our everyday life

Etiology of Carpal Tunnel Syndrome in the Workplace

by Aubrey Bailey

Carpal tunnel syndrome is a painful condition caused by nerve compression in the hand. According to a study published in February 2012 by "Journal of Occupational and Environmental Medicine," this disorder affects approximately 2.7 percent of people in the U.S. Some occupations increase your risk of developing carpal tunnel syndrome.

Overview

Carpal tunnel syndrome is caused by compression of the median nerve in the hand. The carpal tunnel is at the base of the palm, just above the wrist. Nine tendons that bend the fingers and thumb travel through this tunnel with the median nerve. This nerve provides sensation to the thumb, index, middle and thumb side of the ring finger. Early symptoms of CTS include nighttime pain and tingling in the affected hand, and pain with repetitive use of the fingers. Over time, weakness may develop and the hand may become numb in the areas supplied by the median nerve.

Occupational Risk Factors

Several tasks that may be part of a job increase pressure in the carpal tunnel, contributing to the development of carpal tunnel syndrome. Repetitive tasks that require gripping and bending the wrist forward and backward may strain your wrist and finger muscles, causing friction in the carpal tunnel. Keeping the wrist bent fully forward or backward has also been shown to increase pressure on the median nerve. Using vibrating tools is another risk factor for the development of CTS. People working in certain occupations may have an increased risk for CTS, including factory and conveyor belt workers, meat packers, cashiers, construction workers, poultry processors, musicians, mechanics, massage therapists, cooks and plumbers. Workers in occupations with repetitive computer keyboard and mouse use may also develop carpal tunnel syndrome, but the association between this type of work and CTS is not well supported by medical research.

Interventions

Nonsurgical treatments are used first for carpal tunnel syndrome. Splinting the wrist in a straight position reduces pressure on the median nerve. Consistent use of a splint for at least 6 weeks has been shown to decrease symptoms of CTS. The splint is worn at night and all day, if possible. Antiinflammatory medications, such as ibuprofen (Advil, Motrin), are often used to treat CTS, but research has not proven these medications effective. Oral and injectable steroids relieve symptoms for some people. Surgery may be needed if conservative treatment is unsuccessful. The transverse carpal ligament, which forms the fibrous "roof" of the carpal tunnel, is cut to relieve pressure on the median nerve. According to a study published in 2102 in "Patient Preference and Adherence," 70 to 90 percent of patients had good or excellent outcomes after carpal tunnel release surgery.

Ergonomic Principles

The U.S. Occupational Safety & Health Administration explains that ergonomics is the science of fitting workplace conditions and job demands to the capabilities of workers. Although carpal tunnel syndrome cannot always be prevented in the workplace, following proper ergonomic principles can reduce risk factors that may lead to CTS. The large muscles should be used for tasks whenever possible. For example, rather than carrying a bucket by the handle, wrap both arms around it and carry it close to the body. Avoiding repetitive movements as much as possible is also recommended. Work tasks should be broken up to alternate fine motor tasks with larger body movements to allow muscles in the hand to rest. Wearing padded gloves reduces pressure in the carpal tunnel caused by vibration. Larger tool handles fitted to the worker decrease strain on the bending muscles of the hand and wrist, reducing pressure in the carpal tunnel.

About the Author

Aubrey Bailey has been writing health-related articles since 2009. Her articles have appeared in ADVANCE for Physical Therapy & Rehab Medicine. She holds a Bachelor of Science in physical therapy and Bachelor of Arts in psychology from the University at Buffalo, as well as a post-professional Doctor of Physical Therapy from Utica College. Dr. Bailey is also a certified hand therapist.

Photo Credits

  • Comstock Images/Comstock/Getty Images