Carpal Tunnel Syndrome (CTS)

The Cumulative Trauma Disorder getting the most attention in the media is Carpal Tunnel Syndrome (CTS). Our hands and wrists are comprised of various bones, tendons, nerves, muscles and ligaments. The center of the wrist contains a small tunnel called the carpal tunnel. That tunnel is formed by the carpal bones and a thick ligament called the flexor retinaculum (Anderson 1987).

CTS develops when the tendons inside the carpal tunnel swell up. They put excessive pressure on the median nerve. (The median nerve transmits sensory and motor signals to and from part of the thumb and first three fingers.)

CTS sufferers often feel a pain, numbness and a tingling in their hand(s), particularly in the evening or early morning. They have trouble gripping, and frequently drop things.

Treatment can be as mild as a wrist splint, but often requires expensive surgery to relieve the pressure on the median nerve. Unless the conditions that originally caused the problem are changed, CTS is likely to recur.

Don't assume that pain in your wrist or hand comes from a problem in the carpal tunnel. The median nerve can also be entrapped in the elbow and in the shoulder. Because a syndrome is by definition a collection of symptoms, problems which do not originate in the carpal tunnel are often labeled as Carpal Tunnel Syndrome. This can lead to inappropriate surgery.

Some CTS operations fail simply because the patient did not have a problem in the carpal tunnel in the first place. A nerve conduction velocity test must be done before even considering surgery.

After surgery, many computer users expect to return to the same work. If the job is not modified substantially, the problem will reappear.