Carpal tunnel syndrome is a musculoskeletal disorder (MSD) that results from compression of the carpal nerve at the wrist. It then results in numbness, tingling, or even pain in the fingers. In France, where about 10% of the population is concerned, this is the most common MSD in occupational medicine where it is recognized as an occupational disease.
What is Carpal Tunnel Syndrome?
At the wrist, the median nerve and the flexor tendons of the fingers pass into a channel, called “carpal tunnel.” Compression at this level alters the sensitivity of the fingers and disrupts manipulation movements (awkwardness).
This compression of the carpal tunnel causes tingling in the fingers, numbness of the hand and pains in the fingers, particularly in the thumb, forefinger and middle finger. This pain tends to increase at night, depending on the position of the hand during sleep, but also during certain activities (by holding the steering wheel to drive, by phone, etc.). In the long run, the pain radiates from the wrist to the arm, even into the shoulder.
Note that carpal tunnel syndrome frequently affects both hands, but the dominant hand is more often affected.
What are the risk factors for carpal tunnel syndrome?
- Some diseases promote water retention or edema, and thus narrow the carpal tunnel: hypothyroidism, diabetes, rheumatoid arthritis, pregnancy, obesity, etc.
- Trauma or wrist injury
- Arthritis of the wrist.
- A neurological impairment related to diabetes.
- All professions and hobbies that require repetitive movements of the wrist: production line, gardening, etc.
- Vibrations: use of vibrating machines.
- Some restrictive postures for the wrists: use of the mouse and computer keyboard, video games, truck drivers, bus drivers …
Note that this syndrome affects three times more women than men, but the occurrence of this syndrome also varies greatly depending on the professional activity performed.
What treatment for carpal tunnel syndrome?
Treatment of the cause of carpal tunnel syndrome
Treatment of the cause is the first step: correction of carpal tunnel disease or change in behavior and work environment. For example,
- a reorganization of the workstation to avoid hypertension of the wrist should be considered with the help of an occupational therapist doctor and the occupational physician.
- In the case of repetitive tasks, regular breaks are required.
- Finally, when working on a computer, try to change the angle of the keyboard and use a wrist rest to align the hand and wrist.
The treatment of carpal tunnel syndrome pain
To relieve pain, anti-inflammatory drugs are generally effective. Corticosteroid infiltrations can also be performed for more lasting improvement. Ultrasound or laser techniques can also provide some relief.
Otherwise, wearing a gutter at the wrist can alleviate the night pain, keeping the wrist straight. The application of heat can also temporarily relieve pain and improve range of motion.
But in cases of severe carpal tunnel syndrome, pain persistent and resistant to pain, or if the work is at risk of recurrence, the radical solution is based on surgery, which involves cutting the ligament that compresses the nerve.
How to prevent carpal tunnel syndrome?
- Make sure his wrists do not rest on hard surfaces for long periods.
- Avoid prolonged use of highly vibrating tools.
- The handles of the tools must be perfectly adapted: neither too big nor too small.
- Be sure to hold objects in full hand and not with your fingertips.
- Change position frequently Ideally, other movements from one hand to another.
- In the case of repetitive tasks, think of regularly resting your hands and wrists.
- Avoid the position of the wrist “broken,” that is, bent upwards. Use a wrist rest. Wrist and forearm should be aligned and resting on the desk. A readjustment of the height of the seat is often necessary.
- Do not force with your hands when they are too close or too far from the body (cash registers, computer keyboard, for example).
- In case of mice with two buttons, the click with the index should be the most used.
- Manual work done in a cold environment requires the wearing of gloves.