Limbering up: Massage the inside and outside of hand with thumb and fingers. Grasp fingers and gently bend back wrist. Hold for five seconds. Gently pull thumb down and back until you feel the stretch. Hold for five seconds. Clench fist tightly, then release, fanning out fingers. R
Carpal Tunnel Syndrome: Wrist Exercises
The goal here is to keep your wrists limber and strong and alleviate any carpal tunnel strain you might create during the work day. it is recommended these exercises be done three to five times a week.
Keep in mind—these exercises are preventative. If you are experiencing pain or numbness, these exercises may exacerbate an existing problem. Speak with your doctor before doing any exercises.
1. Limber up: Start by massaging inside and outside your hand using the thumb and fingers. Grasp your fingers and very gently bend your wrist backwards (do not go far enough to induce pain or discomfort). Hold it for five seconds. Then gently pull your thumb down and back. Hold it for five seconds. Finally, clench your fist tightly and release it, making sure to fan out your fingers. Repeat this five times.
2. Wrist Rotations: Stand or sit, keeping your elbows close in to your waist, your forearms extending in front and parallel to the floor, and your palms down. Make fists with both hands then make circles with them in one direction. Do ten reps and reverse direction. Follow up with open hands and extended fingers. Repeat the full sequence.
3. Wrist Curls: Stand or sit, keeping your elbows close in to your waist, your forearms extending in front and parallel to the floor, and your palms down. Grab hold of a one-pound dumbbell in each hand; slowly bend your wrists downward, holding that position five seconds. Do ten reps.
4. Sideways Wrist Bends: Stand or sit, keeping your elbows close in to your waist, your forearms extending in front and parallel to the floor, and your palms down. Grab hold of a one-pound dumbbell in each hand. Now, keeping your forearms still, very slowly bend your wrists from one side to the other, moving the weights toward, then away from one another. Do ten reps.
5. Wrist Twists: Stand or sit, keeping your elbows close in to your waist, your forearms extending in front and parallel to the floor, and your palms down. With a one-pound dumbbell in each hand, slowly turn your wrists and forearms until your palms are facing up, then begin to turn them down again. Do ten reps.
Carpal Tunnel Syndrome: Tips For The Workplace
The following tips can help you avoid developing CTS at the workplace:
• Be positioned properly. Your computer screen ought to be around two feet from you, and the top of the document you’re working on needs to be equal to or just below your sight line.
• Position your keyboard flat. Don’t slant your keyboard; it should be flat. Use a three-quarter inch support under the keyboard if necessary.
• Keep your wrists straight. Your wrists should be straight, your forearms should e parallel to the floor, and your elbows ought to be bent at right angles.
• Use attachable forearm rests or a wrist rest. You need to keep your wrists straight, so use a forearm rest that attaches to the chair, or a pad in front of the keyboard. Keep in mind, though, that your wrists shouldn’t be on the pad during work; rather, they should hover a half-inch over the pad.
• Put your chair at a proper height. While sitting at your computer, your knees should be bent at right angles and your feet should be flat on the floor.
• Rest your wrists. Rest them as often as you can, especially when not typing.
• Take frequent breaks. At least five minutes per break. Keep in mind that several small breaks are much better for your wrist than one long break.
• Stretch out. Stretch your wrists prior to beginning work, and stretch them during breaks.
• Exercise. This includes full-body conditioning, since being in good shape helps safe-guard against repetitive motion injuries.
A final note: If, like some clerks, you work at a computer while standing up, you are at an increased risk for CTS—typically, counters are not high enough to support using a straight wrist. In order to prevent injury, do lots of stretching and strengthening exercises and request that your employer make adjustments to your work station to prevent injury. Remind them that it is in their best interests as well as yours.
The first step towards treatment is to not ignore pain in your wrist. If you feel pain, cease whatever you’re doing immediately. Stretch out a bit, ice it if necessary. If you feel the pain or discomfort decline or go away, resume what you’re doing, but resume it gradually, and remember to keep your wrist straight. If you are unable to cease what you’re doing, change your approach to such a way that your wrist is not stressed. Take breaks, stretch it out, and consider doing other things so that you aren’t grinding away with your hands for longer than one to two hours.
Other considerations include:
• Warming up your hands prior to the activity. This can include wrist circles (see end of article) to stretch your fingers and wrists. Do them every hour.
• Using wrist support pads with a computer keyboard. These help maintain your wrist in a straight alignment.
• Applying ice or a cold pack to the palm side of your wrist. Apply it for between five and ten minutes as necessary.
• Taking an over-the-counter anti-inflammatory. OTC pain relievers such as aspirin or ibuprofen can help reduce some of the swelling.
See your doctor if one of the following occurs:
• Severe pain or numbness does not go away despite rest and/or taking a pain reliever
• Your hand grip becomes increasingly weak
• Minor symptoms do not improve despite a month of treatment at home
• Numbness persists after three to four weeks of self-treatment. This is especially important because long-term numbness can lead to permanent loss of the function of your hand.
Carpal Tunnel Syndrome: Medical Treatments
Your doctor has a number of options to treat CTS. They include use of a wrist splint to stabilize the wrist, which can be combined with a change in hand position during the activities that cause the discomfort and pain in the first place. Your doctor may also recommend or prescribe over-the-counter anti-inflammatory medications.
If these measures fail to alleviate your symptoms, another option is a steroid injection, which can help if pain or numbness persist over a longer period of time. Steroid injections can be performed in an office setting by a rheumatologist, a hand specialist or any physician with experience in the procedure.
Sometimes physical therapists apply ultrasound treatments, which help to reduce the inflammation of tissue. A University of Vienna in Austria study from the mid 1990s found that such treatment did in fact decrease CTS symptoms among a majority of patients.
One of the treatments of last resort—if, in other words, other treatments have failed and the weakness in your thumb persists—is carpal tunnel release surgery. This procedure alleviates pressure on the nerve by cutting the carpal tunnel ligament that covers the median nerve. Performed by a surgeon and often on an outpatient basis, carpal tunnel release surgery has shown to be effective provided severe weakness in the area has not progressed.
While discomfort felt in your hands, wrists or forearms does not automatically indicate CTS—it needs to be as a result of strain from overuse, not merely from the area being out of shape—you should always seek your doctor’s opinion on that kind of pain or discomfort. This way your doctor can head off potential problems, whether related or unrelated to CTS.
Sometimes, common early warning signs of CTS arrive at odd hours, such as late at night when you feel like your hand is numb. You may not associate this numbness with CTS, but it is an early warning sign. The following signs and symptoms represent a potential case of CTS—keep in mind that they may only be intermittent at first; and only long-term, as they go untreated, will they become chronic:
• A decrease in finger, hand, elbow or shoulder mobility
• A decrease in hand strength
• Discomfort or pain (as in a dull ache) that begins hurting at night or in the early morning
• Severe pain that wakes you up at night
• Radiating wrist pain, going into the forearm, shoulders, neck and/or chest
• Visible changes in the hand (dry skin, swelling, color changes)
• A decrease in thumb strength
• A tingling feeling in every finger except the pinky
• Hand numbness that results in weakness or clumsiness
Carpal Tunnel Syndrome: Prevention
While CTS can be brought on by anything that compresses the median nerve we discussed earlier, including a cyst or rheumatoid arthritis, in fact it is most often brought on by repetitive motions of the hand and wrist, motions that cause the tenders to press on the nerve. Occupational health experts stress that prevention from serious injuries like CTS requires taking any such pain or discomfort seriously and seeking help immediately. The consequence of not doing so can be permanent damage to the area. The following preventive measures are recommended:
• While doing repetitive hand motions, do not bend your wrist. Your wrist should be straight and relaxed while writing, typing, driving, using tools (including scissors and needlepoint), and playing certain musical instruments.
• While doing repetitive hand motions, take frequent breaks—at least five minutes every hour—so that you can stretch out your fingers (including the thumb), perform some basic wrist curls and circles, and alter your grip.
• Finally, do your best not to sleep on your hands.
People in professions such as computers, cashiers, assembly-line workers, sewing machine operators and musicians are prone to developing a similar injury, because these jobs require repetitive motion in their hands, ones that strain the tendons in the wrist. The injury? Carpal tunnel syndrome, or CTS, a debilitating injury that hits hundreds of thousands of Americans each year, and costs businesses money into the billions. Repetitive stress injuries like CTS are quickly becoming the fastest growing occupational illnesses, according to the Bureau of Labor Statistics,
Work-related injuries such as these have gotten to be such a problem that the Occupational Safety and Health Administration (OSHA) stepped in, proposing new rules. Among them, employees with physician-diagnosed, ergonomic injuries would be entitled to have situation fixed to relieve the cause of the injury (altering keyboard or assembly line height, for example). Additionally, employees would be assigned to lighter duty during their recovery while being assured of normal benefits and pay. Finally, employees who can not stay on the job altogether would be assured of 90% pay and full benefits during their recovery.
The key to avoiding developing illnesses like CTS is to position your hands properly during work while remaining vigilant about pain and watching for early signs of trouble.
Carpal Tunnel Syndrome: How does it happen?
Your wrist features a narrow passageway of bone, ligament and nerves—this is the carpal tunnel. One of those nerves is the median nerve. The median nerve controls sensation in the fingers along with movement in a few hand muscles. This nerve goes through the carpal tunnel as well as some of the finger tendons. Repetitive motion of the hand or wrist can often put stress on those tendons; consequently they swell up, pressing on the median nerve. This pressure leads to pain and numbness, impairing movement in the hand and fingers. Ultimately, anything causing tissues within the carpal tunnel to swell (pregnancy and thyroid disease included), can constrict this nerve.
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Carpal Tunnel Symptoms
Carpal Tunnel Treatment
Carpal Tunnel Exercises