Extend and stretch both wrists and fingers acutely as if they are in a hand-stand position. Hold for a count of 5.
For P.M. Release
Sun., Feb. 25, 1996
Poster D 29
For more information contact
Alvin Nagelberg
Joanne Swanson
Cindy Oertel
Sue Christenson
ATLANTA - A team of orthopedic surgeons has developed special exercises that can help prevent carpal tunnel syndrome (CTS).
The exercises, which should be done at the start of each work shift and after each break, decrease the median nerve pressure responsible for CTS, according to the results of a study presented here today at the American Academy of Orthopedic Surgeons annual meeting.
In addition, the research also determined that newly-diagnosed carpal tunnel syndrome patients should not do everyday activities such as ring a doorbell, hold a coffee cup, or push a shopping cart with the affected hand for the first seven to 10 days of conservative, nonsurgical treatment.
These simple activities were found to substantially increase intra-tunnel pressure on the median nerve of the wrist, thus worsening the condition, said senior author Houshang Seradge, MD, clinical assistant professor of orthopedic surgery, University of Oklahoma Health Sciences Center.
"Any hand/wrist movement will actually reduce the benefit obtained by wearing a wrist brace/splint," said Dr. Seradge.
Standard conservative treatment for CTS is the splint plus anti-inflammatory medication, for several weeks.
Dr. Seradge said that for optimal effect, the CTS patient's hand must be immobilized completely - except for regimented hourly exercises - for at least one week. Then the patient can slowly go back to simple activities.
In the study, orthopedic researchers measured the pressure on the median nerve in functional positions of 102 hands (92 people). A total of 81 hands had documented carpal tunnel syndrome; the remaining 21 served as controls.
"The median tunnel pressure in the resting position in CTS patients was nearly double that of the control group - 43.8 mm/Hg. versus 24 mm/Hg.," said Dr. Seradge.
Whenever a participant made a fist, pointed a finger, or pushed an object, the pressure increased significantly. "For workers with carpal tunnel syndrome, these simple actions could influence their outcome," he said.
The orthopedic surgeons then gave the patients the special exercises and measured the pressure again. "After just one minute of active or passive exercise of the wrist and fingers, the pressure dropped and remained below the resting intra-tunnel measure for over 10 minutes of continuous measurement."
Dr. Seradge said that workers with hand-intensive jobs should do a five-minute exercise warm-up before starting work, just as runners stretch before a run to prevent injury.
Depending on the type of work, employees should also do a slow isometric and isotonic exercise for posturing and toning of neck and arms, Dr. Seradge said.
In addition to keyboard operators, factory workers, and typists, also at risk for carpal tunnel syndrome are workers whose jobs require holding actions, such as barbers and bus drivers.
"In the long run, daily exercises, combined with job modification, will save employers money that they would have had to spend on carpal tunnel syndrome surgery for workers," said Dr. Seradge.
Co-authors of the study with Dr. Seradge are Medhi N. Adham, MD, and Wilafred L. Parker, P.A., both of Oklahoma City.
An orthopedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.
The 17,000-member American Academy of Orthopedic Surgeons is a not-for-profit organization that provides education programs for orthopedic surgeons, allied health professionals, and the public and is an advocate for improved patient care.
The Academy's annual meeting continues through February 26 at the Georgia World Congress Center.
Exercises
(at the start of each shift and after each break)
Extend and stretch both wrists and fingers acutely as if they are in a hand-stand
position. Hold for a count of 5.
Straighten both wrists and relax fingers.
Make a tight fist with both hands.
Then bend both wrists down while keeping the fist. Hold for a count of 5.
Straighten both wrists and relax fingers, for a count of 5.
Repeat exercise 10 times, then hang arms loosely at side and shake them for a couple of
seconds. Total exercise time: 5-10 minutes.
Source: Poster exhibit D-29, annual meeting, American Academy of Orthopedic Surgeons, Feb. 25, 1996.