Hands and wrists can be affected by carpal tunnel syndrome. A region in the wrist called the carpal tunnel is encircled by the wrist bones and a stiff ligament that holds the bones together (see Figure 1). Figure 1: Carpal Tunnel Syndrome The median nerve, along with the flexor tendons of the fingers and thumb, pass via this little tunnel (see Figure 2). The movement of the fingers is transferred from the muscles to the bones of the hand by these tendons. The brain sends impulses to the median nerve, which in turn controls the movements of the fingers and hand. Additionally, it transmits data from the hand's temperature, discomfort, and touch to the brain and regulates hand sweating. The median nerve regulates the thumb, index, middle, and ring fingers (see Figure 2). Figure 2 shows the medial nerve and tendon of the carpal tunnel The median nerve is encircled by the finger tendons in the carpal tunnel. The median nerve, which is softer than the tendons and is squeezed by the swollen tendons, which take up less space in the tunnel. This nerve may become damaged under pressure. Such an injury causes the hand to feel numb, tingly, painful, and clumsy. Carpal tunnel syndrome is the name for this set of symptoms. Tasks like twisting keys, latching buttons, and unscrewing bottle caps are challenging for those with carpal tunnel syndrome.
What causes carpal tunnel syndrome to manifest?
Muscles and tendons are activated when the wrist is bent or when the fingers are moved. For instance, the tendon moves around two inches when a person flexes a finger. Hand tendons are housed in sheaths, or sleeves, through which they can move. Cells that create a slick fluid to lubricate the tendons are found in the inner wall of the sheaths. For the tendons to operate normally and smoothly, lubrication is necessary. The lubricating mechanism may fail if the hand is moved repeatedly or excessively. It could create insufficient fluid or fluid with subpar lubricating properties. Because of friction caused by the lubrication mechanism failing, the tendon and its sheath become inflamed and swollen. The wrist's or carpal tunnel's median nerve is subsequently compressed by the swelling. Fibrous tissue develops as a result of repeated inflammatory episodes. The tendon sheath becomes thicker due to the fibrous tissue, which restricts tendon movement.
What are the causes of carpal tunnel syndrome in the workplace?
Carpal tunnel syndrome is """"frequently the consequence of a combination of circumstances that raise pressure on the median nerve and tendons in the carpal tunnel, rather than an issue with the nerve itself,"""" according to the National Institute of Neurological Disorders and Stroke (USA). Several tasks, including the following, have been linked to carpal tunnel syndrome: hand motions that are repeated. weird hand gestures. firm grasping the palm is under mechanical tension. Vibration. This injury is frequently reported by employees who conduct assembly line work, such as manufacturing, finishing, cleaning, and packaging meat, poultry, and fish. Workers that do repetitive wrist movements in their jobs, such as cashiers, hairdressers, knitters, and sewers, are at risk for developing carpal tunnel syndrome. Other examples are bakers who flex or extend their wrists when working with dough, as well as persons who flex their fingers and wrists while hand-weeding, spray painting, or milking cows. Carpal tunnel syndrome may also be linked to overuse of vibrating hand equipment. There may be a connection between using a computer mouse and carpal tunnel syndrome. While working at a keyboard is generally not a risk factor for getting carpal tunnel syndrome, it can hurt people who already have the condition and make their symptoms worse. Be aware that various injuries may develop as a result of the repeated motions needed for keyboard work and computer mouse use. The following table shows typical jobs and tasks that are connected to carpal tunnel syndrome. Table 1 lists the jobs and tasks that are most likely to cause carpal tunnel syndrome. Job Duties Occupations Pulling fabric, grabbing and tugging at it garment worker, tailor, and production sewer dairy cows Agriculture employee handling items while using conveyor belts worker in an assembly line using a screwdriver, ratcheting down Mechanic weeding by hand Gardener with a spray gun Painter Knitting Crafts-person Scrubbing A janitor, a personal assistant, a cook, and a server bowing while playing stringed instruments use of a laser scanner at the register Cashier chopping and deboning meat cutter or poultry processor Assembling small parts Electronic industry worker Turning keys Locksmith Wearing poorly fitting gloves which apply external pressure Agricultural worker, mechanic, factory worker, those working in cold temperatures Pressing tool into palm Painter, carpenter, stablehand Pounding safety lever or stamping machine Receipt processor Using air-powered hand tools Assembly worker, construction worker Some studies show that psychosocial factors (such as stress) can also contribute to the development of carpal tunnel syndrome.
What are the non-occupational factors of carpal tunnel syndrome?
Carpal tunnel syndrome is associated with several diseases and situations. They are: Arthritis. Diabetes. Gout. Amyloidosis (infiltration of the liver, kidneys, spleen with a starch-like substance). Hypothyroidism (underactive thyroid gland). Tumours of tendon sheaths. Wrist fractures and dislocations. Wrist cysts. Pregnancy. Use of oral contraceptives. Menopause. All these diseases and situations increase the volume of the contents of the carpal tunnel, resulting in compression of the median nerve. Also some individual factors, such as the size and shape of the wrist and the shape of the median nerve, may contribute to the development of carpal tunnel syndrome. Women are three times more likely than men to develop carpal tunnel syndrome and this difference could be because a women's carpal tunnel are generally smaller than those in men.
What are the symptoms of carpal tunnel syndrome?
The typical symptoms of carpal tunnel syndrome are tingling of the thumb, and of the index, middle, and ring fingers, and night pain. The pain awakens the patient, but is often relieved by shaking, hanging, or massaging the hand. Pain may involve not only the hand, but also the arm and the shoulder. Numbness and loss of manual dexterity occur in more advanced cases. Weakness of the hand also occurs, causing difficulty with pinch and grasp. The person may drop objects or be unable to use keys or count change with the affected hand. The skin may dry because of reduced sweating.
How is carpal tunnel syndrome recognized?
People who suspect carpal tunnel syndrome often consult a doctor. The evaluation of occupational carpal tunnel syndrome includes identifying workplace risks. Evaluation begins with a discussion of the person's employment and requires a detailed description of all the processes involved in a typical day's work. It also requires consideration of the frequency, intensity, duration and regularity of each task performed at work. Diagnosis of carpal tunnel syndrome is confirmed by performing certain tests to detect damage to the median nerve. Tinel's test - The physician taps the median nerve at the wrist. A tingling response in one or more fingers indicates damage to the median nerve. Phalen's test - The patient puts the backs of the hands together and bends the wrists for one minute. Tingling of the fingers indicates damage to the median nerve. Electromyography - Electrodes are placed on the forearm and electrical current is passed through the patient. Measurements on how fast and how well the median nerve transmits messages to muscles indicate if there is damage to this nerve.
How is carpal tunnel syndrome treated?
When symptoms of carpal tunnel syndrome are mild or likely to be temporary, treatment includes rest, anti-inflammatory drugs, cold packs, or a splint. Even if a patient wears a splint that has been prescribed, he or she should avoid the activities that caused or aggravate the injury. Where this is not possible, patients should wear the splint after work and particularly during sleeping hours. Specific exercises supervised by a physical or occupational therapist and yoga can be beneficial. Surgery may be necessary if the symptoms are severe and if the other measures do not provide any relief. Surgery should not be the first choice for treatment. Even after surgery, a number of patients may still have some problems. It is best to seek a diagnosis and treatment as early as possible to avoid permanent damage to the median nerve.
How can we prevent carpal tunnel syndrome?
Prevention of carpal tunnel syndrome may involve redesigning work stations, tools, or the job, and educating workers. Proper work station design reduces awkward wrist positions and minimizes the stressful effects of repetitive motions. Awkward positions can originate from unsuitable work station designs that do not take into account the size and proportions of the human body. Work stations should be adjustable and should accommodate a vast majority of people who work in that area. Redesigning work methods is important. For example, using an adjustable fixture to hold an electrical housing, as Figure 3 shows, reduces wrist flexion. (A) (B) Figure 3 - Examples of an adjustable fixture(B) that reduces the wrist flexion shown in (A) Redesigning tools is also important. One study in a poultry processing plant found that workers who used standard knives were prone to carpal tunnel syndrome. When the workers started using knives with a bent handle, they no longer needed to bend their wrists while cutting the meat (see Figure 4). This change significantly reduced the occurrence of carpal tunnel syndrome. Figure 4 - A possible knife handle that eliminates bending the wrist while cutting Good job design minimizes awkward wrist positions and tasks with repetitive motions. Job design includes the following: analysis of the sequence of the tasks to allow changes in body position work-rest schedule to relieve muscles from mechanical stress work breaks to avoid monotonous and repetitive patterns of work rotation of tasks to move workers from one job to another Worker training should aim to reduce the number and types of awkward wrist postures and the number of repetitive motions. Informing workers about the risk factors that can contribute to carpal tunnel syndrome is important. To limit the effects of a physically stressful job, employers should work closely with employees. This is achieved by implementing worker training and job rotation, and by matching employees to job assignments."""