As you'll see, not only is carpal tunnel genetic, but it's also primarily a "women's condition". This painful and progressive condition is most definitely linked to a family history of having it. And recent studies show it's far more prevalent in women than anybody ever thought.

A case in point are two sisters I first met in 2016. They co-owned a small hair styling business where they spent 10 hours per day, 6 days a week. Hard workers indeed. Both women were in their 40's.

And both women had symptoms of severe carpal tunnel syndrome. This article illustrates how and why they are both affected with this disorder.

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The sisters came to me simultaneously with the SAME problem: hand pain in their right (dominant) hand. They were examined by another hand specialist several months prior to our visit.

He diagnosed them both with moderate carpal tunnel syndrome. He also advised they both splint their right hand at night as the best treatment.

After months of nightly splinting, the treatment was unsuccessful in both women. Returning to the specialist, he advised carpal tunnel release surgery for both of them. 

But here's the problem:

Neither sister could take time off to have surgery, much less go through the recovery period. Their business would suffer because it only had 3 stylists. Besides, surgery is only 50% successful. So the risk of their being in the same predicament later on was too high to take.

The sisters came to me for alternatives to surgery. I knew the statistics for hand pain in almost every profession. And the big dis-proportion of hairdressers having carpal tunnel is well-known.

Holding brushes, using scissors, and gripping other instruments for hours on end strains the hands like few other occupations. It means carpal tunnel is just bound to happen in hairdressers.

And sure enough, carpal tunnel syndrome is number 4 among hairdressers’ top 3 health concerns. Fully 15% already have this painful condition.

The fact that both sisters had carpal tunnel symptoms is no surprise. The disorder occurs in families. In fact, your occupation (overusing your hands) is only a secondary factor when it comes to risk, where family history is more predictive.

The hereditary nature of carpal tunnel syndrome means if you have it, your children will likely sufferer as well. Likewise, if a sibling has it, then you're also at high risk. And if you're a female with a parent who had carpal tunnel syndrome, you're at very high risk. (See below.)

No one is really certain what genetic factor cause carpal tunnel syndrome. But two possible candidates for its cause have been proposed.

• Collagen: The pathology of carpal tunnel syndrome begins in the tendons and other connective tissues inside the wrist joint. Evidence suggests that certain genes make tissue proteins which are not optimal for strength or suppleness. Examples are defects in type V collagen, which has already been shown to be associated with acquiring carpal tunnel syndrome.

• Anatomy: Genes also control our physical characteristics. They contain the code for how tall or wide we turn out to be. They also code for the diameter of our wrists. We already know that more slightly built ("small boned") individuals are at higher risk for developing carpal tunnel syndrome. And if you inherited a smaller frame including a smaller wrist diameter, you're at higher risk.
  

I began by explaining what most doctors and scientists have concluded when it comes to my sister patients. That is, carpal tunnel syndrome is determined by genetics, and it's also primarily a women's condition. In fact, the current thought is that women are 3-5 times more likely to develop carpal tunnel syndrome.

But the reason it's a women's condition is not merely due to more narrow wrists commonly seen in females. It's more than that.

One hint comes from Dr. Kramer and others. They have shown that females with carpal tunnel syndrome tend to have elevated levels of type II collagen. Such an increase may change the surface of cartilaginous structures. This impacts how tissues can handle mechanical loads.

Finally, the consequences of repetitive stress cannot be understated. Repetitively stressing the fingers and hands is a major risk factor for developing carpal tunnel syndrome. And the major source of repetitive stress is work-related.

Males make up slightly more than half of the US labor force. And in that workforce, females produce only 10% of the manual labor performed.

Adjusting for this disparity means that women are exposed to manual labor 9 times less than males. Therefore, the chances of women developing carpal tunnel syndrome (under equal working environments) is not 2-3 times higher, but over 30 times higher than in males.

By any measure, this makes carpal tunnel syndrome primarily a "women's condition"

The most reliable way a doctor can diagnose carpal tunnel syndrome is by using "provocative tests". In particular, these are the Phalen, Tinel, and Durkan tests. They're extremely reliable ways to tell if you have carpal tunnel syndrome instead of another condition, like wrist tendonitis. 

Basically, the doctor taps and presses on your wrist area. If the doctor can "provoke" symptoms (or make them worse) then it's positive for having carpal tunnel syndrome. You can do these identical tests for carpal tunnel on yourself, usually with very reliable results. Click here to see these self-tests.

Unfortunately, many doctors still cling to using electromyography (EMG), MR and CT exams to diagnose carpal tunnel syndrome. But the American Academy of Neurology says such tests are valueless compared to these simple, yet precise provocative tests. The electronic tests should be used only to confirm the provocative diagnosis.

The most important partner you have against fighting carpal tunnel syndrome is a stretching exercise regimen. If you do these 3 important exercises every 1-2 hours, then your carpal tunnel pain will usually go away in just a few weeks. And it certainly will never get worse.

Not only is carpal tunnel genetic, but it also occurs in women much more frequently than in men. Having a parent or sibling with this condition is the most accurate way to predict if you’ll also get it. In other words, you're at high risk if there's a hereditary link. And if you're female, you're also at high risk. Unfortunately, having both risk factors almost assures you'll get carpal tunnel syndrome. 

But you don’t have to let carpal tunnel control your life. Perform the simple stretching exercises described above. If you combine these exercises with more aggressive treatments (like night bracing and myofascial release massage ) you can insure that carpal tunnel symptoms don’t dominate your life.