What are the ergonomics (study of people's efficiency in their working environment) at work for preventing carpal tunnel syndrome (median nerve compression)?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

To prevent and manage carpal tunnel syndrome at work, implement proper ergonomic practices immediately, prioritizing a straight or slightly reclined back, abducted shoulders less than 20°, and elbows flexed at 90–100°, as recommended by the most recent guideline from the Association of Anaesthetists in 2021 1.

Key Ergonomic Adjustments

  • Position your keyboard and mouse at elbow height with wrists in a neutral position, not bent up or down, to reduce pressure on the median nerve in the carpal tunnel.
  • Use an ergonomic keyboard and mouse that keep your wrists straight, and consider a vertical mouse to reduce forearm twisting, as suggested by the principles of ergonomics to minimize repetitive strain injuries 1.
  • Adjust your chair height so your feet rest flat on the floor with knees at a 90-degree angle, and ensure the thighs are parallel to the floor, with the hip joint slightly higher than the knee joint.
  • Position your monitor at eye level, about an arm's length away, to maintain a comfortable viewing position and reduce strain on the neck and shoulders.

Additional Recommendations

  • Take frequent breaks—aim for a 5-minute break every hour to stretch your hands and wrists, including simple stretches like extending your arms with palms up, then down, and gently pulling fingers back.
  • Use wrist rests for keyboard and mouse to maintain neutral positioning and reduce the risk of carpal tunnel syndrome.
  • If symptoms persist, consider wearing a wrist splint during work and at night to keep your wrist in a neutral position, as part of a comprehensive approach to managing carpal tunnel syndrome.

From the Research

Ergonomics at Work for Carpal Tunnel

  • Ergonomics plays a crucial role in preventing carpal tunnel syndrome (CTS) in the workplace, as highlighted in a systematic review 2.
  • The review analyzed 11 studies with a total of 1,061 subjects and found that interventions focused on modifying or changing accessories, education in ergonomics, exercise, and physical therapies can help prevent CTS.
  • The study suggests that applying strategies for preventing CTS in the workplace can have a mixed level of evidence, with some studies showing positive results and others showing limited or no effect.

Workplace Interventions

  • Modifying or changing accessories such as keyboards, mice, wrist rests, and workstations can help prevent CTS 2.
  • Education in ergonomics, exercise, and physical therapies can also be effective in preventing CTS 2.
  • Other interventions such as wrist splinting, changing working positions, and using alternative non-vibrating equipment at work can also be beneficial 3.

Treatment Options

  • Physical therapy can be an effective treatment option for CTS, with some studies showing that it can be as effective as surgery 4.
  • Surgery can also be an effective treatment option, particularly if undertaken early on 5.
  • Non-surgical treatments such as medications, wrist splinting, and changes in working position can also be effective in managing CTS symptoms 3.
  • Gabapentin has been found to be partially effective and safe in symptomatic treatment of CTS patients 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Carpal Tunnel Syndrome: Physical Therapy or Surgery?

The Journal of orthopaedic and sports physical therapy, 2017

Research

Work-Related Carpal Tunnel Syndrome: Diagnosis and Treatment Guideline.

Physical medicine and rehabilitation clinics of North America, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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