Experts warn of rising prevalence of carpal tunnel syndrome

Health experts have warned that there is a significant increase in people affected by the carpal tunnel syndrome in the country, with neurosurgeons at major hospitals receiving patients with such complaints regularly.

“Carpal tunnel syndrome can cause a feeling of swelling and sometimes intense pain that radiates up from the wrist towards the forearm and elbow. If you are experiencing these symptoms, an evaluation from a neurosurgeon can be helpful in determining how to help you,” said Prof Abdul Sattar M. Hashim, a renowned neurosurgeon and former head of the Neurosurgery Department of Jinnah Postgraduate Medical Centre, while speaking at a continuing education programme held recently at the Neurospinal & Cancer Care Postgraduate Institute, Karachi.

He said the carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel of the wrist, and the median nerve gives feeling to your thumb, index, middle and ring fingers. When the median nerve is compressed, as it is with the carpal tunnel syndrome, it results in pain, numbness and restricted movement in the hand and fingers. “Diseases or conditions that may increase the chances of developing CTS include broken or dislocation of wrist bones, pregnancy, diabetes, thyroid problems, menopause and obesity. Repetitive and forceful grasping with the hands or repetitive bending of the wrist may also contribute.”

Prof Hashim further explained that these repetitive movements include typing on a computer keyboard (office and IT workers), talking on the phone (holding the phone to the ear), and texting or playing the piano.

“Professional artists (sculptors, printmakers, violinists) who engage in repetitive movements are frequently affected. Jobs or hobbies requiring the use of vibratory tools (e.g. jackhammer), can place a person at risk of developing CTS symptoms,” he said.

“Carpal tunnel surgery traditionally is performed one of two ways: open and endoscopic, open surgery involves an incision from the wrist to the palm over the carpal tunnel to correct the problematic ligament and free the median nerve, while in endoscopic surgery, a small incision is made in the hand or wrist and an endoscope, a tiny camera, is used to see inside the carpal tunnel, helping the surgeon correct the troublesome ligament.”

Prof Hashim said the procedure requires no surgical incisions. Rather, it uses ultrasound technology to help map the treatment area and help guide thin needles carrying a tiny, smooth thread to the problematic ligament. “The thread is looped on either side of the ligament and is manipulated in a back-and-forth motion to separate the ligament and ease pain. Once that is complete, the dissecting thread is removed, including preparation time, the procedure takes about 30 minutes,” he further highlighted the procedure.

Both the more common carpal tunnel release surgery and the minimally-invasive procedure can be performed in the office for most patients and are safe and effective way to treat carpal tunnel release, he added.

Dr Namra Saifullah Khan, chief medical officer of the National Bank of

Pakistan, also spoke at the event and said that the incidence of the carpal tunnel syndrome in the general population in Pakistan ranges from 1% to 5%, and it is more prevalent in females with a 3:1 female to male ratio. “Long-term computer use has been shown to increase the risk of CTS, and there is a strong link between computer user bankers, that is 13.1%,” Dr Namra Khan further elaborted.

NCCI Digital Media Coordinator Jawwad Ahmed Khan thanked the audience and said that employers and workers (corporate sector) and insurance companies can rack up millions of rupees in losses from carpal tunnel syndrome and other ergonomic workplace injuries.

However, the cost goes beyond monetary losses. Workers with carpal tunnel syndrome injury can no longer perform their duties and may have to change jobs. Some carpal tunnel patients undergo painful procedures from which they never recover and may lose quality of life. By implementing preventative programmes and routines into employees’ daily work routines, the painful musculoskeletal disorder can be avoided, saving employers and their employees time and money, and preserving the health and quality of life of workers.