After arthritis, carpal tunnel syndrome is the most common hand disorder. It arises due to pressure on the median nerve deep inside the carpal tunnel of your wrist. This tunnel is a narrow passageway on the palm side of your hand, where the nerve is surrounded by tendons, bones, and ligaments. When pressure is exerted on the median nerve you get symptoms like pain, numbness, and tingling - mostly in the palm, thumb and fingers (but not the pinky finger).

What causes the pressure on the median nerve to begin with? Certain risk factors are known to produce such pressure. They include your occupation (what you do with your hands), wrist anatomy, and other health conditions which can contribute to getting carpal tunnel syndrome.

• Think you have carpal tunnel? Complimentary self-test

• Already know you have carpal tunnel? This Quiz tells you its severity

Symptoms of carpal tunnel syndrome almost never appear overnight. They usually start gradually, first appearing while trying to sleep at night. The symptoms include:

• Numbness and tingling. These sensations will usually first appear in the palm of the hand, and/or the thumb, index, middle and ring fingers.

• Pain. Also in these fingers, pain can occur as burning, aching, stabbing or soreness. At first the pain can be described as intermittent and nagging. As the condition worsens, the pain becomes more constant and intense.

• Electric shocks. Some people feel an electric shock in the fingers while grasping a mug or phone, holding a steering wheel, or turning a doorknob.

• Loss of sleep. Symptoms, especially numbness, often wake you up from a sound sleep with a need to shake out your hands. Sleeping with you hand hanging off the bed usually feels better.

• Radiating symptoms. As carpal tunnel worsens, these sensation can radiate from your hand and up your arm.

• Weakness. Also as the condition worsens, you begin to feel weakness. Your grip strength diminishes, and you may begin to drop objects. Your hands begin to feel clumsy when manipulating small objects like coins or buttons.

One of the most common risk factors for getting carpal tunnel syndrome is your occupation. If it requires stressful hand activities, repetitive movements, or prolonged wrist bending, then you're at high risk.

Of course, most jobs depend on manual work of some kind. But some jobs require more intense hand activity than others. Those high risk jobs are infamous for having workers suffer with this painful and numbing condition.

Almost all of these high risk jobs require hands to move forcefully or rapidly. Many require extensive grip-and-release movements. These and other harmful activities are the recipe to give you symptoms of carpal tunnel syndrome. 

According to OSHA, the people who are most at risk for getting carpal tunnel syndrome work as:

• artists
• musicians
• file clerks
• secretaries
• cashiers
• hairdressers
• dental hygienists
• radiographers
• gamers
• meat packers
• construction workers
• assembly line workers
• graphic artists
• draftsmen
• programmers
  

Fundamentally, carpal tunnel syndrome is an occupational disease. That means you must take steps to address it in the workplace. In most cases, if you don't make the proper workplace changes, any carpal tunnel therapy you try will never be fully effective. And it might even fail.

Workplace and occupational factors can result in getting carpal tunnel syndrome. However, other factors can increase the risk of irritation to the median nerve, causing swelling of (and subsequent pressure from) the tissues around it. These factors include:

• Anatomy. People with a small wrist diameter (and a narrower carpal tunnel space) are more likely to get carpal tunnel syndrome. Also, changing the wrist's anatomy, such as after a fracture or dislocation, can allow carpal tunnel syndrome to appear because they can alter the carpal tunnel's shape.

• Arthritis and inflammatory disorders. Disorders like arthritis (particularly rheumatoid arthritis), gout, and other inflammatory disorders can cause swelling, which then exerts pressure on the median nerve. Thus, these disorders put you at high risk for developing carpal tunnel syndrome.
  

• Sex. Carpal tunnel syndrome is more common in women. This may be because the carpal tunnel space is relatively smaller in women compared to men. It may also be due to the effect of hormones on the flexor tendons.

• Nerve damage. Certain chronic disorders, such as diabetes and alcoholism, increase the risk of peripheral nerve damage. This includes median nerve damage.

• Obesity. This is a risk factor for carpal tunnel syndrome, although the underlying reason is not understood.

• Changes in body fluids. Conditions that cause fluid retention can increase the pressure inside the carpal tunnel space. As a result, the median nerve can become compressed. The most common of such conditions are pregnancy and menopause. Carpal tunnel symptoms usually disappear after childbirth.

• Other medical conditions. Some conditions like thyroid disorders, lymphedema, and kidney failure can increase your probability of getting carpal tunnel syndrome.

No single strategy has proven successful against getting carpal tunnel syndrome. But multiple, simultaneous strategies can lessen the probability of getting the disorder. At their core, these strategies reduce the stress on your hands and wrist. Some of these strategies are simple, relatively minor adjustments to your life. 

Analyze the hand and finger movements you make on the job. Focus on reducing stress on your hand and fingers. Can you stop or cut down on some or all of the activities? Can you do the same things without so many hand or finger movements? Can you use a more relaxed grip to get the job done? If your work involves a cash register or keyboard, for instance, can you hit the keys more softly? Consider a carpal tunnel keyboard or mouse to reduce arm stress.

Take frequent rest breaks, even if for a minute or two every hour. During the break, do carpal tunnel stretching exercises. You can also gently stretch and bend your hands and wrists periodically. Also, see if you can alternate left and right tasks when possible.

If you use vibrating equipment, work in the cold, or hold a tight and prolonged grip, protect you hands with padded gloves. Use ergonomic tools when you can.

A good sitting posture is hugely important in preventing carpal tunnel syndrome. A poor posture rolls your shoulders forward, shortens the neck and shoulder muscles, and compresses nerves in your neck. This can result in neck pain which can transmit to your arms and hands. Therefore, when at a computer, always sit in a chair - never on the floor or couch. Don't slouch backward or hunch over the keyboard. Do not bend your wrist too far down or up on the keyboard (strait wrists are best). Keep your keyboard at about elbow height.

A great carpal tunnel preventative is to massage your wrist and forearm area. Do this 3 to 4 times daily for about 3 to 4 minutes. Massage by pushing, kneading, and twisting the skin and underlying tissues with your opposite thumb. In other words, try to replicate what therapists call a myofascial release massage. This is what the CarpalRx device does automatically.

The causes of carpal tunnel syndrome can be many. Usually it's the result of how you use you hands in your occupation. Hand stresses like forceful gripping and repetitive motions can produce tendon swelling and subsequent pressure on you median nerve. You can prevent this from happening with a few simple measures such as activity avoidance, stretching exercises, good posture, hand protection, and massage.