Carpal Tunnel: The potentially career-ending condition you need to know about
Most of us have heard of carpal tunnel syndrome but few of us actually understand what it is and the risks we face of developing it. In this article, we will discuss what carpal tunnel syndrome is, what risk factors exist for welders and fabricators, how to effectively mitigate them, and when you should see your doctor.
What is carpal tunnel syndrome (CTS)?
Carpal tunnel syndrome is a musculoskeletal disorder caused by compression of the median nerve inside the carpal tunnel, a narrow passageway surrounded by bones and ligaments on the palm side of the wrist. The median nerve is responsible for providing sensation to the palm side of your thumb and other fingers, except the little finger as well as nerve signals which control the muscles at the base of the thumb. Symptoms of CTS include numbness or tingling (which may travel up the wrist to the forearm), weakness (which may cause the afflicted person to drop objects), or atrophy of the muscles in the hand and fingers.
Who is most at risk for CTS?
Workers who perform highly repetitive tasks that involve stress-inducing forces on the wrist over a long period of time are most at risk for developing CTS. These stress inducing forces include weight, flexion, vibration, temperature, and strain. Repeated flexion and extension of the wrist can cause the protective sheaths which surround the tendons around the median nerve to thicken, exerting excess pressure on the median nerve and causing CTS. In welding and fabrication, workers often hold torches in their hands and move them in repetitive motions for hours per day in addition to operating grinders, scalers, hammers, bevelers, and other high-risk tools.
The size, shape, and weight of these tools all contribute to the risk the operator faces of developing CTS. Simply holding and operating a welding torch can be a high-risk task since increases in carpal tunnel pressure can be induced by wrist, forearm, and finger posture as well as pressure applied to the fingertips. Welders are often forced to alter their both their body and wrist posture to gain access to a joint. This sub-optimal posture when combined with the need to operate mechanical controls such as triggers or switches and support the weight of the torch in addition to the period of time the operator spends doing all of the above can greatly increase the risk of CTS development.
What other factors increase the risk of CTS?
- Sex: CTS is generally more common in women, likely because women have a smaller carpal tunnel area than men.
- Previous Injury: Wrist fractures or dislocations can affect the space within the carpal tunnel.
- Diabetes: Diabetes and some other chronic illnesses carry an increased risk of nerve damage, including the median nerve.
- Rheumatoid arthritis: Inflammation caused by rheumatoid arthritis can affect the lining of the tendons in the carpal tunnel.
- Obesity: Overweight people are at higher risk for developing CTS.
- Anatomy: People of smaller stature are more likely to have smaller carpal tunnels.
- Temperature: CTS is more likely to develop at lower temperatures.
How can the risks of CTS to welders and fabricators be minimized?
While there are no hard and fast rules for preventing the development of CTS, there are some generally accepted practices that will serve to reduce the risk. No matter the task being performed, the risk is lower when a worker’s hands are in a neutral position (not flexed or extended), force applied to the fingers is minimized (less resistance), hands and wrists are kept warm, and shock load and vibration exposure are reduced.
Risks specific to welding can be mitigated by practicing better posture when welding, selecting a torch which allows for a more neutral wrist position, taking frequent, but short breaks from welding, and performing stretching exercises whenever possible.
When should I see a doctor?
Early diagnosis and treatment are vital to the prevention of permanent median nerve damage. You should see your doctor if you experience numbness, tingling, or weakness of the hands, frequently drop objects or have difficulty determining hot from cold objects when touching them with your hands. Your doctor can perform tests to determine if you are experiencing CTS or another condition such as arthritis. When CTS is diagnosed early, non-surgical treatments such as stretching and strengthening exercises, anti-inflammatory drugs, and corticosteroids are often effective.
As the old adage says “An ounce of prevention is worth a pound of cure.” In the modern workplace, safety is taken far more seriously than ever before, but that doesn’t mean risks are wholly addressed or completely eliminated. It is the responsibility of each and every worker to assess the tasks they perform and make a determination of the best safety practices to follow, whether they are mandated by their employer or not. If you are unsure of the risks you encounter on the job or how to address them, consult your safety manager, human resources department, or the Occupational Safety and Health Administration (OSHA).
For more information about safe welding practices, see our other articles about Welding.