Posted on 6-11-2002

Preventing Carpal Tunnel Syndrome

The American Academy of Orthopaedic Surgeons has issued tips to prevent
carpal tunnel syndrome (CTS), one of the most common reasons for hand and
wrist pain, caused by repetitive stress injury.

CTS occurs when there is pressure on the median nerve, one of the important
nerves that supply sensation to the thumb, index, middle, and ring fingers
of the hand. When tissues in the carpal tunnel become inflamed and swollen
from overuse or other causes, they press on the median nerve, producing
pain and numbness in the hand.

The tips:

*Avoid activities requiring excessive up-and-down and side-to-side
movements of the wrist.

*Position your hands properly while working. The arm, wrist, and hand must
remain in a straight line; bending can cause friction that can lead to
inflammation. In other words, wrists should be parallel, and elbows should
be at a 90 degree angle to your desk, keyboard, or work table.

*Take frequent short breaks from your activity; stand up, walk around,

*Ask your orthopaedic surgeon about wrist splints to limit wrist movements.

*Avoid direct pressure on the heel of the hand, such as pushups or pressing
hard on seat surface to rise from a chair.

*Do not wear restrictive watchbands or jewelry or clothes with tight
elastic sleeves.

*Learn to use the computer mouse sensibly.

-- Choose a mouse that allows you to work with an open relaxed hand posture.

-- Don't squeeze or grip the mouse between your thumb and little finger.

-- Don't twist the mouse side-to-side; move the mouse with the entire arm.

-- Don't use a wrist rest; this doubles the pressure inside the carpal tunnel.

-- Keep the mouse close to the keyboard; don't stretch out to the side of
the desk.

"To prevent serious injury and maybe permanent damage, you should pay
prompt attention to the first twinges of pain or discomfort," advises
Vernon T. Tolo, MD, president of the American Academy of Orthopaedic
surgeons and pediatric orthopaedic surgeon at Children's Hospital in Los

"However, wrist pain may not necessarily mean carpal tunnel syndrome,"
warns Dr. Tolo. "There are other conditions that may cause these symptoms,
and it is important that an orthopaedic surgeon evaluate any wrist pain to
rule out other causes."