We often go through our daily routines without considering how repetitive motions – such as using a computer keyboard and mouse, scrolling our phone screens, or even housework – can silently contribute to health risks such as carpal tunnel syndrome.
The condition, which can affect anyone regardless of age, occurs when the median nerve located in the carpal tunnel – the narrow passageway running from the forearm to the palm of the hand – becomes compressed. Common symptoms include weakness when gripping objects along with pain, numbness, and/or tingling sensations.
It is most often triggered by repetitive movements caused by tasks carried out with our hands.
“Other factors such as joint or bone diseases, hormonal or metabolic changes, and fluctuations in blood sugar levels can contribute to the development of carpal tunnel syndrome as well,” said Dr Raymond Yeak, a consultant orthopaedic, trauma and sports surgeon from a medical centre in Sunway Velocity, Kuala Lumpur.
For instance, inflammatory arthritis can cause the protective sheath around multiple tendons in the wrist’s carpal tunnel to thicken, putting pressure on the median nerve.
“Moreover, diabetes can cause neuropathy – a nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness – which means even a slight narrowing of the carpal tunnel can have a significant impact on diabetic patients,” he added.
Are women more susceptible?
Notably, carpal tunnel syndrome tends to affect women more than men, with pregnancy being a significant contributing factor.
Yeak’s colleague Dr Maria Shelynn Wong highlights that while approximately 4% of adults in the general population are affected by carpal tunnel syndrome, there is an estimated 31-62% prevalence of symptoms among pregnant women.
“Every expectant mother experiences a doubling of their blood volume. As a result, the additional fluid exerts increased pressure, leading to swelling in the blood vessels throughout their body,” Wong explained.
In confined areas such as the wrist, this swelling can compress the median nerve, potentially resulting in carpal tunnel syndrome. After giving birth, symptoms typically subside as fluid levels return to normal, alleviating pressure on blood vessels.
Nonetheless, it is advisable for pregnant mothers to consult a doctor if they experience painful symptoms in their hands. Seeking medical guidance allows for a better understanding and assessment of carpal tunnel syndrome, providing mothers with peace of mind during their pregnancy journey.
Getting triggered
Individuals who experience carpal tunnel syndrome may also face a condition known as trigger finger. Scientifically known as stenosing tenosynovitis of the flexor tendons, it presents as a digit or digits that become stuck, causing pain and tightness.
Wong describes it as a clicking or catching sensation when opening and closing the fingers, which can be uncomfortable.
One of its main causes is repetitive actions such as twisting, squeezing, grasping, or forceful hand activities. Even simple activities such as knitting, sewing, or hand-washing clothes has been known to cause it; while medical conditions such as diabetes and rheumatoid arthritis can contribute to its development.
Similar to carpal tunnel syndrome, pregnant women are more vulnerable due to fluid retention and swelling during pregnancy. Trigger finger is also more commonly observed in older individuals, but is rare in children.
Fortunately, there are simple measures that can be taken to mitigate the risk of carpal tunnel syndrome or trigger finger. Yeak suggests reducing unnecessary repetitive hand motions, such as limiting leisurely use of a mobile phone and taking breaks.
Gentle stretching exercises during resting periods can decrease stiffness and improve range of motion in the affected area.
Treatment options are tailored to each individual case, the first of which is splinting to restrict wrist movement while allowing finger mobility. By providing the median nerve with a break, splinting can help reduce swelling and facilitate the healing of mild to moderate nerve damage.
Another approach is physiotherapy, which may involve exercises to improve wrist and finger motion to strengthen the affected area.
Lastly, medication can be considered. Injections containing a combination of steroids and a local anaesthetic into the median nerve may benefit some patients. However, Yeak stresses that prescribing steroids during pregnancy is generally avoided to prevent potential side effects.
For mothers, Wong advises that they should remain vigilant even after giving birth: the frequent lifting of the baby and engaging in repetitive motions can potentially contribute to tendinopathies caused by overuse.
It is, therefore, important to maintain awareness and take necessary precautions to prevent strain or injury post-delivery.