Carpal Tunnel Syndrome

Carpal Tunnel Syndrome: Cause, Control, Commit

Eastern Alliance LogoBy: Eastern Alliance Insurance Group 

Do you have tingling, numbness and/or loss of strength in your hand and wrist?

These could be symptoms of Carpal Tunnel Syndrome (CTS). The Dental Research Journal reported 5 percent of dentists and 56 percent of dental hygienists complained of one or more symptoms of CTS throughout their career.

Employees with routine hand and wrist exertions, repetitive movements and extended use of vibrating tools are at risk for CTS. CTS is a type of musculoskeletal disorder that occurs when continued pressure is applied to the carpal tunnel, a pathway of ligaments and bones running from the forearm to palm. The carpal tunnel begins to swell causing the channel to narrow and the median nerve to become compressed. Female employees are more likely to develop CTS primarily due to a naturally smaller carpal tunnel and continued hormonal changes, which cause fluid retention and additional pressure. 

You can begin to address CTS concerns by identifying potential causes, implementing controls and facilitating safety commitment in your workplace.

Contributing causes of CTS include, but are not limited to:

  • Repetitive movements of the hand or wrist.
  • Forceful grasping of small instruments and tools.
  • Continued unnatural positioning of the hand or wrist.
  • Extended use of vibrating instruments.

Controls can be implemented at a minimal cost. Consider the following:

  • Chair height should be adjusted to a position that reduces straining and allows the wrist to remain in a straight position. Employees should avoid unnatural positions and alternate between sitting and standing.
  • Frequent breaks should be taken in between procedures that require forceful and repetitive motions. Continued breaks can alleviate strain and pressure on the hand and wrist regions.
  • Exam gloves should fit snuggling around fingertips and palms. Gloves that are too big or too small can cause additional strain during hand and wrist motions. Consider providing employees with multiple sizes as well as hand specific (left vs. right) gloves.
  • Implement workplace stretching. Examples of CTS prevention exercises can be found below. 

Creating commitment will be necessary to maintain a safe workplace and address CTS concerns. How can you get employees engaged?

  • Print and place CTS stretching and exercise examples in employee common areas, as a constant reminder of prevention controls.
  • Designate an employee to lead group stretching once or multiple times a day. Not only will employees be taking a proactive part in addressing CTS risks, this exercise will facilitate team building and employee engagement.
  • Encourage early reporting of injuries. Employees should be educated on the symptoms of CTS and seek medical treatment in the event of injury.
  • Lead by example. It is important that management promote safety and CTS prevention within the workplace.

Please note that although no article or resource can identify every unsafe condition or procedure, the above can act as a guide to increase the culture of safety in your workplace. If you have specific questions regarding Carpal Tunnel Syndrome (CTS), contact your workers’ compensation carrier or PDAIS consultant.

Information Cited from:

Ayatollahi, J., Ayatollahi, F., Ardekani, A. M., Bahrololoomi, R., Ayatollahi, J., Ayatollahi, A., & Owlia, M. B. (2012). Occupational hazards to dental staff. Dental Research Journal, 9(1), 2–7.

Nutalapati, R., Gaddipati, R., Chitta, H., Pinninti, M., & Boyapati, R. (2009). Ergonomics in Dentistry and the Prevention of Musculoskeletal Disorders in Dentists. The Internet Journal of Occupational Health, 1-9.

North Carolina Department of Labor Occupational Safety and Health Division. North Carolina: OSHA.

White, S. W. (2003, January 1). Ergonomics...How does dentistry fit you? Retrieved March 24, 2017, from Dentistry IQ:

USAF Dental Evaluation and Consultation Service. Musculoskeletal Disorder and Ergonomics in Dentistry: An Introduction. PowerPoint presentation.