How Carpal Tunnel Syndrome Affects Workers

Source: Siam Pukkato - 123RF

The California Department of Public Health, CDPH, is highlighting its ergonomics resources for employers and workers following a recent report on the rates of carpal tunnel syndrome in the state.

The Oct. 5 issue of CDC’s Morbidity and Mortality Weekly Report identified more than 139,000 probable and possible cases of carpal tunnel syndrome reported by workers in California during 2007–2014.

According to the National Institute of Health (NIH), carpal tunnel syndrome (CTS) occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist.

The carpal tunnel — a narrow, rigid passageway of ligament and bones at the base of the hand — houses the median nerve and the tendons that bend the fingers.  The median nerve provides feeling to the palm side of the thumb and to the index, middle, and part of the ring fingers (although not the little finger). It also controls some small muscles at the base of the thumb.

Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men.

Researchers analyzed California workers’ compensation claims for carpal tunnel by industry and occupation, to determine which industries have the highest rates of carpal tunnel syndrome.

According to the report, female workers and workers in industries that manufacture apparel, process food, and perform administrative work were at highest risk for carpal tunnel syndrome.

High rates of carpal tunnel were also found among:

  • Telephone operators;
  • Cafeteria, food concession, and coffee shop counter attendants; and
  • Electrical, electronics, and electromechanical assemblers.

Researchers noted that workers in these occupations are often required to perform forceful or repetitive tasks with their hands, or maintain an awkward posture on the job, which puts them at increased risk for developing carpal tunnel syndrome.

CDPH’s online ergonomic resources include educational materials for specific occupations and ergonomic guides such as the “Physician’s Guide to the California Ergonomics Standard”.

Non-surgical treatments for the disorder are as follows:

  • Splinting.  Initial treatment is usually a splint worn at night.
  • Avoiding daytime activities that may provoke symptoms.  Some people with slight discomfort may wish to take frequent breaks from tasks, to rest the hand.  If the wrist is red, warm and swollen, applying cool packs can help.
  • Over-the-counter drugs.  In special circumstances, drugs can ease the pain and swelling associated with carpal tunnel syndrome.  Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may provide some short-term relief from discomfort but haven’t been shown to treat CTS itself.
  • Prescription medicines.  Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into the wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve in people with mild or intermittent symptoms.  (Caution: Individuals with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels.)
  • Alternative therapies.  Yoga has been shown to reduce pain and improve grip strength among those with CTS.  Some people report relief using acupuncture and chiropractic care but the effectiveness of these therapies remains unproven.