Carpal tunnel syndrome is well-known work ailment


December 24, 1990|By Michael Enright | Michael Enright,Special to The Sun

Of the myriad occupational diseases and ailments found in the modern workplace, perhaps none has received as much attention in the last decade as carpal tunnel syndrome, a painful swelling of the tendons and nerves in the hand and wrist.

The media has depicted the ailment as an unfortunate product of the Information Age, where computer keyboards and other repetitive workplace tasks force workers' wrists and hands into the same awkward motions hundreds or thousands of times a day.

But Dr. Louis B. Halikman, a Baltimore orthopedist with an interest in industrial orthopedic problems, remembers one baffling case of the syndrome in which he could find nothing in one patient's average workday routine that would explain the ache in his hands and wrists.

"It turns out he was an avid hooker of rugs -- he would spend hours a day at it," Dr. Halikman says. "I don't think CTS is as prevalent as it may seem although I'm not saying the ailment doesn't exist. I am saying that the workplace is not always the culprit."

Dr. Halikman says there are three factors involved in virtually all instances of carpal tunnel syndrome: repetitive motion, timed activity and fine manipulation of an object or controls.

CTS receives its name from the eight bones in the wrist called carpals. These bones form a tunnel-like structure that surrounds the tendons controlling finger movement, providing a pathway for the median nerve to reach sensory cells in the hand.

The syndrome results from the continued flexing and bending of the wrist for hours on end, causing the tendons in the hand to swell and increase pressure in the bony carpal channel; consequently, the median nerve is pinched and can result in a numbness, tingling or sharp pain in the fingers or a total loss of feeling.

If nothing is done to treat the condition, the pain can move up a person's arm to their neck, shoulder and back. An important sign of CTS occurs when a person wakes up in the middle of the night complaining of pain in the wrist and arm, said Dr. Halikman, or when they have difficulty picking up a small object such as a pin.

Some CTS relief has been achieved by redesigning some tools and tool handles that previously had put unnecessary pressure on the wrist. Other solutions have been found by simply redesigning an employee's workstation or changing the way his or her job is done.

But in many cases, researchers have found that the best cure for workers with CTS is more frequent breaks. In certain instances, employers have rotated workers into other jobs during the day to prevent a loss of manpower hours.

Additionally, a wrist pad attached to the bottom edge of a keyboard that keeps the user's wrists even with the keyboard can provide relief on the job. Another aid is a wrist splint that prevents the wrist from making the motion that aggravates the median nerve.

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