Many Causes To Blame For Carpal Tunnel Syndrome

DANBURY –– A lot of people think that working on a computer keyboard all day can cause carpal tunnel syndrome, but a connection between the two has not been established, according to John Lunt, MD, of the Hand Therapy Center of Western Connecticut in Danbury.

“Computers are actually quite safe,” said Dr Lunt, speaking at a recent Medical Town Meeting sponsored by Danbury Hospital on “Carpal Tunnel and Repetitive Strain Injuries.”

Repetitive motion disorders, also known as cumulative trauma disorders, can result from overuse of a joint or muscle, and can include bursitis and tendonitis. They are a very common problem and account for most workplace injuries today.

Carpal tunnel syndrome is one of the better known repetitive injuries and occurs when pressure builds up in the part of the wrist called the carpal tunnel, inflaming ligaments and compressing the nerve.

The cause of the pressure build up is water, according to Lionel Brown, MD, a hand surgeon at the center. “The culprit is water,” he said. “Water accumulates in certain places, and as we age we become more water-logged.” The carpal tunnel, he said, is a small place, and if it gets one drop more water, pressure builds up. This is why people often feel more symptoms at night, as water builds up during sleep, according to Dr Brown.

The causes of carpal tunnel syndrome are multifactorial, according to Dr Lunt, including a predisposition, body tissue stress and strain, environmental factors, ergonomics, and psycho/social factors.

A person could be predisposed to carpal tunnel syndrome by on-the-job stress, monotony, production demands, smoking, poor extremity strength, diabetes, aging, being out of shape, and a previous injury. High repetition and force, bad posture, extremes in motion, and a prolonged static position can also make one more at risk for a repetitive injury. Extremes in temperature and vibration and bad body mechanics are risk factors, too. Low job satisfaction and being unhappy can also contribute, according to Dr Lunt.

Carpal tunnel syndrome can be treated, he said, and people should not suffer without getting help. A diagnosis is made after an evaluation, complete patient history, and thorough exam. Rest from a single activity that is aggravating the risk, oral anti-inflammatory medications, good work ergonomics, and cortisone injections, when needed, best treats it. A last resort is surgery, but it is more than 99 percent successful, according to Dr Lunt.

Therapy and good body mechanics are also very import. Dr Lunt recommends using good common sense, rather than being quick to buy expensive adaptive equipment. Occupational Therapist Tina Steen recommends taking breaks from work every 20 minutes, stretching, using padded surfaces and holding wrists in the proper position when using a computer keyboard. She recommends avoiding extremes in joint motion.