Carpal Tunnel Syndrome - Prevention

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Highlights	Risk Factors	Treatment
Introduction	Prognosis	Surgery
Symptoms	Prevention	Resources
Causes	Diagnosis	References

Innovative keyboard designs may reduce hand stress:

Ergonomic keyboards allow the user to adjust and modify hand positions and key tension. Most have a split or "slanted" keyboard that places the wrists at an angle. Studies suggest these keyboards help keep the wrist in a more neutral position.
The continuous passive motion (CPM) keyboard lifts and declines gently and automatically every 3 minutes to break tension on the hands and wrist.
A keyless keyboard (orbiTouch) is an innovative device that uses two domes. The typist covers the domes with his or her hands and slides them into different positions that represent letters.

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Reducing Force from Hand Tools

The force placed on the fingers, hands, and wrists by a repetitive task is an important contributor to CTS. To alleviate the effect of force on the wrist, design tools and tasks so that the wrist position is the same as it would be if the arms dangled relaxed at the sides.

No task should require the wrist to deviate from side to side or to remain flexed or highly extended for long periods of time.
The handles of hand tools such as screwdrivers, scrapers, paintbrushes, and buffers should be designed so that the force of the worker's grip is distributed across the muscle between the base of the thumb and the little finger, not just in the center of the palm.
People who need to hold tools (including pencils and steering wheels) for long periods of time should grip them as loosely as possible.
In order to apply force appropriately, the ability to feel an object is extremely important. Tools with textured handles are helpful.
If possible, people should avoid working at low temperatures, which reduces sensation in the hands and fingers.
Power tools and machines should be designed to minimize vibrations.
Wearing thick gloves, when possible, may lessen the shock transmitted to the hands and wrists.

Hand and Wrist Exercises for the Prevention of Carpal Tunnel Syndrome

Hand and wrist exercises may help reduce the risk of developing carpal tunnel syndrome. Isometric and stretching exercises can strengthen the muscles in the wrists and hands, as well as in the neck and shoulders, improving blood flow to these areas. Performing the simple exercises described below for 4 - 5 minutes every hour may be helpful.

Exercises for Carpal Tunnel Syndrome

Wrists

Exercise 1

Make a loose right fist, palm up, and use your left hand to press gently down against the clenched hand.
Resist the force with the closed right hand for 5 seconds. Be sure to keep your wrist straight.
Turn your right fist palm down, and press the knuckles against the left open palm for 5 seconds.
Finally, turn your right palm so the thumb-side of the fist is up, and press down again for 5 seconds.
Repeat with your left hand.

Exercise 2

Hold one hand straight up shoulder-high with your fingers together and palm facing outward. (The position looks like a shoulder-high salute.)
With the other hand, bend the hand you are exercising backward with the fingers still held together and hold for 5 seconds.
Spread your fingers and thumb open while your hand is still bent back and hold for 5 seconds.
Repeat five times with each hand.

Exercise 3 (Wrist Circle)

Hold your second and third fingers up, and close the others.
Draw five clockwise circles in the air with the two fingertips.
Draw five more counterclockwise circles.
Repeat with your other hand.

Fingers and Hand

Exercise 1

Clench the fingers of one hand into a tight fist.
Release, fanning out your fingers.
Do this five times. Repeat with the other hand.

Exercise 2

To exercise your thumb, bend it against the palm beneath the little finger, and hold for 5 seconds.
Spread the fingers apart, palm up, and hold for 5 seconds.
Repeat five to 10 times with each hand.

Exercise 3

Gently pull your thumb out and back and hold for 5 seconds.
Repeat five to 10 times with each hand.

Forearms (stretching these muscles will reduce tension in the wrist)

Place your hands together in front of your chest, fingers pointed upward in a prayer-like position.
Keeping your palms flat together, raise your elbows to stretch your forearm muscles.
Stretch for 10 seconds.
Gently shake your hands limp for a few seconds to loosen them.
Repeat frequently when your hands or arms tire from activity.

Neck and Shoulders

Exercise 1

Sit upright and place your right hand on top of your left shoulder.
Hold that shoulder down, and slowly tip your head down toward the right.
Keep your face pointed forward, or even turned slightly toward the right.
Hold this stretch gently for 5 seconds.
Repeat on the other side.

Exercise 2

Stand in a relaxed position with your arms at your sides.
Shrug your shoulders up, then squeeze your shoulders back, then stretch your shoulders down, and then press them forward.
The entire exercise should take about 7 seconds.

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Review Date: 02/17/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).