Carpal Tunnel Syndrome What is carpal tunnel syndrome?
	What is the carpal tunnel and how does it work?
	How can you prevent CTS? What role does ergonomics play in CTS?	David seeks a medical opinion about his sore wrists.

Contents

Insights & Connections
Resources
Main Actvity
Try This

INSIGHTS

The carpal tunnel is a very crowded, narrow passageway on the inside of your wrist, filled with nerves, tendons, and blood vessels. When you engage in quick, repetitive actions with your hands and wrists hour after hour, day after day, you can irritate and traumatize that narrow area. Inflammation and swelling might result, producing tingling, numbness, and pain in the hand. When that happens, you have carpal tunnel syndrome (CTS).

Imagine a water hose with a kink in it. Even when you turn the water on full force, the flow coming out of the nozzle will not be full strength. This resembles what happens with CTS. When the median nerve in the carpal tunnel is squeezed, the result can be pain, numbness, some weakness, and eventually the inability to properly use the hand. The index finger, the middle finger, and thumb are most severely affected.

If you've ever fallen asleep on your arm or hand, the sensation of 'pins and needles' that you experience upon waking is similar to what people with CTS experience. To test for CTS, doctors tap a patient's wrist area. If the patient feels a tingling in the fingertips, it could indicate CTS.

Although medical experts have known about this problem for over a hundred years, recent changes in the workplace have made CTS more common. People who work as typists, grocery checkers, and postal workers are among those most at risk for acquiring it.

For people who already have CTS, medical treatment includes splinting the wrist, medication, and sometimes surgery.

But something can be done to reduce the chances of acquiring CTS. Medical personnel suggest that workers keep their wrists in a neutral position, cut down on repetitive wrist motions or take frequent breaks from them, and practice various exercises.

Experts estimate that by the year 2000, repetitive motion injuries (including CTS) will make up half of all occupational-related illnesses. Some people are studying work environments and trying to make them more comfortable and physically less stressful. They might suggest wrist rests for people who type a lot, anti-glare filters on computer terminals, and chairs with firm back support. This new area of study is called ergonomics, and it is a growing field.

As schools, homes, and workplaces become more computerized, more people may develop CTS. Everyone needs to be aware of this problem, since prevention is so important.

CONNECTIONS

1. Why is it especially important to know about CTS today?
2. What simple steps can office workers take to prevent CTS?
3. What jobs or activities make you prone to CTS?

• carpal tunnel- the narrow channel formed by bones, ligaments, and bands of connective tissue at the wrist through which nerves, tendons, and blood vessels must pass on their way to the fingers
• ergonomics- a new scientific field designed to alter the workplace so that it will more safely accommodate workers
• median nerve- a very important sensory and motor nerve that passes through the carpal tunnel
• nerves- the specialized cells that connect the brain and spinal cord to sensory organs, muscles, glands, and other body parts. They conduct impulses that are responsible for our ability to feel and do motor functions.
• tendon- a band of tough fibrous tissue that connects a muscle with its bony attachment
• traumatize- harm by physical injury

RESOURCES

• Goldoftas, B. (1991, Jan) Hands that hurt: Repetitive motion injuries on the job. Technology Review, pp. 42-50.
• Greer, B. G., Jenkins, W. M., & Roberts, R. (1992, Apr-June) Carpal tunnel syndrome: A challenge for rehabilitation. The Journal of Rehabilitation, p. 43.
• McCormick, E., & Sanders, M. (1992) Human factors in engineering design. NY: McGraw-Hill.
• Meyer, A. (1991, June) Carpal tunnel pain: Surprise! You may be at risk. Here's help. Better Homes & Gardens, pp. 38-40.
• O'Malley, C. (1992, Mar) Don't get all bent out of shape by your computer. PC Computing, pp. 268-269.

Additional sources of information

National Institute for
	Occupational Safety and
	Health
200 Independence Ave. SW
HHH Building, Room 714B
Washington, DC 20201

The National Safety Council
444 North Michigan Avenue
Chicago, IL 60611

US Department of Labor
OSHA Publication Office
200 Constitution Avenue
Room N-3101
Washington, DC 20210
(publication # OSHA 3123: Ergonomics: The study of work)

Community resources

Local physicians who specialize in orthopedics, neurology, or neurosurgery

WORKPLACE WISDOM

Modify a work space to cut down the risk of CTS.

MAIN ACTIVITY

Learn how to alter a work space to lower the risk of acquiring carpal tunnel syndrome. Take this activity one step further by working on the ergonomics of the entire workplace.

Materials

• foam (firm but pliable)
• covering of your choice
• pillow
• light fixture
• cardboard to create a nonglare computer screen

1. Choose a workplace with a computer. It could be the computer area in your classroom or the school library.

2. Use the area and talk to other students who have used it for long periods of time. Find out what they think is uncomfortable about it. List these things.

3. First deal with the computer keyboard. Decide if the user¹s wrists are straight or at an uncomfortable angle when typing. If the wrists are bent, make a wrist rest to raise the hands to a more natural level. Do this by measuring the distance between the user¹s wrists and whatever they might comfortably rest on. Cut your piece of foam to this height. Place it on the rest area. Try it out. You may need to make adjustments. Now cover the wrist rest with a nonirritating covering material.

4. Check out the chair and the lighting in this area. Make necessary adjustments to improve them.

5. Check the position of the computer monitor. Try raising or lowering it or tilting it. What position is most comfortable?

6. Decide if too much glare shows on the computer screen. If so, use cardboard to cut down the glare. You may also reduce glare by simply repositioning the screen.

Questions

You can take some simple and effective steps to help prevent carpal tunnel syndrome when you work in an office. But what if you are a musician or a beautician? What could you do to prevent CTS if you worked in these professions?

Divide into teams. Each team tries to list as many occupations with workers at risk for developing CTS as possible. The team with the longest list wins. Remember, repetitive action in the workplace is the key.

Imagine that you have carpal tunnel syndrome. Keep your dominant hand (the hand that you use the most) immobile for an entire afternoon at school. How difficult is eating lunch, taking notes, and packing up your backpack? What sports or activities would be most difficult?

Plan a class trip to your local medical center with an orthopedic department or invite a therapist who deals with CTS to speak to your class. Ask the therapist to bring a night splint or wrist rest to show you and to demonstrate the stretches and exercises you can do to prevent CTS.

...

Name 15 at-home activities that a person with CTS would have difficulty doing.

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