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Carpal Tunnel Syndrome
What Is Carpal Tunnel Syndrome?
You've probably already heard about carpal tunnel syndrome (CTS) and its effect on different occupations, like computer programmers and assembly line workers. Maybe you even know someone who has CTS or you yourself are suffering from it. But what exactly is CTS, and how do you keep from getting it?

Carpal tunnel syndrome is a condition that may be caused by repeatedly performing stressful motions with your hand or holding your hand in the same position for long periods of time. CTS is classified as a cumulative trauma disorder, an ailment that attacks the body's musculoskeletal system. The musculoskeletal system is made up of muscles that pull on tendons and move the bones at joints. The joints are held together by ligaments. Carpal tunnel syndrome specifically affects the sensitive nerves of, and the blood supply that feeds, the hands and wrists. 

The Carpal
Carpal tunnel syndrome has been around for a long time. Meatpackers began complaining of pain and loss of hand function in the 1860s. Back then, these complaints were largely attributed to poor circulation.

But the nature of work has changed over the years. Today, more jobs are highly specialized and require use of only a small number of muscles repeatedly. With the growing numbers of people using computers and keyboards, plus the focus on better health care for workers, carpal tunnel syndrome is of real concern to both employers and the health care professions.

Recent studies have shown that carpal tunnel syndrome, like all other cumulative trauma disorders, is on the rise while other workplace injuries have leveled off. Many companies are turning to physical therapists for help in designing and implementing health promotion and injury prevention programs to protect their employees from CTS.

This article explains what carpal tunnel syndrome is and the role physical therapists play in treating this debilitating disease and in educating people about possible risk factors. It also tells you how you can avoid CTS both at work and at home.

What Are The Symptoms?
People with CTS usually experience feelings of numbness, weakness, tingling, and burning in their fingers and hands. If not treated, the symptoms may escalate into acute, persistent pain. CTS can become so crippling that people can no longer do their work or even perform simple tasks at home.

Carpal Tunnel

At its most extreme, carpal tunnel syndrome forces people to undergo surgery and miss many days of work, or prevents them from working at all because their hand functions are permanently impaired.
Who's At Risk?
Carpal tunnel syndrome strikes men and women of all ages, and is often found in workers whose tasks require repeating the same motion in the fingers and hand for long periods of time.

CTS has surfaced among meatpackers, assembly line workers, jackhammer operators, and employees who spend hours working at a computer or typewriter. Carpal tunnel syndrome shows up in athletes as well as homemakers.

The U.S. Department of Labor has cited carpal tunnel syndrome, as well as other cumulative trauma disorders, as the cause of 48 percent of all industrial workplace illnesses. The disease affects more than five million Americans.

CTS's impact on American businesses is devastating. It shows up in the workplace in the form of fatigue, poor work performance, discomfort and pain, and poor employer/employee relations. The high cost of treatment for an employee with CTS, plus the lost productivity when that employee is absent for a long period of time, strains the company's ability to operate efficiently and can lead to morale problems when other employees have to take over the absent workers' responsibilities.

How Physical Therapists Can Help
Physical therapists with specialized training in cumulative trauma disorders have been working in industrial and corporate settings for many years to meet the health care needs of America's workforce. They work closely with employers to educate employees about CTS- what causes it and how to avoid it through proper use of the musculoskeletal system. Physical therapists can target and correct poor work habits and improper work designs, such as tools, furniture, equipment, and work space. They also can assess the risk potential of an individual and determine if that person is physically unsuited for a particular job.

Among their many responsibilities, physical therapists teach health awareness and job safety. A typical education program includes exercises employees can do at work and at home, adjustments to the overall work environment and individual work stations, plus early detection of symptoms to avoid painful and costly surgery.

Workstation
Physical therapists also work with employers and their engineering departments to design and modify the work environment, helping to remove the causal factors of CTS.

If you or anyone you know has symptoms of carpal tunnel syndrome, consult a physical therapist or other qualified health care practitioner for an evaluation and individualized treatment.

In the Workplace
A physical therapist will begin by observing how employees work and evaluating the ergonomics of the work environment. Ergonomics is the study and control of the effects of postures, stresses, motions, and other physical forces on the human body engaged in work. For instance, computer programmers may be sitting in a chair that forces them to slouch. Their computer screen may be too high, causing stress in the neck and shoulders, and the keyboard may be in a position that forces continued pressure on the wrist muscles. Factory workers standing on their feet all day may have to use tools that are designed for individuals with a larger grip. Their work station may be too high or too low, forcing them into an awkward body position. This action puts added strain on the neck, shoulders, and arms.
A physical therapist can show employees how to adjust their work area, handle tools, or perform tasks in a way that puts less stress on the body. They may teach employees a number of exercises to increase flexibility of their arm/hand region while they are at work. Hand Tools in the 











Workplace
Frequent brief stretching and relaxation exercises can help reduce injuries and improve productivity in the workplace. Physical therapists also suggest short rest breaks after two hours of using the hands.
At Home
Many activities outside of work may contribute to carpal tunnel syndrome: knitting, sewing, or needlepoint; cooking and housework; TV computer games and home computer work; playing sports or cards; and hobbies or projects like carpentry or using power tools for extended periods of time.

Sewing

You can do the same exercises at home that you do at work. You should also take frequent breaks and examine the tools you use at home that could be causing strain on your hands. You may need to wear a wrist splint at night, while playing sports, or when working at home. The wrist splint assists in maintaining the wrist in a neutral or straight position and allows the wrist to rest.
Your physical therapist will help you design an exercise program that allows you to enjoy daily activities at home. To begin with, your physical therapist will instruct you on exercises to stretch the forearm muscles to reduce tension on tendons that pass through the wrist. Knife
After swelling in the wrist decreases, your physical therapist will give you some isometric strengthening exercises that are correct for your particular injury.

You can do these isometric and stretching exercises at work or at home. They'll strengthen the muscles of your wrists and hands, as well as in your neck and shoulders, improving the blood flow to those areas.

Fist Extension ExercisesShoulder stretch
Make a FistShoulder shrug

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