This issue isn’t just from texting or typing.
Carpal tunnel can stem from multiple factors beyond repetitive motion
General consensus has it that carpal tunnel syndrome, a hand issue caused by nerve compression, is the result of repetitive activities such as holding a mobile phone a certain way for long periods of time while scrolling on social media or from administrative work such as typing. Yet a direct relationship between repetitive work activity and carpal tunnel has never been objectively demonstrated, according to Keith Santiago, MD, an orthopedic surgeon at Lowcountry Orthopaedics & Sports Medicine. Possible contributors, he said, could be related to having had a broken wrist or other injury, pregnancy, the regular use of heavy machinery like a jackhammer, diabetes or thyroid issues. While controlling diabetes and thyroid levels can help alleviate some symptoms, these measures are not necessarily preventive.
Kyle P. Kokko, MD, Ph.D., an orthopedic hand surgeon at Novant Health and co-founder of the Hand Institute of Charleston, added that there is nothing that prevents carpal tunnel. Signs of the syndrome, he said, can include numbness and tingling in the thumb, pointer finger and middle finger, wrist pain, burning, dropping things or experiencing difficulty while executing common daily activities such as fastening a button or jewelry clasp. When a patient starts experiencing these symptoms, Dr. Kokko suggests they be their own best advocate for health and do their research.
“An educated patient is easier to work with. Plus, if a patient catches it early, the disorder won’t become a problem,” he said.
Managing early symptoms and reducing nerve compression
Dr. Santiago explained how to avoid nerve compression in the wrist. “Taking breaks and moving the wrist has been found to help with preventing pain at work. Wearing a brace to bed at night will also restrain the hand from flexing for long periods of time, easing compression on the median nerve.”
Dr. Kokko also suggested that if the pain or discomfort gets bad enough that it disturbs sleep, shaking the hand and wrist out so that the blood can start flowing again is helpful. He said, “Initially, I recommend buying a brace from a drugstore or online. The metal in the palm prevents extending of the wrist and keeps it neutral or in a straight position, which decreases pressure. Try it for several months as steps 1, 2 and 3 before booking an appointment.” In addition to wearing the brace, he recommended taking a nonsteroidal anti-inflammatory drug such as ibuprofen or naproxen sodium.
If the brace doesn’t provide relief, Dr. Kokko advised looking into steroid injections, which can sometimes reverse acute inflammation. However, he cautioned that injections are not a cure. Another treatment option, he said, is working with an in-office physical therapist on nerve-gliding exercises. “Although there’s not much data regarding therapy or injections, these alternatives are a good place to start,” he pointed out.
When to consider surgical options
In cases of acute pain and to avoid further nerve damage, surgical options for carpal tunnel syndrome may be required. Dr. Santiago said the five- to 10-minute routine procedure, which has a quick recovery with hardly any down time, involves a small incision in the palm to release pressure. “Although anesthesia is required, numbing locally under sedation, the patient may return to work the next day. After two weeks, we take the stitches out, and we suggest massaging the scar, which will be sensitive because of its location.”
“If the symptoms are bothering you enough that they become a nuisance, causing difficulty in daily life, I recommend considering surgery,” Dr. Kokko concurred. “It opens the tunnel, releasing pressure on the nerve and thus giving swollen tendons more room to breathe. Within one to two weeks, numbing and tingling sensations can disappear.”
Dr. Kokko emphasized that carpal tunnel is common. “One in 10 people get it in their lifetime,” he said. “The average age is 50, but there is a broad curve. For example, I’ve operated on someone as young as 12 years old who had an injury that led to carpal tunnel. The oldest patient I’ve treated was 93. Her mother lived to 110, and I wanted to fix her wrist pain so she could enjoy many more years.”
By Sarah Rose
