If, for you, working nine to five means tapping a computer keyboard, punching cash-register keys, working a jackhammer, or doing any other repetitive motion with your hands, you may be at risk for a painful condition called carpal tunnel syndrome (CTS). CTS are a collection of symptoms that can include tingling, numbness, burning, and pain from the wrist to the fingers. By far the most common cause of CTS is repetitive motion with the hands. For this reason, CTS is considered a cumulative trauma disorder. However, medical conditions such as rheumatoid arthritis. hypothyroidism (low levels of thyroid hormone), pregnancy, and overweight can also cause symptoms of CTS.
If you suffer from CTS, youre not alone. According to the United States Bureau of Labor Statistics, cumulative trauma disorders, including CTS, currently account for more than half of all occupational illnesses reported in the United States today. To understand why CTS occurs, it helps to take a look inside the wrist. The carpal tunnel is a narrow passageway that runs through the wrist. It is only about the size of a postage stamp, but it is crowded with nerves, blood vessels, and nine different tendons, packed in like strands of spaghetti. that control finger movement. Repetitive motions or medical conditions can cause the tendons to swell, decreasing blood flow and compressing the median nerve, which supplies the thumb, index finger. and middle finger. This compression can cause the numbness, pain, tingling, and burning we call carpal tunnel syndrome. If left unchecked, muscle wasting and permanent damage to nerves can result.
For most people the key to beating this syndrome is prevention making changes before CTS becomes a problem. If youre already experiencing the tingling, numbness, and pain associated with CTS, you may be able to prevent further damage and promote healing by making a few simple changes in your lifestyle. The tips that follow can help you keep your hands and wrists healthy and help reduce symptoms of CTS. If your symptoms are severe or if they dont resolve after two weeks of self-care, however, see your doctor.
Stay in shape.
Youll be less likely to suffer injury your bodys circulation and repair systems work well, says Mark Tager, M.D., president of Great Performance, Inc., a company in Beaverton, Oregon. specializing in occupational health. suggests practicing good nutrition, getting adequate sleep, taking frequent exercise breaks, and avoiding smoking (cigarette smoking cuts down circulation to all areas of the body).

Take minibreaks.
Fatigue in the joints or muscles is a warning sign to change your pattern of working, says Michael Martindale, L.P.T., a physical therapist at the Sports Medicine Center at Portland Adventist Medical Center in Oregon. "The body is trying to tell you something, he says:
Its up to you to listen and take a break.
Get up and change your activity, advises David Rempel, M.D., assistant professor of medicine and director of the Ergonomics Laboratory at the University of California at San Francisco. A 1- to 2-minute break every 20 or 30 minutes is a good idea. Then take a longer break every hour.

Dont snooze and lose.
Some people are bothered more by CTS symptoms at night. Many doctors believe this is because the fluid in the body is redistributed when you lie down, so more of it accumulates in the wrist. In addition, many people unwittingly cause wrist-nerve compression by sleeping with one hand tucked under their head, says Tager. He suggests altering your sleep position to keep your wrist from being bent or compressed.

Take some weight off.
Excess weight can compress the nerves in the wrist, says Tager. He advises keeping your weight within five to ten pounds of your ideal weight by eating a low-fat diet and getting plenty of exercise.

Rotate jobs.
Experts at the National Safety Council suggest that you rotate between jobs that use
different muscles and avoid doing the same task for more than a few hours at a time.
Rempel offers the following example: If your job is to tie a knot in a rope, and the guy down the line cuts the rope, see if you can modify your job so that either you switch tasks frequently or you combine tasks so youre not just doing the same thing over and over.
If your job doesnt allow rotation, talk with your supervisor or union about a change. Rotation reduces job stresses and minimizes production losses.

Keep it in neutral.
Work with your body and your wrists in a comfortable. neutral position, advises Rempel. For wrists, a neutral position is straight, not cocked. Check the height of your computer screen (it should be at eye level). Rearrange the level of your key-board or workstation so that you dont have to strain, reach, or bend your wrists. Your wrists should always be in a straight line with your forearms. And be sure your work is within your comfort zone (not too close or too far away).

Get the right grip on it.
Most of us have a tendency to grip with only the thumb, index, and middle fingers, which can increase pressure on the wrist. If you have to grip or twist something, such as the lid of a jar, Tager suggests you use your whole hand.

Alternate hands.
Whenever possible, Martindale suggests, give your dominant hand a break.

Watch those pressure points.
Too often, typists rest their wrists on the sharp edge of a desk or table as they work, which can cause excess pressure on the wrists, says Rempel. Adjust your workstation, if necessary, to keep your wrists off the edge.

Soften up and slow down.
Its often powerful movements done at high speed that cause carpal tunnel problems. Martindale suggests slowing down and applying only the force needed.

Decrease bad vibes.
People who use vibrating tools, such as sanders and jackhammers, for extended periods are at risk for wrist problems. If you are one of these folks, take frequent breaks and, when possible, operate the tool at the speed that causes the least vibration.

Go ergo.
Often, CTS can be prevented or treated by adopting tools and workstations that have been ergonomically redesigned to cause less stress on the body. Some tools have been designed to work with less force, while others now feature better grips and handles. Some knife manufacturers, for example, have redesigned knives for meat packers that require less wrist bending. Other companies have created aids such as wrist rests for computer users that can prevent or reduce CTS problems.
Look for items that can ease the strain on your wrists and hands, but be wary of miracle machines and gadgets. Some of the ergonomic aids can be really helpful, says Rempel. But I tell people to be careful about devices that make medical claims that say theyll cure CTS.

Watch for symptoms, and take action.
Pay attention to early warning signs of CTS, such as morning stiffness in the hands or arms, clumsiness, inability to make a fist, or thumb weakness, and take preventive and self-care action immediately, says Tager.

Ice it.
If youre having CTS symptoms, use ice to reduce swelling and inflammation. Place an ice pack on the wrist and forearm for 5 to 15 minutes two or three times a day, advises Rempel. At the same time, however, be sure to take steps to eliminate the cause of the trauma to your wrist.

Take the heat off.
Heat can worsen CTS. Heat may be good for loosening sore muscles, but you should never use heat with a nerve problem, says Rempel. Heat causes the tissue to swell, which can make the problem worse.

Nix flimsy splints.
Wrist splints prescribed by physicians can help CTS; too often, however, people who develop CTS symptoms rush to the pharmacy for a wrist splint as a home remedy. Rempel says these splints can do more harm than good. "The wrist splints you buy at the pharmacies are pretty flimsy, he says. They often allow the wrist to move. If people put them on and dont take them off for long periods of time, they can cause muscle shrinking (atrophy).

Reach for over-the-counter relief.
For minor pain and swelling, take aspirin or ibuprofen.

Stay Loose
A lot of times, initial problems with the wrist are actually tendon problems that dont yet involve the nerve, says David Rempel, M.D. Exercises map be able to help these svmptoms.
Rempel says that in many work settings today the problem is that workers dont move around enough. Youre seated in front of a computer for hours in the same position, he says. Its bound to cause problems. Exercises can help promote blood flow and strengthen the muscles and tendons.
The National Safety Council suggests performing the following four exercises twice a day or whenever you need a break. Stop doing any exercise, however, if it makes your symptoms worse.
Wrist Circles: With your palms down and your hands out, rotate both wrists five times in each direction.

Thumb Stretch: Hold out your right hand, and grasp your right thumb with your left hand. Pull the thumb out and back until you feel a gentle stretch. Hold for five to ten seconds, and release. Repeat three to five times on each thumb.

Five-Finger Stretch: Spread the fingers of both hands far apart and hold for five to ten seconds. Repeat three to five times.
Finger- Thumb Squeeze: Squeeze a small rubber ball tightly in one hand five to ten times. Afterward, stretch the fingers. Repeat with the other hand.
In addition, Rempel suggests strengthening the wrist tendons by doing the following exercises using small hand-held weights. Once again, however, stop any exercise that makes your symptoms worse.

Palm-Up Wrist Curls: Rest your forearms on a table, with your palms facing upward and your hands held straight out over the edge of the table. With a light weight (one to two pounds) in each hand, flex your wrists up ten times. Over the course of several weeks, gradually build up to 40 repetitions. Increase the weight of the dumbbells each week by one pound to a maximum of five pounds. Dont exceed five pounds with this exercise, however, or you may traumatize the wrist.

Palm-Down Wrist Curls: Adopt the same position as in the previous exercise, but have your palms facing downward. Flex your wrists up ten times. Gradually increase the number of repetitions over several weeks.

Arm Curls: Stand and hold the weights at your sides, palms facing forward. Slowly curl your arms up, keeping your wrists straight. Do 10 curls, and over several weeks, build up to 40 curls.

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