The association between stress, anxiety and carpal tunnel syndrome is well-documented. The reason is because emotional pain, stress and anxiety change the way the body functions. One key way the body changes is how upper body muscles become unbalanced. 

To see how muscle balance is affected, let's first discuss the actual condition called carpal tunnel syndrome. (Most people just call it "carpal tunnel" for short.)

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1. Early carpal tunnel signs & symptoms

Carpal tunnel syndrome is an abnormal disorder. It primarily affects the fingers and palm of the hand. Warning signs and symptoms of carpal tunnel are very specific. In the beginning stages of carpal tunnel, symptoms usually appear while trying to sleep. These symptoms may rob your sleep, and often appear as:

• Numbness or tingling in the fingertips or hand.
• Pain that feels dull, achy, or sharp. 
• Burning or extreme itchiness in the fingers or palm.
  

As the condition progresses and worsens, the symptoms above also appear during the daytime. These symptoms can be intermittent or constant. You may also feel:

• Shooting electric shocks in your hand, especially when grasping
• Loss of grip strength (cannot hold a coffee mug, frying pan, large jars)
• Clumsiness and dropping things (drop large items, infants, boxes)
• Loss of dexterity or fine finger abilities (cannot tie shoelaces, button shirt, turn door handle)
• Loss of temperature sensitivity (diminished feelings of hot or cold water)
  

3. How carpal tunnel happens

Carpal tunnel syndrome happens because flexor tendons in your forearm become irritated and swell. The swelling is greatest in a space deep inside your wrist joint called the "carpal tunnel" (how the disorder gets its name).

The carpal tunnel space not only contains tendons, but also the median nerve. That's a main nerve to the hand and fingers. As the tendons swell, they inflate and narrow the available room in the carpal tunnel space. The result is that the median nerve is gradually crushed under pressure. 

Since the median nerve crushing is gradual, carpal tunnel symptoms usually begin slowly. But as the nerve is crushed more and more, symptoms worsen. Pain, numbness, tingling, and and other symptoms get more intense. That's when your hand strength starts to weaken. Your hand also gets clumsy as you lose finger dexterity and grip strength.

All of this misery is due to fluid pressure that has built up as a result of swollen tendons. So what does that have to do with stress & anxiety? Carpal tunnel is a physical problem, not an emotional one, right? Just wait and see...

The root cause of carpal tunnel syndrome is fluid build-up in the confined space within your wrist joint. That results in the median nerve being crushed.

But what actions or situations make carpal tunnel happen? There are several "risk factors" associated with getting carpal tunnel syndrome. These include:

• Having a small diameter wrist (and therefore a narrower carpal tunnel space)
• High risk jobs that repetitively stress your hand, like assembly line work, video gaming, computer use, hairdressing, and construction (see these harmful activities for your hand)
• Wrist injury or swelling
• Pregnancy
• Chronic diseases like rheumatoid arthritis, diabetes or bursitis
• Being a woman (women are 3 times more likely to get it)
• Family history or genetics (if a parent or sibling had it then you're at risk)
• Psychological & emotional stress

Yup, there it is. The last risk factor is psychological & emotional stress. But in what way are emotional stress, anxiety & carpal tunnel syndrome linked together? 

So far, there's no direct evidence of this. But it's well known that psychologically stressed people are more prone to getting carpal tunnel syndrome. So there MUST be a link - but what is it?

How does the mind create physical stresses and forces inside the carpal tunnel? If we look at what else emotional stress does to the body, then we get a clue about what happens inside the wrist joint.

Imagine the boss is looking over your shoulder. You have work deadlines and you MUST produce or else...  

At work, emotional stress and anxiety are high because "time is money". These on-the-job pressures cause huge amounts of tension. 

As a result, getting the job done quickly and accurately is paramount. That's why some people pay almost NO attention to their sitting or standing posture as they work. This usually results in poor or unhealthy posture. It includes the 3 bad habits of sitting:

• Hunching
• Slouching
• Upper body muscle tension 

Any one of these can cause disturbance in your overall musculoskeletal balance. This is especially pronounced in the neck and shoulders. They hurt after work because the muscular forces are out of balance. But those hurt muscles are not alone. The forces causing the pain are transmitted all the way down to your fingers. 

So the neck and shoulder pain can be the first warning sign. It's the exact recipe you need to start producing hand pain - and carpal tunnel syndrome. 

Poor standing or sitting posture while you work is unhealthy. It will produce upper body pain because it disrupts normal muscle balance and bone alignment. In other words, your natural muscle forces become unbalanced. For most workers, maintaining a poor posture is an everyday occurrence. 

Look at your posture right now:

• If at a computer workstation, chances are you're slouching or hunching.
• If you're looking at a portable device, your head and neck are most likely bent forward.

All of this is throws your upper body's muscles out of balance. And now your entire body must compensate for it.

As we've seen, there is an indirect link between stress, anxiety & carpal tunnel syndrome. But even though it's indirect, the relationship is still a strong one. The sequences in the link are as follows:

1. Emotional stress produces upper body tensions. Those tensions are most pronounced during our workday. Often, the result is not paying attention to our posture, which degrades with more and more stress and tension.

2. The poor posture creates a musculoskeletal imbalance in our upper body. Those unbalanced forces are transmitted down the arm to the carpal tunnel space in the wrist joint.

3. The unbalanced, abnormal forces alter the carpal tunnel's shape, thereby adding pressure on the median nerve.

4. The result is carpal tunnel syndrome, with all the associated pain and numbness that comes with it.

Having emotional stress, anxiety & carpal tunnel syndrome are definitely connected. Psychological stress and anxiety cause tension in upper body muscles. They tighten and produce unbalanced forces. Those forces are transmitted to the shoulder, arm and wrist. As a result, the carpal tunnel space is anatomically changed for the worse. The median nerve becomes compressed and carpal tunnel syndrome ensues. So emotional stress and anxiety absolutely (although indirectly) contribute to getting carpal tunnel syndrome.