Introduction to Carpal Tunnel Syndrome
Carpal Tunnel Syndrome(CTS), also known as the most common entrapment neuropathy in human life, exists when the median nerve is compressed through the wrist (Sevy et al., 2023). The compression in the median nerve gives sensation in our hands of tingling, weakness, pain, and numbness (Sheikh & WebMD Editorial Contributors, 2024). There are many different sources to diagnose Carpal Tunnel Syndrome. The most prevalent source is due to repetitive hand motions that make humans contract CTS. Even with heavy research, there remains a subset of the population that acquires Carpal Tunnel Syndrome due to unknown (idiopathic) cases, such as environmental factors, anthropometric factors, and more (Dahlin et al., 2024).
This lack of understanding of Carpal Tunnel Syndrome represents the difficulty in addressing CTS in different contexts, such as the labor industry. Labor workers in this sector are frequently subjected to more repetitive hand motions, which applies more median nerve pressure on their hands, and thus have a higher chance of contracting CTS. The increased risk to contract CTS represents the importance and the dire need for greater attention to labor workers which subject their hands to more motion. By addressing the vulnerabilities of labor workers, we can implement different preventive strategies and policy changes to protect this group. In this paper, we will determine these connections with statistics around the globe, as well as finding preventive policies and strategies to reduce the incidence and impact of CTS in the industrial workplace.
Carpal Tunnel & History
The first recorded case of Carpal Tunnel Syndrome originates back to 1854, where James Paget, an English surgeon and pathologist, received a patient with a coil stuck around his wrist. This patient stated that he had symptoms of pain and a damaged sensation in his hand (Biron, 2018). Though his fingers were blistered and resisted treatment, Sir James Paget took the cord and adjusted it in such a way that the tension on his median nerve was removed, which alleviated pain. However, as soon as the man was allowed to use his hands freely, the pain resurfaced (Simovic & Weinberg, 2000). This instance where the cord was used to remove the tension on the nerve was the first discovery and fix of Carpal Tunnel Syndrome. Later in 1924, Abraham H. Galloway performed the first Carpal Tunnel release surgery on a woman, but it was followed by a pinched nerve on her median nerve (Simovic & Weinberg, 2000). This was the first discovery of Carpal Tunnel Syndrome.
Carpal Tunnel & Pressure on the Hand
Figure 1. A normal carpal tunnel is shown with no pressure with the hand on the left, as well as the space under the transverse carpal ligament(TCL) and the median nerve. However, as pressure builds up, it pushes the TCL further downwards, which impacts the hand in two different spots, paralyzing the median nerve inside of the hand, and therefore leaving very low space at the Carpal Tunnel. This is Carpal Tunnel Syndrome, and is shown on the right of figure 1.
Effect & Treatment of Carpal Tunnel on Humans
Carpal Tunnel Syndrome is renowned for its dominating damage. If left untreated, it can cause high nerve damage to the hand as well as complete defective use of your hand permanently, which represents the importance of getting to a doctor quickly to treat Carpal Tunnel Syndrome. Symptoms include numbness, tingling, burning, or pain in your hands. If it interferes with sleep or any activities, see a doctor immediately (Mayo Foundation for Medical Education and Research, 2024). Treatment can involve surgery to stop the median nerve pressure, such as cutting the transverse carpal ligament from pressuring the median nerve. Nonsurgical methods include using a wrist splint and injecting corticosteroids, which are a form of synthetic drug to help ease the pain of Carpal Tunnel Syndrome. A wrist splint needs to be worn all day, and synthetic drugs such as Depo-Medrol or Lidocaine may be injected into the wrist to relieve pain (Rehman, 2020).
Carpal Tunnel and Workers in the Industry
Carpal Tunnel Syndrome is typically experienced due to repeated harmful hand motions such as in the labor industry. In a study that was conducted in 1994, 101 Japanese and 306 American workers’ median nerve movements were tracked in the furniture factory workplace. The study showed the median nerve slowing down with increasing repeated labor, 17.8%, and 22.0% of slower change in the median nerve. The study also concluded that the rate of Carpal Tunnel diagnosis increased by 2.0% in 407 workers (Nathan et al., 1994). The change in increase in the emergence of Carpal Tunnel with increased repetitive labor suggests labor-industry workers repetitively move their hands more. This applies more median nerve pressure, and therefore represents how labor-workers have a higher rate of contracting CTS.
Carpal Tunnel and Extensive Labor in Society
Although Carpal Tunnel Syndrome is known to be common in all countries and is known to affect at least 5% of all people, it is mostly prevalent in the African region, where 12.1% of people in East Africa contract CTS. Moreover, 29.2% of people in Ethiopia contract Carpal Tunnel Syndrome (Yesuf et al., 2023). This may be because of the working conditions of Ethiopia and East Africa, which are named harsh and unbearable, and (Bicha et al., 2024). The frequent labor alongside the intense conditions they work in, shows how increased labor correlates to increased pressure on the median nerve, and therefore weakens and paralyzes their hands, or gives more of the population Carpal Tunnel Syndrome.
These intense working conditions, including insufficient recovery periods, sustained and frequent pressure on the wrist, and awkward hand postures increase the risk of contracting CTS. Regions around the world are unable to access proper modifications or ergonomic tools, which makes people more receptive to wrist-related neuropathies. The prevalence and the working conditions represent the connection of not only the repetitive motions but the broader context of the work environment when implementing protective strategies for CTS. By recognizing and stopping these intense working conditions, we can reduce the frequent use of CTS in regions around the world, for better health outcomes for workers.
Research Conclusion
In the end, the studies that have been discussed in this paper showed the instance of CTS in the workplace increasing by 2.5%, and the raw labor of Ethiopians or East Africans correlating to a high rate for Carpal Tunnel Syndrome, all show how Carpal Tunnel Syndrome is more common when there is higher amounts of labor (Nathan et al., 1994; Yesuf et al., 2023). This suggests that in factories, where the amount of industrial labor is higher, they nurture a higher chance for the industrial workers to subject their hands to more repetitive motion, which applies more median nerve pressure on their hands, and a higher chance of contracting Carpal Tunnel Syndrome.
Written by: Sarthak Tayal
Works Cited
Bicha, N., Gashaw, M., Chanie, S. T., Mekie, M., & Yalew, E. S. (2024, May 21). Burden of carpal tunnel syndrome and its associated factors among construction industry workers in Gondar Town, Ethiopia. Frontiers.
Biron, A. B. (2018, February 5). Carpal tunnel (a.k.a. my hand is Numb, tingly, and I can’t sleep!): Orthopedics & Sports Medicine. UConn Health.
https://health.uconn.edu/orthopedics-sports-medicine/2018/02/05/carpal-tunnel-my-hand -is-numb-tingly-and-i-cant-sleep/
Dahlin, L. B., Zimmerman, M., Calcagni, M., Hundepool, C. A., van Alfen, N., & Chung, K. C. (2024, May 23). Carpal tunnel syndrome. Nature News.
Mayo Foundation for Medical Education and Research. (2024, February 6). Carpal tunnel syndrome. Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatm ent/drc-20355608
Nathan, P. A., Takigawa, K., Keniston, R. C., Meadows, K. D., & Lockwood, R. S. (1994, February). Slowing of sensory conduction of the median nerve and carpal tunnel syndrome in Japanese and American Industrial Workers. Journal of hand surgery (Edinburgh, Scotland).
https://pubmed.ncbi.nlm.nih.gov/8169474/#:~:text=As%20part%20of%20a%20continuin g,abnormal%20slowing%20of%20nerve%20conduction.
Rehman, A. (2020, July 10). Carpal tunnel treatments & medications | singlecare. Single Care. https://www.singlecare.com/conditions/carpal-tunnel-treatment-and-medications
Sevy, J. O. O. (2023, October 29). Carpal tunnel syndrome. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK448179/#:~:text=Carpal%20tunnel%20syndrom e%20(CTS)%20is,tunnel%2C%20leading%20to%20entrapment%20neuropathy.
Sheikh, Z., & WebMD Editorial Contributors. (2024, May 15). What is carpal tunnel syndrome?. WebMD.
Simovic, D., & Weinberg, D. H. (2000, May 1). Carpal tunnel syndrome. Archives of Neurology. https://jamanetwork.com/journals/jamaneurology/article-abstract/776401#:~:text=Sir%20 James%20Paget%20(1854)1,drawn%20tightly%20around%20his%20wrist. Strauch, B. H. (2020). Normal Carpal Tunnel vs. Median Nerve Compressed in the Carpal Tunnel. Johns Hopkins Medicine. Retrieved June 26, 2024, from
Yesuf, T., Aragie, H., & Asmare, Y. (2023, January 1). Prevalence of carpal
tunnel syndrome and its associated factors among patients with musculoskeletal complaints at Dilchora Referral Hospitals in dire dawa administration, eastern Ethiopia, 2022. medRxiv. https://www.medrxiv.org/content/10.1101/2023.02.10.23285779v1.full
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