Dear Doctor: After knitting, I sometimes get tingles in my right hand, and my doctor thinks it might be the start of carpal tunnel syndrome. What can I do to prevent it?
Dear Reader: Carpal tunnel syndrome is a common and often painful condition that occurs when the median nerve, which plays a role in movement and feeling in part of the hand, becomes squeezed or compressed. This happens as the nerve passes from the forearm to the palm via a narrow passageway in the wrist, known as the carpal tunnel. Formed in part by small wrist bones known as carpals, it’s hard and rigid and measures roughly an inch across. In addition to the median nerve, the carpal tunnel guides the nine flexor tendons that bend the thumb and fingers.
Injury, anatomy and certain health problems can contribute to developing carpal tunnel syndrome. People with metabolic disorders such as diabetes, inflammatory conditions such as rheumatoid arthritis, and those who are obese are at greater risk. Heredity can also affect the size of the carpal tunnel, and there is evidence the syndrome runs in families. The condition is three times more common in women than in men, and also is more common in older adults. Repetitive hand and wrist motions, like those used in knitting, sewing, assembly line work, playing an instrument and typing, also play a role. Performed over time, these actions can irritate the tissues around the flexor tendons and cause them to swell. When this happens, the carpal tunnel becomes crowded, which puts pressure on the median nerve.
Symptoms include tingling; numbness; weakness; pain; and a burning sensation in the hand, particularly in the palm, thumb, and second and third fingers. Sometimes, the pain can extend along the arm. In more severe cases, it’s possible for carpal tunnel syndrome to weaken grip strength, and to affect the ability to distinguish between cold and heat.
When the onset of carpal tunnel syndrome arises due to the health problems mentioned earlier, those should be addressed first. If the condition begins to develop due to overuse of the hands and wrists, lifestyle changes can be helpful.
Pay attention to wrist position while knitting and during the day. Keep your wrists in a neutral position and avoid extreme bending. You may have to change how you perform certain tasks, including your knitting technique. Some people find it helpful to wear wrist splints, which promote optimal hand position and minimize pressure on the median nerve. Take frequent breaks during any activities that involve the hands and wrists. Never rest wrists on hard or sharp surfaces, like the edge of a desk or a table. When using a keyboard or mouse, adjust seat height so wrists don’t have to flex. Gentle stretching and gentle massage, the use of cold to reduce swelling, and over-the-counter pain relievers can help. Recent studies have shown acupuncture to be clinically effective in reducing physical symptoms and improving grip strength. If your symptoms continue or become worse, please see your doctor.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.