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Carpal Tunnel Syndrome

You're rattling down the bumpy Navajo sandstone on the long descent from the Swiss Cheese Ridge at Slickrock. Your right hand becomes tingly and numb.

Carpal Tunnel Syndrome is caused by pressure on the median nerve in the wrist. This nerve provides feeling in the thumb, index and middle fingers, and half of the ring finger. It also works the muscle that rolls your thumb around so it can aim at your fingers. Many bikers develop temporary carpal tunnel symptoms when riding. These symptoms usually go away after a few minutes by straightening the wrist out and resting it.

bf-carpt.jpg (8210 bytes) As the symptoms become chronic, pain sets in. The hand and wrist become painful. Pain may shoot or radiate up as far as the shoulder.

The numbness of carpal tunnel syndrome spares the little finger -- although you might not notice this unless you touch each finger. The shaded area the area of decreased skin sensation and tingling.

Change your riding style (and your bike) to minimize pressure and vibration in the wrist. If you ride with your wrist bent back so a couple of fingers are on the brake lever, loosen the stem and tip the handle bar down slightly. This makes the wrist straighter while you ride. To reduce weight on the wrist, raise the stem (if possible) and consider replacing a straight stem with an upward angled stem -- a couple of inches increased height of the handlebars makes a big difference in how much pressure you put on your wrist. Put bar ends on your bike. During long smooth stretches, grasp the bar ends to change your hand position.

Evaluate your riding style -- see if you're leaning on your wrists. Centering your weight more onto the pedals -- less on your butt and wrists -- might help. And of course, a smooth dual-suspension system helps a lot. So if changes to stem angle, handlebar angle, and riding technique don't eliminate the problem, go buy a new bike with cushy shocks front and rear.

Bike rigged to avoid carpal tunnel symptoms: brakes and shifters properly placed (see our bike setup page), bar ends (to trade off wrist position), riser to elevate stem, original stem replaced with 40 degree stem.

ca-t-pre.jpg (15543 bytes)

If carpal tunnel symptoms persist after the ride, the tightness in the carpal tunnel is a bigger problem, and must be treated more aggressively. If symptoms become constant, surgery may be necessary to ease the pressure on the nerve.

Immediate care:
Straighten the wrist so the hand is aiming straight out from the forearm. Elevate the wrist. If symptoms don't go away quickly, begin cold-packing the underside of the wrist (right at the base of the hand).

Ongoing care:
If symptoms persist after resting and cold-packing, apply a wrist splint. Wear it for a few days. Apply cold packs for 1/2 hour every two hours of the day. It's especially important to wear the splint at night, because many people sleep with their wrists bent sharply down. (Symptoms of chronic carpal tunnel syndrome usually flare at night.) Take an anti-inflammatory medicine such as ibuprofen 600 mg four times a day.

Watch for:
If numbness, pain, or tingling persist after a few days of rest, splinting, and cold-packs, see your doctor.

 [First Aid Index Page]