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Many of today’s occupations have developed to the point where job specialization requires the same hand and wrist motions to be repeated endlessly throughout the workday. Dentists, cashiers, clerks, assembly line workers, secretaries, computer operators, meat processors, and scores of others spend hours each day overusing the same muscles and tendons as if they were indestructible.
A sixty words-per-minute typist depresses the keys 18,000 times in one hour. Each and every press of the finger requires about eight ounces of pressure effort. In just one day those fingers have pressed the equivalent of 54,000 pounds. That’s twenty-seven tons pushed by the fingers’ muscles and tendons!
This strain of repeated movement and pressure overworks muscles in the hands, fingers, and arms and causes the nine tendons in the narrow carpal tunnel to become irritated, inflamed, and swollen. Since the swollen flexor tendons inside the tunnel have nowhere to expand, they expand into each other and the adjacent median nerve. The final result of this swelling is additional pressure in the tunnel and, of course, on the median nerve itself.
As pressure increases in the tunnel due to tight muscles and inflamed tendons, the blood-carrying structures collapse, leading to hypoxia, edema, and fibrosis of the nerve. The end result is a nerve that does not receive nutrition, so it will not properly conduct synaptic impulses and cannot heal. This is the condition that causes the symptoms of CTS, such as pain, burning, tingling, numbness, and loss of strength and motor function.
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