Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed or restricted as it passes through the wrist. Early on, this may cause mild, intermittent tingling, numbness, or pain in parts of the hand, but over time, symptoms can become more frequent and activity-limiting. While CTS can develop at any age, it’s most common during midlife due to the convergence of three key factors: occupational stress, hormonal and metabolic changes, and age-related anatomy.
When we perform frequent, repetitive hand movements, the tendons that run through the carpal tunnel glide back and forth against one another. Over time, the lubricating sheaths surrounding these tendons can become inflamed and sustain micro-injuries that need time to recover. However, occupations or hobbies that involve non-neutral wrist positions, high gripping forces, or vibration exposure often provide little opportunity for rest. After years—or decades—of repetitive stress, minor irritation can progress into chronic inflammation that’s difficult to ignore or manage with over-the-counter remedies.
In addition to repetitive movement, hormonal changes and worsening metabolic health during midlife increase CTS risk. Chronically elevated blood sugar can thicken connective tissue (including the transverse carpal ligament) and increase fluid retention, both of which reduce space inside the carpal tunnel and place pressure on the median nerve. Poor metabolic health also damages the microvessels that supply the nerve and fuel systemic inflammation that can narrow the tunnel even further. Women face an added risk during this stage of life, as changes in estrogen and thyroid hormones can make tissues less elastic and more vulnerable to shear forces.
Age-related changes compound the problem. As we grow older, damaged tissues heal and regenerate more slowly. Tendons thicken, ligaments stiffen, and the myelin sheath that insulates nerves can begin to thin, leaving the median nerve more susceptible to compression at the carpal tunnel. Muscle mass naturally declines as well, reducing the stabilizing forces around the wrist. These changes affect not only the carpal tunnel itself but the entire course of the median nerve—from the neck and shoulder down through the elbow and forearm—meaning that restriction anywhere along its path can heighten sensitivity to compression at the wrist.
Fortunately, all is not lost. Although we can’t stop the aging process, we can control occupational and metabolic risk factors. Adjusting tools to maintain a neutral wrist position, scheduling regular micro-breaks, and performing nerve-gliding or wrist-mobility exercises can help reduce pressure in the tunnel. Supporting overall metabolic health is equally important: limit sugary drinks and ultra-processed foods, increase fruit and vegetable intake, take daily walks, and aim for 150 minutes of moderate activity plus two resistance-training sessions per week.
Finally, chiropractic care can help restore normal motion to the wrist and surrounding joints, reducing strain on the median nerve along its entire pathway. Your chiropractor can also teach you the most effective exercises for symptom management and guide you on ergonomic adjustments to keep your wrists healthy long-term.