ANYBODY'S PRONE TO IT: CARPAL TUNNEL SYNDROME

Most people in most jobs are susceptible to contracting carpal tunnel syndrome during their careers. But people who routinely perform repetitive tasks are more prone to contracting it than others.

"Anybody's prone to it," physical therapist Robert Sherrill said, adding that it's not always a job-related illness.

But carpal tunnel syndrome is a rapidly growing occupational hazard for many data-entry workers, secretaries, cashiers, assembly line and construction workers.

Most known cases are reported by women. About two-thirds of the 250,000 people affected nationally are women. However, increased fluid during pregnancy can also trigger symptoms.

And with several factories and offices in Southeast Missouri, doctors and therapists see about 30 patients a year.

Carpal tunnel syndrome is caused by increased pressure on the median nerve in the wrist. The carpal tunnel, a passageway in the wrist, swells when repetitive movements cause the wrist's tendons to become inflamed and put pressure on the median nerve.

The nerves inside the tunnel don't have anywhere to expand and stay swollen, causing pain in the hand and fingers, said Sherrill of the Mid-America Rehab, 304 S. Mount Auburn Road.

The increased pressure from the swollen nerves can cause a loss of blood flow and then symptoms begin, he said.

The most common symptoms include a numbness in the thumb, index and middle fingers and a decreased strength of the thumb. People often report night pain or numbness.

Because treatment of carpal tunnel syndrome begins with assessing the problem, that often means evaluating how a person works -- the study of ergonomics.

"It's a team effort," said Julie Bricknell, an occupational therapist who specializes in hand therapy at The Hand Center, 48 Doctors Park.

Many of the problems that lead to carpal tunnel syndrome can be prevented with patient education and better working posture.

To avoid symptoms, people should complete a task with their work directly in front of them while keeping their shoulders slightly flexed, elbows at a 90-degree angle and wrists in a neutral position, Bricknell said.

Complete recovery depends on several factors -- weight, job posture, the type of treatment and the willingness to change how a repetitive task is completed.

About 60 percent of carpal tunnel cases can be treated with a simple ergonomics evaluation, Sherrill said.

For example, if a carpenter who has been hammering nails for eight hours a day with a bent wrist develops carpal tunnel syndrome, therapists might suggest using a curved hammer to prevent future stress on the wrist.

Therapists often limit wrist movement with the aid of a splint and often require a steroid injection to reduce inflammation.

When the symptoms become too severe, corrective surgery may be required. Doctors usually cut the ligament to relieve the pressure on the median nerve. Surgery increases the tunnel area and creates more room for the nerves to expand, Sherrill said.

"There's no magical exercise to prevent it," he said. "The body is meant to move in equal and opposite directions."

Although there is no cure for carpal tunnel syndrome, exercises can help alleviate some pain, Sherrill said, but added that too much movement can cause more pain.

HANDTIPS

Some common symptoms of carpal tunnel syndrome are:

-- Numbness of the hand or tingling in the fingers.

-- Decreased mobility and strength of the hand and fingers.

-- Dull, aching pain that occurs in the morning or at night or awakens you from sleep.

Some ways to prevent carpal tunnel syndrome are to:

-- Avoid doing repetitive motions with a bent wrist. Keep the wrist in a neutral or straight position.

-- Reduce the speed of the repetitive movement.

-- Take frequent breaks from repetitive motions to rest your hand.

-- Do warm up exercises before beginning repetitive tasks and stretching exercises throughout the day.

-- Avoid sleeping on your hands.