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Stress, Anxiety & Carpal Tunnel

Dr. Z • May 06, 2020

How Stress, Anxiety & Carpal Tunnel Syndrome are Related

It was once thought to be completely unrelated. But today, doctors & scientists understand that stress, anxiety & carpal tunnel syndrome are linked together. The reason is because emotional pain, stress & anxiety change the way the body functions. One key way the body changes is how upper body muscles become unbalanced. 


To see why this is important, let's first discuss the actual condition called carpal tunnel syndrome. (Note that most people just call it "carpal tunnel" for short.)


Carpal tunnel basics

Carpal tunnel syndrome is an abnormal disorder. It primarily affects the fingers and hand. Warning signs and symptoms of carpal tunnel  are very specific. Most times, it begins as numbness or tingling in the fingertips or hand. Sometimes pain is involved. That pain can feel dull or sharp. Many times it feels like electric shocks shooting toward your arm.


Carpal tunnel syndrome happens because flexor tendons in your forearm become irritated and swell. The swelling is greatest in a space deep inside the wrist joint. That space is called the " carpal tunnel " (where the disorder gets its name). 

The carpal tunnel space not only contains tendons, but also the median nerve. That's a main nerve to the hand and fingers. As the tendons swell, they inflate and narrow the available room in the carpal tunnel space. The result is that the median nerve is gradually crushed under pressure. 


Since the median nerve crushing is gradual, carpal tunnel symptoms usually begin slowly. But as the nerve is crushed more and more, symptoms worsen. Pain, numbness, tingling, and soreness get more intense. Then your hand strength starts to weaken. Your hand also gets clumsy as you lose finger dexterity and grip strength.


All of this misery is due to fluid pressure built up as a result of swollen tendons. So what does that have to do with stress & anxiety? Carpal tunnel is a physical problem, not an emotional one, right? Just wait and see.

carpel tunnel

Causes of carpal tunnel

The root cause of carpal tunnel syndrome is fluid build-up in a confined anatomical space. That results in the median nerve being crushed.


But what actions or situations make carpal tunnel happen? There are several "risk factors" associates with getting carpal tunnel syndrome. These include:

 

  • Having a smaller wrist (and therefore a narrower carpal tunnel space) than other people
  • High risk jobs that repetitively stress your hand, like assembly line work, video gaming, computer use, hairdressing, and construction
  • Wrist injury or swelling
  • Pregnancy
  • Chronic diseases like arthritis, diabetes or bursitis
  • Being a woman (women are 3 times more likely to get it)
  • Family history or genetics (if a parent or sibling had it then you're at risk)
  • Psychological & emotional stress

 

Yup, there it is. The last risk factor is psychological & emotional stress.  But in what way are emotional stress, anxiety & carpal tunnel syndrome linked together? 


So far, there's no direct evidence of this. But it's well known that psychologically stressed people are more prone to getting carpal tunnel syndrome. So there MUST be a link - but what is it?


Somehow the mind is creating physical stresses and forces inside the carpal tunnel. If we look at what else emotional stress does to the body, then we get a clue about what happens inside the wrist joint.

pregnant

Effect of stress & anxiety on posture

The boss is looking over your shoulder. You have work deadlines and you MUST produce or else...  


At work, emotional stress and anxiety are high because "time is money". These on-the-job pressures cause huge amounts of tension. 


As a result, getting the job done quickly and accurately is paramount. That's why some people pay almost NO attention to their sitting or standing posture as they work. This usually results in poor or unhealthy posture. It includes hunching, slouching and overall muscle tension in the body's upper regions. 


You feel this mostly in the neck and shoulders. They hurt after work because the muscular forces are out of balance. But those hurt muscles are not alone. The forces hurting them are transmitted all the way down to your fingers. 


So the neck and shoulder pain can be the first warning sign. It's the exact recipe you need to start producing hand pain - and carpal tunnel syndrome. 

good and bad posture

Stress, anxiety, carpal tunnel & workstation posture

Poor standing or sitting posture while you work is unhealthy. It will produce upper body pain because it disrupts normal muscle balance and bone alignment. In other words, your muscles become  unbalanced. For most workers, maintaining a poor posture is an everyday occurrence. 


Look at your posture right now. When typing or using a mouse at a computer workstation, chances are you're slouching or hunching. If you're looking at a portable device, your head is most likely bowed forward. All of this is throws your upper body's muscles our of balance. And now they have to compensate for it.


It's old news that the
National Institutes of Health warns that too much computer use results in carpal tunnel syndrome. That’s because of two problems:

 

  1. Too much typing causes repetitive stress on fingers and flexor tendons. The added stress makes tendons sticky and not as supple as they need to be to make fingers move.

  2. Poor posture at the computer creates unbalanced forces in the neck, shoulder and arm. The unbalanced forces transmit to the wrist joint which disrupts the carpal tunnel's anatomy. 

 
Just a small change in the natural anatomy of the carpal tunnel space can disrupt it. That means even a tiny anatomical change can result in more pressure on the median nerve. 


This also means that simply adjusting your posture so there are no muscle imbalances can prevent carpal tunnel from ever happening.

stress, poor posture, carpal tunnel

Bottom Line: stress, anxiety & carpal tunnel are linked by poor posture

There is an indirect link between stress, anxiety & carpal tunnel syndrome. But even though it's indirect, the relationship is a strong one.


Emotional stress produces upper body tensions. Those tensions are most pronounced during our workday. Often, the result is not paying attention to posture, which degrades with more and more stress and tension.


The poor posture creates a musculoskeletal imbalance in the upper body.  Those unbalanced forces are transmitted down the arm to the carpal tunnel space in the wrist joint.


The unbalanced, abnormal forces alter the carpal tunnel's anatomy and cause pressure on the median nerve. The result is carpal tunnel syndrome, with all the associated pain and numbness that comes with it.

Summary

Emotional stress, anxiety & carpal tunnel syndrome are most definitely connected. Psychological stress and anxiety cause tension in upper body muscles. They tighten and produce unbalanced forces. Those forces are transmitted to the shoulder, arm and wrist.


As a result, the carpal tunnel space is anatomically changed for the worse. The median nerve is compressed and carpal tunnel syndrome ensues. So emotional stress and anxiety absolutely (although indirectly) contribute to getting carpal tunnel syndrome.

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