Do you type for a living? If so, here’s what you need to know about carpal tunnel syndrome from typing. I recently sat down to do an interview with the folks over at Well + Good about carpal tunnel and typing, and figured I’d share the original interview questions and answers here.
Now, most of my own clinical career involves treating upper extremity (arm and hand) issues like carpal tunnel syndrome, so this is an area where I feel very comfortable. In fact, I used to teach an entire upper extremity course at Augusta University in their Occupational Therapy Department. In that course, I focused on nerve issues like Carpal Tunnel Syndrome (CTS) from typing and other repetitive activities. We covered treatment options as well as options for braces and splints.
Since, carpal tunnel syndrome is one of the most frequently diagnosed nerve issues, it helps to learn a bit about it and how to prevent it. below are the original interview questions and answers.
1. What is carpal tunnel syndrome?
Carpal Tunnel Syndrome (CTS) refers to an entrapment of the median nerve at the volar (front) part of the wrist. By entrapment, we simply mean that the nerve experiences pressure when passing under the large ligament called the flexor retinaculum, which forms the carpal tunnel. The median nerve and several tendons pass through this tunnel at the wrist. Often times, due to inflammation in this small space, the median nerve gets pressed and “squished”, causing sensations of numbness, tingling, and even burning in the hand and fingers (thumb, index, and middle fingers).
2. What causes carpal tunnel syndrome?
As described above, CTS results from decreased space available in the carpal tunnel. Since the median nerve carries sensation and motor signals, when it gets pinched or pressed, the area below the entrapment (fingers and hand) experience the symptoms of paresthesia (numbness/tingling). It can be caused by improper positioning during work tasks or repetitive movements. CTS is referred to as a repetitive strain injury, so people that work on an assembly line or at a computer doing the same movement over and over again are at a greater risk.
3. How can you prevent it?
Prevention includes proper ergonomics, especially at computer-related or repetitive work stations. This typically means making sure you keep your wrist at neutral (flat) when completing these tasks. Repetitive flexion (bending down) of the wrist, especially combined with grasping of the digits, can place strain on the areas of the carpal tunnel and produce CTS symptoms. If you do begin to experience CTS-related symptoms, the research is pretty clear that using a wrist cockup splint, which keeps the wrist at approximately 15 degrees of extension can help prevent symptoms and allow the inflamed areas to heal. Night time splinting has also been shown as an effective method to address paresthesia that tends to occur at night or in the morning when you first wake up. Median nerve glides exercises can also help reduce symptoms.
4. Who is susceptible? Are desk warriors susceptible?
Anyone who does repetitive movements at the wrist is susceptible. We’ve treated musicians, office workers, people working in food production, and industrial assembly line workers.
5. What can you do to protect yourself from getting it? What habits are the most risky?
As mentioned earlier, proper ergonomics is the best protection method, especially if the aggravating activity is something you have to do, like a work-related task. Aside from that, avoiding repetitive movements of the wrist, primarily in wrist flexion, when you’re experiencing symptoms helps reduce paresthesia. The most risky habit would be to continue doing whatever the aggravating task is and not changing your body position. CTS often times starts out as mild symptoms, and many people simply shrug it off. However, those initially symptoms are your body’s way of telling you that something needs to be changed, either in the task or the way you’re positioning your body during that task.
6. Any misconceptions?
Many times, people associate any kind of paresthesia at the hand with CTS. This is understandable, since CTS is the most common peripheral nerve entrapment in the upper extremity. There are however several other nerves that can cause numbness and tingling in the hand. For example, the ulnar nerve can get entrapped at the wrist or elbow, causing carpal tunnel-like symptoms at digits 4-5. You can also experience carpal tunnel syndrome that stem from issues at the neck, thoracic outlet, or brachial plexus. It’s always a good idea to seek out the assessment of a qualified medical provider like an Occupational Therapist or physician to help rule some of these other syndromes out, particularly if nerve glides and splinting have not helped reduce symptoms.
Summary
I hope this helps you understand a bit about carpal tunnel syndrome and how repetitive activities like typing affect it. If you do experience symptoms associated with carpal tunnel syndrome, and evaluation by a clinician, like an occupational therapist or doctor, can help guide you in treatment options. Sometimes, nerve glide exercises and bracing provide enough relief that surgeries and injections can be avoided altogether.
If you have carpal tunnel syndrome, or wrist and hand pain, reach out for a wrist and hand assessment here.
