Carpal tunnel syndrome is an inflammation and compression of the tendons of the forearm. It is usually an overuse injury, often the result of repetitive motion syndrome. People develop repetitive motion syndrome from any activity that is performed for hours on end and which uses the same muscles over and over. Two typical examples of repetitive motion syndrome and overuse injury-inducing activities are working on an assembly line and typing. However, activities which bring on Carpal Tunnel Syndrome need not be a work-related activity. Athletes often develop overuse injuries from working out too intensely without sufficient rest. The common impression of overuse injuries as a result of work activity is due to the fact that most people work for eight or more hours at a stretch. Such stretches are rarely the norm for non-work activities.

The most important (and often the hardest) thing to do if you think you are developing an overuse injury is to stop the activity and rest the muscles involved. This may not be practical if the activity is part of your job. It is not always a simple thing to change job activities.

If you are developing an overuse injury from a work activity check with your personnel department and see if your company has an ergonomics consultant. This consultant will come to your office and by observing you performing your job will make suggestions on ways for you to optimize your work environment, making it possible to perform your tasks without hurting yourself. Most companies will pay in full for this service, since having an ergonomics consultant will save money in two areas: Lower worker's compensation (insurance) payments, and increased productivity as a result of fewer employees needing to take time off due to injuries.

If you want to prevent or treat a developing overuse injury here are some suggestions.

Ice, ice and more ice. I know everyone hates to put ice on their body parts, but ice reduces inflammation (heat increases inflammation) and also increases the blood flow to an area from the deep, larger blood vessels. Heat increases the blood flow through the smaller, surface blood vessels. The best and easiest way to apply ice is to take an ice cube from the freezer and wrap it in a towel. Leave one face of the cube uncovered and apply the uncovered face directly to the skin. As long as you keep the ice cube moving you will not damage the skin. Rub it along the entire length of the affected muscles, including the joint above and below the muscle. Continue until the area is numb or the ice cube is gone. The more frequently you use ice the less the time it will take to numb your muscles.

After applying the ice, while your muscles are still numb, massage the affected muscles. For carpal tunnel syndrome this means the muscles of the forearm; for other overuse injuries it may be other muscles. We will focus on the muscles of the forearm.

Start by placing your arm on a table or other flat surface that is high enough to take the weight of your arm off your shoulder. Your hand should be palm down and the hairy side of your forearm facing up. There are two bones in your forearm. The radius runs from your elbow to the thumb side of your wrist, while the ulna runs from the elbow to the pinky side of your wrist. Feel the forearm to identify the area between the two bones. First, massage the inner face of each of those bones. Do not press in the center where the muscle is, between the bones, but rather push on the bone where the muscle attaches. (This is all along the edge of the bones from the elbow to the wrist on the inner edges of the bones.) Make sure you massage all the way into the elbow. Second, flip the arm over and massage starting with the elbow points on the underside of the elbow. Work your way down the arm to the wrist. The third step takes a bit of explanation.

Look at your upturned wrist. There are two creases running across the wrist, with the pulse running perpendicular to them. Starting with the crease closest to your hand and for about a half an inch toward your elbow (crossing the area where the pulse is felt) is a band of connective tissue known as fascia. The purpose of the fascia is to hold the tendons, blood vessels and nerves in place. When the tendons become inflamed they swell (like anything that gets inflamed), and since the fascia is tight, there is no room for the swelling. The pressure that the swelling tendons exert on the surrounding structures (nerves in particular) as they jockey for more space creates the wrist pain characteristic of carpal tunnel syndrome. When someone has surgery for carpal tunnel syndrome this band of fascia is cut.

With a second person (who does not have long fingernails) we are going to attempt to stretch out the band of fascia, thereby creating more room in the wrist for these structures, reducing or eliminating wrist pain and reducing the need for surgery. With your wrist still underside face up, have your friend lift the band of fascia that crosses over the tendons just at the wrist joint. They need to start at one end of the wrist and roll the fascia between their fingers, lifting it as they go. The fascia is very tight-if you are able to lift the skin easily you do not have hold of the fascia; just the skin. The second person must work the fascia all the way to the other end of the wrist, using both hands in order to roll the fascia and not let go of it. If you cannot find the band of fascia, ask a massage therapist or physical therapist to show you where it is. Lastly, massage again with the ice.

Massage your arms as described here once a day to in order to significantly reduce the chances of developing carpal tunnel syndrome.

Leslie Hope has been licensed, certified massage therapist since 1988 when she graduated from the Massage Institute of New England. She is the owner of the Healing Hands of Hope in Boston, MA.