The dramatic increase in the use of computers in the home and workplace has added many new terms and expressions to the English language. It has also brought increased publicity to some terms that are not so new.

One of these is carpal tunnel syndrome. It is estimated that three out of every 100 individuals in the U.S. are affected by carpal tunnel syndrome, resulting in thousands of days of missed work every year. Although carpal tunnel syndrome is often associated with heavy computer use, it is not just using a keyboard that can cause it. Anything that involves extensive and repetitive wrist movements can lead to carpal tunnel syndrome.

What this means for you is that some of the repetitive tasks you perform in your childcare center or at home--tasks such as drawing, sewing, even playing a musical instrumen--may cause carpal tunnel syndrome if proper precautions are not taken.

The carpal tunnel is a narrow canal in the wrist through which tendons and nerves connect the forearm to the hand. The median nerve that runs through this canal controls the sensations and muscle movements in the thumb and first three fingers (the little finger is the sole exception).

When this nerve is compressed or inflamed, carpal tunnel syndrome can occur. Women are more likely than men to suffer from this disorder because their carpal tunnel is usually smaller, making the median nerve more vulnerable to inflammation and injury.

Middle-aged women, in particular, are said to be more susceptible, as are individuals who smoke. Underlying medical conditions such as arthritis and diabetes, as well as pregnancy and obesity, also may play a role in determining whether you develop carpal tunnel syndrome.

The initial symptoms of carpal tunnel syndrome may be minor tingling or weakness, usually in the dominant hand; but chronic pain and loss of motor function can be the end result. It is important to recognize the symptoms and seek treatment before the problem worsens.

For many, the symptoms first appear during the night because many people sleep with their wrists flexed. You might awake in the morning to find that your fingers feel swollen or numb. Shaking out your hands may help relieve the pressure on the nerve and ease the discomfort.

The problem can carry over into daily activities. You may find yourself no longer able to form a fist, grasp small objects in your hand, or tell the difference between hot and cold with a simple touch.

One of the best ways to prevent carpal tunnel syndrome is to limit the flexing or bending of your wrist, whether playing the piano or guitar, typing on a keyboard, or stitching by hand. Adequately protecting yourself includes an awareness of your posture when sitting at a desk or worktable.

The following suggestions can help prevent injury while at a computer workstation:

• Keep the top of your monitor at or just below eye level.
• Make sure your head and neck are in line with your torso.
• Support your wrists and lower back so that when lifting, you lift with your back, not your wrists.
• Align your wrists and hands with the keyboard.
• Take frequent breaks to stretch and shift position.

In addition, if you sew or work on crafts a lot, it is recommended that you take precautions related to how you hold your scissors and how often you use a pinch grip to hold or cut fabric. By applying the guidelines for workstations to your crafts and hobbies, you can further protect yourself from injury.

As a childcare provider, you can adapt and apply these guidelines to your particular workspace and activities or to any situation that requires you to sit or stand for long periods of time.

Initial treatment of carpal tunnel syndrome involves rest and avoidance of the activity that is causing strain on the median nerve. By treating the injury before it gets serious, it is often possible to alleviate the pain through non-surgical methods.

Some recommended treatments during this early stage include a wrist brace to prevent further injury, ice packs to alleviate swelling, and stretching or other exercises as directed by a physician or physical therapist.

If these treatment attempts are not successful, surgery may be needed. In fact, carpal tunnel surgery is one of the most common procedures performed today. Because it requires only a local anesthetic, it usually can be performed as an outpatient procedure for otherwise healthy individuals.

Many patients report immediate relief following surgery. However, surgery is not a cure-all. Some individuals do not fully recover from the cutting of the median nerve and may have to change job duties to compensate for the loss of sensation and strength.

In addition, because of the time needed for full recovery and its impact on motor functioning, physical therapy is often recommended. The good news, according to the National Institute of Neurological Disorders and Stroke, is that recurrence of carpal tunnel syndrome following surgery is rare.

Diona L. Reeves
Freelance writer and former employee of the American Academy of Pediatrics’ Healthy Child Care America program

Mayo Clinic Carpal Tunnel Syndrome Guide and fact sheets; www.mayoclinic.com

Preventing Carpal Tunnel Syndrome, familydoctor.org /023.xml

OSHA Ergonomics, Outreach and Assistance; www.osha.gov; 800-321-OSHA (6742).

National Institute of Neurological Disorders and Stroke Carpal Tunnel Syndrome Fact Sheet; www.ninds.nih.gov; 800-352-9424.

National Library of Medicine, www.nlm.nih.gov/medlineplus/carpaltunnelsyndrome.html