the nerve in the carpal tunnel. For computer work, an ergonomic mouse and keyboard may help. To reduce strain from repetitive activities, consider training the non-dominant hand to scroll and click with the mouse some of the time.
Additionally, wrist bracing helps reduce the symptoms of carpal tunnel syndrome. Bracing works by keeping the wrist in neutral position which reduces the pressure on the nerve. Studies show a benefit from wearing a wrist brace at night and during aggravating activities.
There are some key features to look for when selecting a carpal tunnel brace. The brace should be an adequate size for the wrist, provide immobilization, and keep the wrist in a neutral position. Many braces come in sizes based on the size of the wrist; make sure to check this. A tight brace on a compressed carpal tunnel may worsen symptoms. Also, stability, a carpal tunnel brace should provide immobilization of the wrist joint. Metal or plastic supports in the brace provide this.
Importantly, optimize the therapeutic benefit of a brace by wearing it at night and during aggravating activities. Interestingly, brace wear at night may be so effective because many people sleep with their wrists flexed, unknowingly compressing the carpal tunnel when sleeping. As symptoms improve, reduce brace wear to just at night, and then slowly off. If the above interventions do not improve symptoms there are additional treatments available, such as steroid injections or even surgery.
To summarize, technology-associated carpal tunnel syndrome is common in today’s world. It is frequently seen in those who work heavily with their hands. Initial treatments for carpal tunnel syndrome can be done at home and includes proper positioning, relative rest, and bracing. A wrist brace should be the correct size, provide stability, and rest the wrist in a neutral position. If symptoms do not improve more treatment options are available.