Prevention of Carpal Tunnel Syndrome

You can reduce your risk of carpal tunnel syndrome in several ways by preventing repetitive strain and learning to keep your wrists in a safer neutral position. However, you may be more prone to carpal tunnel syndrome due to underlying health conditions, anatomic factors, or a wrist injury. 

Health Factors

Being overweight is a major risk factor for carpal tunnel syndrome. If your body mass index (BMI) is 30 or above, you are at greater risk. It isn't known exactly why being overweight increases the risk. You will also reduce many other health risks if you can maintain a body weight below a BMI of 30.

Rheumatoid arthritis, diabetes, and hypothyroidism increase your risks of carpal tunnel syndrome. These conditions and others that result in inflammation or water retention narrow the space in the carpal tunnel. High blood sugar in diabetes damages the nerves. Getting treatment for these conditions can reduce your risk for carpal tunnel syndrome.

Age is a risk factor; the occurrence is highest in people over age 40 and is rarely seen in children. As you age, it's important to take more care to protect your wrists.

Wrist Flexion and Repetitive Strain

Being aware of your wrist position can reduce your risk of carpal tunnel syndrome. Neutral wrist position is the most protective. This is the position when your hand is in line with your wrist. A flexed position is palm down, with the palm and fingers bent towards the inner wrist. An extended position is with the palm up.

Sleeping

Sleeping on your hands, especially if they are in a flexed position, increases your risk. Pay attention to your hand position during the night. If you are already experiencing numbness or tingling in your hands at night or when you awaken, buy a wrist brace to wear while sleeping. This will keep your hand in a neutral position and help prevent progression of carpal tunnel syndrome.

Posture, Arm, and Hand Positioning

Keep your shoulders squared rather than rolled forward when sitting, standing, or walking. A hunched posture contributes to strain down your entire arm and to your wrists and hands. Any task you are doing, including checking your cell phone, should be done with your arms comfortably away from your body—not too close, not too far.

If you find yourself gripping an object such as a pen or your cell phone tightly, learn to relax your grip or modify how you hold the object. Use a larger soft-grip pen and a cell phone stand or holder. Any tools should be the correct size for your hands as tools that are too large can result in strain.

Avoiding Repetitive Strain in Tasks

At any task or job, pay attention to how you are using your hands, especially when you are performing the same action repetitively. Avoid tasks that require bending or twisting motions with your hand for extended periods of time. If you must perform these movements, gradually increase your time spent doing them and take frequent breaks. If possible, switch hands during your tasks.

On-the-job risk for carpal tunnel syndrome is seen mostly in assembly line occupations in manufacturing, cleaning, and food processing. In addition to redesigning these tasks to reduce strain, it would be helpful if your employer rotated jobs requiring these actions so you don't spend long hours doing the same movement.

Computer Workstation Positioning and Habits

The good news is that studies have not found a solid link between computer keyboard or mouse use and carpal tunnel syndrome. But there are some computer and typing habits that may increase the stress on your wrists. Changing these practices can reduce the day-to-day strain: 

  • Posture and positioning: Your keyboard and chair should be at a height where your forearms are level when using the keyboard and your wrists are not flexed when you type. Keep your monitor at eye level and your back supported. Your feet should be squarely on the floor (don’t sit with crossed legs for any length of time). Position your screen at arm’s length away from you. Assess your workstation and make all the changes you can.
  • Keep wrists neutral: When typing, your wrists should not be bent outward toward your pinky nor inward toward your thumb. Keep your wrists straight.
  • Don’t rest your wrists: When typing, your hands should float above the keyboard, allowing your fingers to find the right keys by moving your whole arm. If your wrists rest in one place, you have to contort your hands to strike all the keys. Wrist rests can be confusing because you really should not rest your wrists while you type. Your wrists should serve as a reminder not to rest your hands on the edge of a desk or table; keep your wrists floating in the air when you type.
  • Don’t contort: There are certain combinations of keystrokes that contort your hands and wrists. For example, try pressing control-Y with your left hand only. Anytime you need to do a key combination that involves holding down one key and pressing another, use both hands. This will seem strange at first but it will keep you from twisting into strange positions. This applies to using the shift key too.
  • Change hand positions often: Turning your hands over (knuckles on the table) when pausing at the keyboard is a great way to give your wrists a break from being in the same position all day long. Get in the habit of turning your wrists over when thinking of the next sentence to write, talking on the phone, or reading on the computer.

Exercises and Stretches

Stretching and conditioning for tasks that require the use of your hands and wrists are important for preventing injury and repetitive strain. If you already have some symptoms of carpal tunnel syndrome, discuss exercises with your doctor as they may or may not be recommended. Unfortunately, research has not shown nerve gliding and tendon gliding exercises to be effective in treating the condition once you have symptoms. Gliding exercises are hand motions aimed to keep the nerves and tendons sliding smoothly through the carpal tunnel, such as the wrist stretch below.

Wrist Stretch Sequence

Stretch the tendons and muscles in your wrists daily. Do so in the morning, at lunchtime, and at the end of the day.

  1. While standing, hold your arms straight out in front of you with your fingers extended, palms facing the ground.
  2. Raise both hands in the “stop” position (palms facing the wall in front of you) while keeping your arms straight. Hold this position for five seconds.
  3. Return your hands to the starting position and make a fist. Hold for five seconds.
  4. Rotate your fist down so the back of your hand is facing the wall in front of you and you can see your knuckles. Hold for five seconds.
  5. Finally, return to the starting position and relax your hands and fingers. Hold for five seconds.
  6. Repeat the series 10 times.

Add about two minutes of stretching for the rest of your body to your stretching routine. Loosen up your shoulders and straighten your back. Move your head from side to side. Stretch your back. You’ll feel more energized and have much less tension and pain.

Grip Strengthening: Squeeze a soft rubber ball. Hold the squeeze for five seconds. Repeat 15 times.

Yoga: Yoga can help strengthen and condition your upper body and improve your posture and grip strength. It has been recommended for people with symptoms of carpal tunnel syndrome.

On-the-Job Conditioning: If your job requires tasks that require twisting and bending your hands, especially if you must use forceful motions or carry a load, it is best to gradually increase the time you spend in these activities. Ask your employer for conditioning exercises.

Prevent Worsening

If you have hand or finger tingling, numbness, or pain, take steps to prevent the condition from worsening. See your doctor if you have had these symptoms for several weeks. If they remain untreated and progress, you are at risk of muscle and nerve damage that can be irreversible.

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