A few weeks ago, I was chatting with a friend of mine. This gentleman, a seasoned journalist, spends hours on his keyboard sometimes doing home-office work for long hours. As we spoke, he complained about numbness, tingling, and pain in some of his fingers, a feeling of pins and needles. I asked him about his work on the computer, to which he responded in the affirmative since this discomfort had lasted a few days. He had a backlog of work because he had just returned from a holiday in Rwanda and had been compelled to spend hours on end on his laptop catching up on some stories.
It got me thinking, research has shown that people whose work involves repetitive and forceful hand exertions for long periods, especially computer-based jobs, are more prone to developing carpal tunnel syndrome.
Carpal tunnel syndrome is a common hand and wrist disorder. This is mostly caused by the compression of the median nerve as it passes through the tight carpel tunnel in the wrist. The median nerve provides the feeling and movement functions to the thumb and three middle fingers. It's the compression of that nerve that may cause symptoms in the wrist and fingers. These symptoms usually occur gradually and can be worse at night. Some patients have the sensation that their fingers are swollen, yet they are not. Weakness of the hand, mainly at the pinching function of the thumb, may also be present and manifest itself as difficulty in holding small objects, buttoning a shirt or grasping a glass or cup. Its slightly more common in women, precisely why, remains unclear.
Carpal tunnel syndrome is common during pregnancy, affecting around 60 per cent of pregnant women, particularly in the third trimester. Hormonal changes can cause swelling in the wrists, leading to fluid buildup in the carpal tunnel, which compresses the median nerve. Symptoms include pain, numbness, tingling, swelling, and difficulty gripping objects. These symptoms often worsen in the morning, at night, or with repetitive hand movements. Self-management options include resting the hands, elevating the affected arm, and using ice to reduce swelling.
For patients with carpal tunnel syndrome, maintaining good wrist posture while typing is essential. This involves keeping the elbows at a 90-degree angle and the wrists straight, slightly flexed, or slightly elevated, avoiding extreme positions. Proper wrist alignment helps prevent increased pressure within the carpal tunnel, which can restrict blood flow to the nerve and cause numbness in the fingers. Adopting a good posture can reduce pressure in the carpal tunnel and alleviate symptoms.
If carpal tunnel symptoms are present in both hands, it could indicate an issue originating from the neck or be related to underlying conditions like hypothyroidism, diabetes, or rheumatoid arthritis. Such symptoms should be taken seriously, as they can be a warning sign of a more significant problem.
If you experience neck pain along with numbness and tingling in both hands, it is important to seek medical evaluation promptly. For patients diagnosed with carpal tunnel syndrome, it is important to take brief, frequent breaks from activities like keyboarding. During these breaks, performing small stretches can help before returning to the activity. While carpal tunnel syndrome involves nerve issues, the symptoms are often caused by compression.
To alleviate these symptoms, it is recommended not to type for extended periods. Instead, try typing for about half an hour and then taking a few minutes off to restore circulation. Carpal tunnel syndrome should not be left untreated for an extended period, as early diagnosis and treatment significantly increase the chances of a successful outcome.
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Treatment for carpal tunnel syndrome depends on various factors, such as age, overall health, the severity of symptoms, and personal preference. Options include splinting to stabilise the wrist, anti-inflammatory medications to reduce swelling, and surgery to relieve nerve compression. Worksite adjustments, like ergonomic changes, can also help alleviate symptoms.
For those whose symptoms have improved, supervised stretching and strengthening exercises may be beneficial. Surgical options, performed on an outpatient basis, include open surgery, where tissue compressing the nerve is cut, and endoscopic surgery, which uses a small camera and tools to relieve nerve pressure through a minimally invasive approach.
Dr Vincent Mutabazi is an applied epidemiologist.
