Carpal Tunnel Syndrome

Causes and Risk Factors Prevention Pressure on the median nerve causes To help prevent carpal tunnel syn- carpal tunnel syndrome. This pressure drome or keep it from coming back, can come from swelling or anything take care of your basic health. Stay that makes the carpal tunnel space at a healthy weight. If you smoke, smaller. Sometimes it is not possible consider quitting. Exercise to stay to tell what causes the increased strong and flexible. If you have a pressure. However, certain lifestyle long-term health problem, such as and medical risk factors that may arthritis or diabetes, follow your contribute to carpal tunnel syndrome doctor’s advice for keeping your include: condition under control. • Illnesses such as hypothyroidism, Also, take good care of your wrists rheumatoid arthritis, and diabetes and hands by: • Pregnancy • Keeping your wrist in a neutral What is Carpal Tunnel • Obesity position as much as possible. Your Syndrome? • Forceful gripping or grasping activi- wrist is in a neutral position when ties with your hands it is straight or only slightly bent. Carpal tunnel syndrome (CTS) is • Making the same hand or wrist Holding a glass of water is an pain, tingling, and weakness due movements over and over, especially example of your wrist in a neutral to pressure on the median nerve in if the wrist is bent down (your position. your wrist. The median nerve and hands lower than your wrists) • Keeping your wrist straight while: several tendons run from your fore- – Using the computer, typing, or arm to your hand through a small • Wrist injuries and bone spurs using the mouse space in your wrist called the carpal • Smoking, because it can reduce – Writing tunnel. The median nerve controls blood flow to the median nerve – Driving movement and feeling in your – Using scissors, power tools, pliers, thumb and first three fingers (not Symptoms screwdrivers, or other tools your little finger). Carpal tunnel syndrome can cause tingling, numbness, weakness, or – Playing the piano pain in the fingers or hand. Some – Knitting, crocheting, and people may have pain that can radiate embroidering from the hand all the way up the arm. • Using your whole hand—not just Symptoms most often occur in the your fingers—to hold objects. thumb, index finger, middle finger, • Using a soft touch when typing. and half of the ring finger. If you A gel pad may help keep your have problems with your other fingers wrist straight. but your little finger is fine, this may • Relaxing your shoulders when be a sign that you have carpal tunnel your arms are at your sides. syndrome. Pain in the wrist or hand is often greater at night or early morning. • Avoiding sleeping on your hands.

Reprinted by Kaiser Permanente with permission.

HEALTH EDUCATION • Switching hands often when you • Stop activities that cause numbness • you are not responding to the ice need to repeat movements. and pain. Rest your wrist between and splint • Stretching regularly throughout activities. Corticosteroids, such as cortisone, the day. • Take frequent breaks from repetitive can relieve some of the pressure on hand motions. Switch between dif- the median nerve. Diagnosing Carpal Tunnel ferent activities as often as possible. Surgery: If your nerve test is posi- Syndrome • Change the way you do activities tive and the injections have worn Your doctor may do a physical exam so your wrist is not stressed. Try to off, or if you prefer not to receive and ask about your health and activities. keep your wrist straight as much as shots, your doctor may refer you Your doctor will ask if you have any possible. to the Orthopedic Department (or health problems—such as arthritis, • Do wrist circles and stretch your Plastic Surgery Department at some hypothyroidism, or diabetes—or if fingers every hour. locations) for a surgery consultation. you are pregnant. He or she will also • Reduce the amount of salt in your The surgeon will discuss the risks and ask if you recently hurt your wrist, diet to help decrease swelling. benefits of surgery and can help you arm, or neck. Your doctor will want • Maintain good posture. Avoid decide what the best option is for you. to know about your daily routine rounding your shoulders or slouching. Call Kaiser Permanente if: and any recent activities that could • Ice your wrist for 10 to 15 minutes, have hurt your wrist. • Your symptoms do not get better 1 or 2 times an hour. or you still have numbness in your During the exam, your doctor will • Over-the-counter (OTC) nonste- hand or wrist after 1 month of check the feeling, strength, and roidal anti-inflammatory drugs home treatment. appearance of your neck, shoulders, (NSAIDs), such as ibuprofen, may arms, wrists, and hands. • You are experiencing severe pain or relieve pain and reduce swelling. numbness that does not go away Your doctor may also suggest tests, Carefully consult the package so with rest, ice, changing positions, such as: that you take the correct dosage. or a normal dose of pain relievers If you have questions, please contact • Blood tests to see if another health like aspirin or ibuprofen. your doctor. problem might be causing your • Your hand grip feels weak. symptoms. • Wear a wrist splint at night to keep your wrist in a neutral position. • Nerve testing to find out if the This takes pressure off your median median nerve is working as it nerve. Other resources should. Corticosteroid Injections (Shots): • Visit your doctor’s home page Treatment Your doctor may recommend cor- at kp.org/mydoctor to use online health tools, view your At Home: Mild symptoms can usu- ticosteroid shots directly into your Preventive Health Reminders, ally be treated with home care. The wrist if: check most lab results, and sooner you start treatment, the better • your symptoms are frequent or much more. your chances of reducing symptoms increasing • Contact your Kaiser Permanente and preventing long-term damage to • you have more numbness in Health Education Center or the nerve. your hand Department for health information, programs, and other You can do several things at home to • your hand is taking longer to resources. help your hand and wrist feel better: wake up

This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.