Carpal Tunnel

The human body has a vast network of nerves that trek from your head down to your toes. These structures allow the body to have sensation and motor tasks.

Just like the rest of our body’s tissues, these nerves are susceptible to damage. 

Nerve dysfunction can come about from traumatic injuries, genetic diseases, or something as simple as body positioning. 

What is carpal tunnel?

Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed in the wrist.

This compression can be caused by swollen tendons of one of numerous muscles that share the tunnel with the median nerve.  Obesity may also play a role in CTS.  Increased fat cell storage in the wrist will lead to a decrease in space in the carpal tunnel. Furthermore, women are more likely to get CTS since their overall body structure is often smaller. Those who smoke cigarettes also face an increased risk for carpal tunnel.

Workplaces and fields at risk

People who are in the construction field, assembly industry, or use a computer for most the day are more at risk for developing CTS. Continuous vibrations, extreme forces, and high repetitions are the common actions that provoke CTS.

Impacts

Since there are many predisposing factors to CTS, it is difficult to state exactly what measures one should take to prevent this condition. That said, general exercise and proper posture can decrease the stress placed on the median nerve in the carpal tunnel. Strengthening the muscles in the hand and wrist is very important in preventing CTS.  When these muscles become weak, the body looks for ways to adapt in order to perform tasks. For example, if a person has weakness when extending their wrist, they may compensate for that lack of wrist movement by manipulating the shoulder’s function.  This can not only cause wrist problems, but also lead to shoulder complications. 

Posture is also important when talking about CTS. Many people do not think about posture throughout their daily activates.  Furthermore, gym-goers often neglect postural muscles when training, since these are not the typical “beach body” muscles. The shoulder complex is extremely important when referencing wrist joint mechanics.  Maintaining strong shoulder stabilizer muscles will allow the joint to maintain its integrity throughout daily activities.  However, if these muscles are weak, a person’s posture may be affected.  This is where the concern of CTS may arise. A person must continue through their day-to-day activities, which can inadvertently place an increased stress on the wrist.

Reducing risk

While there are many methods to treating CTS, current research suggests splinting, nerve gliding exercises, forearm strengthening exercises, grip strengthening exercises, and intermittent activity breaks are most efficient in reducing the symptoms of carpal tunnel syndrome.  

Splinting

Splinting allows the wrist to stay in a fixed position, which reduces the stretch applied to the median nerve. Splints also allow a person to preserve finger function.  Nerve gliding exercises can be done in almost any environment.  These exercises promote a stretch in the targeted nerve and increase the mobility of that nerve in its respective compartment.7

Grip strength

Grip strength and forearm strength can be increased through home exercises as well.  These are not large muscles and do not require heavy barbell activities to create hypertrophy and strength gains. Something as simple as squeezing putty or a towel can be used to remedy strength deficits. 

Take a break

CTS may arise as an overuse injury. Occasional breaks during the work day may help alleviate the stress placed on the median nerve.  Furthermore, relaxing your grip with your functional activities may decompress the carpal tunnel structures.

Carpal tunnel syndrome can vary in severity.  This condition can be developed quickly or over a long period of time. However, it is important to be progressive if this condition affects you.  Also, while there are many at home exercises and work place modifications, a doctor should always be contacted and consulted. 

References

  1. Aboonq MS. Pathophysiology of carpal tunnel syndrome. Neurosciences. 2015;20(1):4-9.

  2. What is carpal tunnel syndrome?. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet. Published January 2017. Accessed on May 2, 2017.

  3. Pourmemari M-H, Viikari-Juntura E, Shiri R. Smoking and carpal tunnel syndrome: A meta-analysis. Muscle & Nerve. 2013;49(3):345-350. doi:10.1002/mus.23922.

  4. Palmer KT. Carpal tunnel syndrome: The role of occupational factors. Best practice & research Clinical rheumatology. 2011;25(1):15-29. doi:10.1016/j.berh.2011.01.014.

  5. Carpal Tunnel Syndrome. University of Maryland Medical Center. http://www.umm.edu/health/medical/reports/articles/carpal-tunnel-syndrome Published May 26, 2012. Accessed on May 2, 2017.

  6. Piazzini D, Aprile I, Ferrara P, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clinical Rehabilitation. 2007;21(4):299-314. doi:10.1177/0269215507077294.

  7. Pinar L, Enhos A, Ada S, Güngör N. Can we use nerve gliding exercises in women with carpal tunnel syndrome? Advances in Therapy. 2005;22(5):467-475. doi:10.1007/bf02849867.

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