What's Really Causing Carpal Tunnel Syndrome?

Carpal tunnel, which is a common nerve compression disorder causing pain, tingling and numbness in the wrist, hand and fingers, is an occupational disease, right? “Wrong,” says Alejandro Badia, M.D., a noted hand and upper limb specialist and founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®. He brands claims that carpal tunnel syndrome develops because of overuse of the wrist a “myth, much like saying cracking your knuckles leads to arthritis or eating chicken soup will cure the common cold.”

Carpal tunnel syndrome (CTS) is more likely due to hormonal changes, underlying inflammatory diseases, simple wrist anatomy, or even genetics, says Dr. Badia, whose statement conflicts with that of some professionals who still believe a link exists between the disorder and computer-keyboard typing, painting, piano playing, and other activities involving excessive wrist movements.

The syndrome occurs when the median nerve, which extends from the forearm to the hand through the narrow tunnel of bone and ligaments on the wrist’s palm side, becomes pinched and inflamed from irritated tendons or other conditions that cause swelling and thickening of the connective tissue surrounding the nerve in the wrist canal. Dr. Badia explains that symptoms begin gradually and worsen over time. These symptoms include wrist or forearm pain; persistent burning, tingling or numbness in the fingers; and decreased hand and wrist strength.

“CTS is an extremely common, readily diagnosable medical condition. However, it is often misunderstood, even by the scientific community,” Badia says. 

Recent studies bear him out.

For example, the latest research, published in a July 2020 issue of Nature Communications, indicates that genetics may play a much greater role in CTS than once thought. In analyzing nearly 100 cases of CTS in two families, scientists report finding mutations of a gene “highly expressed” in the tissue around the median nerve. The mutated gene is believed responsible for promoting an accumulation of cells that cause the connective tissue to thicken and press on the nerve. Study results could eventually lead to new treatments and preventive measures.​