Today, roughly 3-5% of the general U.S. population suffers from carpal tunnel syndrome. Since repetition of hand use is one factor causing carpal tunnel syndrome, the increase of computer use may be involved in this statistic.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a medical problem of the hands. The pinching of a large nerve, the medial nerve that travels under the palm, causes the problem. Normally, the nerve carries information about the sensation of touch from the hand to the brain, but when the nerve is pinched, the sensation of touch can be blocked.

Causes. The use of highly repetitive wrist movements appears to be connected with development of carpal tunnel syndrome, but medical conditions like diabetes, rheumatoid arthritis, thyroid disease, and pregnancy can be causes as well. In an office environment, carpal tunnel syndrome can be worsened by incorrect use of a computer keyboard.

Symptoms. The symptoms of carpal tunnel syndrome can include numbness, tingling, pain and weakness in the thumb, index, middle and ring fingers. Initially, the feelings may come and go, but the pain is often worse and night and can wake you up. The symptoms may worsen when you are doing forceful or repetitive work with your hands, like driving, gardening, cleaning, or using a computer. Symptoms, which would suggest the problem is not carpal tunnel syndrome, include pain in the forearm or shoulder, or worsening symptoms when reaching overhead (e.g., washing hair).

Prevention. The best prevention for individuals who may be at risk for carpal tunnel syndrome (data entry clerks, word processors, or computer programmers), is correct use of the keyboard and mouse.

Treatment. Because problems of the hands can also be caused by other medical problems, it is important to know the specific cause of a hand problems because the treatments differ. It is also important to treat carpal tunnel syndrome early, because if treated correctly it can be reversed. If treatment is delayed, the condition is likely to worsen and surgery may be necessary. After a physical examination, a doctor with appropriate training will be able to tell what the cause of the problem is and should know what treatments will work. Treatment is surgical or non-surgical. Non-surgical treatment is usually the first choice, and may include:

• Modifying the way you use your hands (at work and home)
  • Using wrist splints properly worn at night, not while doing daily tasks
  • Worn loose, not so tight that they restrict blood flow
• Injecting the Carpal Tunnel with steroid medication

These non-surgical treatments are especially valuable for people with mile symptoms, or symptoms which come and go. The surgical treatment for people with carpal tunnel syndrome should be considered when symptoms have failed to respond to the treatments above or if CTS is at a late stage (constant symptoms). The symptoms should be severe enough to interfere with the patient's activities.

If you think you have carpal tunnel syndrome, what should you do?

You should immediately schedule an appointment with a doctor who has appropriate training in problems of the hand--hand surgeon, occupational medicine physician, physiatrist (rehabilitation medicine), or neurologist. Other specialists may have additional training in taking care of hand problems. The diagnosis should be based on a study of the nerve as it goes through the wrist called a nerve conduction study (NCS) or electromyograph (EMG). This study will detect approximately 90% of persons with carpal tunnel syndrome. In addition, some people without carpal tunnel syndrome will have an abnormal test. Thus, although the EMG is the best test we have, it is not perfect.