When you go to the pediatrician for a
well-child check, you’ll always review your baby’s or child’s growth. It’s probably the most important piece of data your pediatrician gets. The reason is, it can capture so much about your child’s vitality.
Growth Chart Downloads:
WHO Growth Charts
CDC Growth Charts
First 3 Years – A Major Growth Period
In the first 3 years, we use one growth chart that looks at the head’s circumference and the weight and length. It’s based on gender and lots of data. We watch for changes in the size of head circumference in infancy because we want to know that the brain is growing. Growth grids have been used since the 1970s, but back in 2000, they were revised to really reflect different cultural and ethnic diversities that exist within our population.
Why Percentiles Are Not Like the Grades in School
What we want from a growth grid is to really map out the ideal growth for children. This isn’t like grades in school. When your child comes in at the 10th percentile, it’s really no better or worse than coming in at the 90th. What we care about most is the trend at which your baby or child gains weight, height, or head circumference.
After age 2, you can use the growth chart to expand between the ages of 2 and 20. In addition to weight and height at that point, we also look at
body mass index, that number where we try to capture how children’s proportionality is. Are they at risk for
overweight or are they too lean?
Everything from
genetics, to environment, to
nutrition, to
activity, to health problems really influence how your child grows. Why we review it each time is to talk about threats to your baby’s or child’s health and ways that you can take great opportunity to make changes.
How to Follow the Grid:
When you’re looking at a growth grid, what you want to focus on is how your child is changing. One static point on the growth grid isn’t as relevant as 5 data points over time. You want to know rates at which your baby or child is growing and the rate compared with the grid.
As you follow the grid along from infancy into toddlerhood, you’ll notice that each time it will rise. Each data point at each set of time will increase. We care about the rate at which your baby or child grows, not the number.
Why You Shouldn’t Focus on the Number:
Parents often come in to the office and say, “What percent is she at?” She might be at the 13th percentile; that might be phenomenal based on where she’s been previously, or it might be concerning. Don’t focus on the number. Have your pediatrician, family doctor, or nurse practitioner help you understand what the trends are for your baby’s growth.
Parents, pediatricians, and nurses have been using growth charts since the late 1970s to track growth in infants and children. The charts were revised back in 2000 as data for the first charts (from a small study in Ohio) didn’t accurately reflect the cultural and ethnic diversity of our communities.
The Hallmark of the Well-Child Check:
The hallmark of a well-child check is the review of a child’s growth. Growth can be a reflection of a child’s overall health, nutrition, or tolerance of possible underlying medical conditions. So understanding what your doctor or nurse practitioner says about your child’s growth should be a priority.
If your doctor doesn’t have a computer in the examination room, ask to see the chart on paper or on a computer in the office. It will not only inform you, I suspect it will delight you to see what your child has done since the last time he was seen. The human body really is a fine-tuned machine, and growth is simply astounding if you really stop to think of it. It’s true your baby will at least double his weight by 6 months and triple it by about 1 year of age.
If You Have Questions:
If you have a challenge understanding how your child is growing or how the growth chart is presented, demand clarification. It’s OK if you don’t understand the presentation of facts on these grids; have confidence to speak up and ask the doctor or nurse practitioner to explain it.
Additional Information from HealthyChildren.org:
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Welcome to a special Gut Health Month episode of The Dietitian Connection Podcast. This March, we’re celebrating Gut Health Month 2026 by bringing dietitians together to deepen our knowledge, strengthen our confidence, and amplify our voice to create meaningful impact in practice and beyond.
In this episode, we’re joined by leading gut health dietitian Nicole Dynan to explore how dietitians can build confidence in this rapidly growing space. Tune in for practical insights and inspiration to help you feel empowered in your gut health practice.
Hosted by Kate Agnew
Biography
Nicole Dynan is the founder of The Gut Health Dietitian (established in 2014) and one of Australia’s leading gut health experts. After a decade in corporate chronic disease management, Nicole saw first-hand how gut health impacts energy, stress, mood, and overall well-being. Since then, and together with her team, she’s helped over 40,000 people improve their gut health, feel more comfortable, and regain control of their overall health through science-backed nutrition.
In this episode, we discuss:
How dietitians can build confidence and credibility in gut health through targeted upskilling and staying across emerging research and trends
The shift in gut health care from restriction to focusing on foundations
Why it’s important for dietitians to raise their voice, strengthen their influence and work together to lead evidence-based gut health conversations
The importance of recognising what stage of behaviour change a client is in and adapting your approach to meet them where they are
The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see here for terms and conditions.
Autoimmune diseases occur when the body’s defense system mistakenly targets its own healthy tissues, and understanding autoimmune disease causes is key to making sense of this process.
Instead of attacking only viruses, bacteria, and other invaders, the immune system becomes confused and identifies normal cells as threats. This misfire can damage joints, glands, organs, and other tissues, leading to a range of conditions such as type 1 diabetes, rheumatoid arthritis, and lupus.
How the Immune System Normally Works
In a healthy person, the immune system acts like a security team that distinguishes between the body’s own cells and foreign invaders.
White blood cells and antibodies recognize markers on pathogens and respond by neutralizing or destroying them. This recognition process usually protects the body from infection while leaving healthy tissues unharmed.
What Happens in an Autoimmune Disease?
In autoimmune diseases, this recognition system breaks down. The immune system creates autoantibodies that target the body’s own cells or activates immune cells that attack normal tissues as if they were dangerous.
Over time, this can cause chronic inflammation, pain, and organ dysfunction. Some conditions focus on one organ, while others affect multiple systems.
How Many Autoimmune Diseases Are There?
Experts estimate that there are more than 80 autoimmune diseases. Some, like psoriasis or Hashimoto’s thyroiditis, are relatively common, while others are rare and harder to recognize. Because symptoms often overlap, these conditions are grouped as autoimmune disorders driven by similar immune system errors.
What Are the Main Autoimmune Disease Causes?
Autoimmune disease causes are complex and usually involve several factors rather than a single trigger. Genetics, environmental exposures, infections, hormones, and lifestyle all appear to influence risk. No single factor explains every case; instead, risk comes from interactions between a person’s underlying susceptibility and their environment.
Is Autoimmune Disease Genetic or Environmental?
Genetics play a strong role in autoimmune disease causes. People with a family history of conditions like lupus, multiple sclerosis, or celiac disease are more likely to develop an autoimmune disorder.
However, many individuals with risk genes never develop disease, suggesting that environmental triggers—such as infections, certain drugs, or pollutants—may “switch on” disease in those who are genetically predisposed.
Can Infections, Stress, and Lifestyle Trigger Disease?
Some infections may trigger autoimmune diseases through mechanisms like molecular mimicry, where parts of a virus or bacterium resemble the body’s own proteins. When the immune system attacks the infection, it may also begin targeting similar-looking tissues, according to Harvard Health.
Stress and physical trauma can alter immune and hormone balance and may contribute to symptom onset or flare-ups, especially in those already at risk. Lifestyle factors such as smoking, obesity, poor diet, and exposure to toxins can amplify inflammation and appear to influence both the development and severity of autoimmune diseases.
Are Autoimmune Diseases More Common in Women?
Many autoimmune diseases are more common in women, especially during their reproductive years. Hormonal differences, including the effects of estrogen on the immune system, may help explain this pattern. Researchers continue to study how sex hormones interact with genes and environmental factors.
Does Autoimmune Disease Run in Families?
Autoimmune conditions often appear in families, even when relatives have different diagnoses. One person might have type 1 diabetes, another thyroid disease, and another lupus. This suggests that people may inherit a general tendency toward autoimmunity rather than a single specific condition.
Organ-Specific vs Systemic Autoimmune Diseases
Autoimmune diseases can be organ-specific or systemic. Organ-specific conditions mainly target one tissue or gland, such as the thyroid in Graves’ disease or the pancreas in type 1 diabetes. Systemic diseases, like lupus or vasculitis, affect multiple organs and often cause more widespread symptoms.
Common Autoimmune Diseases and Early Signs
Well-known autoimmune diseases include rheumatoid arthritis (joints), systemic lupus erythematosus (multiple organs), type 1 diabetes (pancreas), multiple sclerosis (nervous system), Hashimoto’s thyroiditis and Graves’ disease (thyroid), celiac disease (intestine), and inflammatory bowel diseases.
Early symptoms are often subtle and nonspecific: fatigue, joint or muscle pain, low-grade fever, skin rashes, digestive issues, hair loss, or numbness. Because these signs resemble many other conditions, autoimmune disease can be difficult to recognize early, as per Cleveland Clinic.
How Are Autoimmune Diseases Diagnosed?
Diagnosis usually combines medical history, physical exam, and targeted tests. Blood tests can detect autoantibodies and markers of inflammation.
Imaging studies such as X-rays or MRI scans may reveal joint or organ damage, and biopsies can confirm immune-related injury. Because symptoms overlap with many other illnesses, it may take time and specialist referrals to reach a clear diagnosis.
How Are Autoimmune Diseases Treated?
Most autoimmune diseases are chronic and cannot currently be cured, but many can be controlled. Treatment aims to reduce inflammation, calm the overactive immune response, protect organs, and relieve symptoms.
Common medications include anti-inflammatory drugs, immunosuppressants, and biologic therapies that target specific immune pathways involved in autoimmune disease causes. Short-term corticosteroids may be used to manage flares, while disease-modifying drugs aim to limit long-term damage.
Can Lifestyle Changes Help?
Lifestyle changes can support medical treatment and improve quality of life. Regular physical activity, balanced nutrition, adequate sleep, and stress management can help regulate immune function and may reduce flare frequency for some individuals.
Avoiding smoking and limiting exposure to known triggers can further support disease control.
Prevention, Daily Life, and Outlook
There is no guaranteed way to prevent autoimmune diseases, in part because autoimmune disease causes are still being fully understood.
However, early recognition of symptoms, attention to family history, and timely medical evaluation can lead to earlier intervention and fewer complications. For those already diagnosed, coordinated care, medication adherence, and healthy routines can make day-to-day life more manageable.
Living with an autoimmune disease often requires adjustments at work, at home, and in social life. Fatigue, pain, and cognitive difficulties may require pacing, flexible schedules, or accommodations.
Many people benefit from a support network that includes healthcare providers, mental health professionals, and peer support. Advances in research are improving therapies and deepening understanding of autoimmune disease causes, offering hope for more precise treatments and better long-term outcomes.
Frequently Asked Questions
1. Can someone have an autoimmune disease without abnormal blood tests?
Yes. Some people have clear symptoms and exam findings of autoimmune disease even when early blood tests are normal or borderline. Follow-up testing over time and specialist evaluation are often needed.
2. Do all autoimmune diseases cause lifelong disability?
No. Many autoimmune diseases can be managed well with treatment and lifestyle changes. Some people experience long periods with mild symptoms or remission and continue working and staying active.
3. Are vaccines a common cause of autoimmune diseases?
Current evidence does not support vaccines as a common cause of autoimmune diseases. Infections themselves are more strongly linked to triggering autoimmunity than vaccination.
4. Can changing diet alone reverse an autoimmune disease?
Diet changes may reduce symptom severity and inflammation for some individuals, but they typically do not replace medical treatment. Food choices work best as part of a broader care plan, not as the only therapy.
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If you find yourself stuck in a stress cycle, try this gentle practice to pause, calm your nervous system, and reset.
It’s not always an instinctual go-to for us, but self-compassion is one of the most powerful forms of healing and restoration for our mental and physical well-being.
In this meditation, mindfulness teacher Shamash Alidina offers three ways to show compassion for yourself when you’re stressed and need a reset.
Shamash Alidina has been practising mindfulness since 1998 and runs his own successful training organisation. He is the author of Mindfulness For Dummies and most recently, The Mindful Way Through Stress. He frequently pops up in newspapers, magazines and on radio shows. Based in London, he runs online trainings and speaks at conferences all over the world. He’s been teaching mindfulness full-time since 2010.
Self-Compassion for Nervous System Reset
Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
Let’s take these 12 minutes for a nervous system reset—to step out the doing mode and into the being mode. Start by finding a posture that feels like a hug for your body, whether you’re sitting or lying down. See if you can be one or two percent more comfortable. Maybe that means a cushion behind your back or unclenching your jaw just a fraction.
Now let’s take a deep slow breath in. And as you exhale, imagine you’re letting go of the days to-do list. Just let it drop to the floor for now. It’ll still be there later, if you really want it, but for now, you’re off duty.
What is the state of your nervous system? Is it buzzing? Is it tight? See if you can greet it with a bit of curiosity rather than judgment. Instead of saying, I shouldn’t feel stressed, try saying Oh, that’s interesting. Stress is visiting me right now. That’s okay. It’ll pass in time.
Now let’s bring some kindness to the physical body. Our nervous systems often get stuck in high alert because they’re trying to protect us. Let’s send a signal that it’s safe to rest.
Begin by bringing awareness to your lower abdomen. Invite it to soften. So as you breathe in, it gently expand. And as you breathe out, it gently contracts. If it feels okay with you, placing a hand over your heart. Or if you prefer, cradling one hand in the other. Feel the warmth and the gentle pressure. This isn’t just a gesture, it actually releases oxytocin. The body’s natural soothing chemical.
As you gently bring awareness to your breath, there’s no need to breathe “perfectly.” Just feel the breath moving in and out, like the tide of the ocean. Each inhale is a gift of energy. And each exhale is an opportunity to release.
You could say, breathing in, I know that I’m breathing in. Breathing out, I gently smile to my nervous system. When we’re overwhelmed, we tend to isolate.
Let’s practice the three steps of self-compassion together. Step 1: Mindfulness. Acknowledge any struggle that you’re going through right now. Silently say to yourself, This is a moment of suffering or this is really tough right now. You’re not trying to minimize it. You’re validating your own experience.
Step 2: Common humanity. Remind yourself that you aren’t alone. Thousands of people will feel exactly like this, right now. This buzzing feeling or heaviness feeling is part of being human. You’re part of the big, messy, beautiful club. The Club of Humanity.
Now Step 3: Self-kindness. Ask yourself the magic question. How can I be kind to myself right now? Maybe you need to hear the words, It’s going to be okay. You’re doing the best you can. Say these words to yourself, with the warmth you’d use for a dear friend. Or perhaps to a little puppy that’s struggling.
Now, just sit in this stillness for a moment for a bit. If your mind wonders, which it will, because that’s what minds do, just gently, playfully invite it back. Imagine a golden light of kindness radiating from your heart, filling up your chest, your limbs. And there’s space around you, creating a buffer zone of peace. The nervous system is gently recalibrating. Shifting from fight or flight to rest and digest and restore. You don’t have to earn this rest. You deserve it simply because you exist.
When you’re ready, as we gradually come to the end of this short journey, give your fingers and toes a little wiggle. Try to carry this kindness muscle with you into the rest of your day. Things get hectic later, remember you can always come back to that soft lower abdomen or that gentle hand on your heart. Thank yourself for taking this time. It’s a radical act of kindness to stop and breathe. When you’re ready, slowly open your eyes. Do a good stretch. And perhaps give yourself a little smile.
Infusion therapy is now a vital component in the treatment of autoimmune arthritis, offering timely access to medications in a convenient and controlled setting. In-office infusion centers, commonly found in rheumatology practices, provide a patient-friendly alternative to hospital-based care by combining clinical oversight with convenience. As noted by Jatin Patel, MD, these centers not only enhance the patient experience but also allow physicians to maintain tighter control over treatment adherence and outcomes.
As the healthcare industry continues to shift toward value-based care models, integrating infusion services into outpatient settings can support cost savings and improve care delivery. Patients benefit from reduced wait times, easier appointment scheduling, and a more familiar environment, while providers gain efficiency and oversight.
Infusion Therapy and Its Role in Arthritis Treatment
Infusion therapy has become a cornerstone in managing autoimmune arthritis, particularly in patients who don’t respond well to oral medications alone. Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are among the conditions that often require biologic infusions to help control inflammation and slow progression.
Many of these medications, such as rituximab and tocilizumab, target specific parts of the immune system. Administering them via infusion allows for controlled dosing under medical supervision, which is crucial when dealing with complex autoimmune responses. Patients often report improved mobility and reduced pain after regular treatments, underscoring the importance of maintaining a consistent schedule. During flare-ups, timely infusion can be the difference between regaining function and experiencing prolonged discomfort.
When these therapies are provided consistently, patients are more likely to experience disease remission or at least a reduction in symptoms. Missed doses or irregular treatment can lead to flare-ups, joint damage, and diminished quality of life. Regular laboratory monitoring and periodic assessments are often coordinated with infusion appointments to ensure safety and therapeutic effectiveness.
Patient-Centered Benefits
Receiving infusion therapy in a physician’s office is often more convenient, especially for individuals juggling work, caregiving responsibilities, or mobility issues. Shorter wait times and easier appointment coordination make it simpler to stay on track with treatment, which is often critical in chronic disease care.
Patients tend to feel more at ease when their infusion sessions occur in the same clinic where they see their rheumatologist. This continuity fosters trust and allows for better communication about how the treatment is working. One person undergoing monthly infusions may feel more confident knowing any concerns can be addressed quickly by a familiar team.
Beyond the physical comfort, in-office infusion centers often provide a quieter, more personalized environment. Staff are trained to monitor closely for side effects, and patients can relax during infusions, sometimes even catching up on reading or work, making the experience less stressful overall.
Clinical and Operational Advantages for Providers
Integrating infusion services directly into a rheumatology practice streamlines care and enhances efficiency. Providers have immediate access to patient records, lab results, and previous infusion notes, which allows for more informed decisions during treatment sessions.
Physicians can also monitor adherence more closely. When infusions take place in-house, it’s easier to track whether patients are receiving therapy as prescribed. This can be particularly valuable in managing chronic conditions where missing treatments may lead to disease progression or complications.
Cost and Coverage Considerations
In-office infusion centers offer a more cost-effective option than hospital-based settings. Insurance companies, including Medicare, have increasingly recognized the value of shifting care to lower-cost environments without compromising quality. Patients may face lower out-of-pocket expenses due to reduced facility fees, which can make it easier to remain consistent with therapy.
Health systems and payers are also aligning with site-of-care policies that encourage treatment in outpatient or office-based settings. As more patients transition to this model, providers may see fewer administrative hurdles and more streamlined reimbursement processes.
The foundation of cancer prevention is plants, not pills.
“The vast majority of cancer research is devoted to finding cures, rather than finding new ways to prevent disease. The results of these skewed priorities are plain to see.” It’s been nearly 55 years since President Richard Nixon declared war on cancer, yet deaths from the most common cancers in the United States have continued unabated.
“We have been looking at the very nature of cancer in the wrong way. Breast cancer doesn’t begin when a lump is first felt or detected by a mammogram. All the common epithelial cancers (lung, colorectal, breast, prostate, pancreas and ovary), which account for the majority of deaths, have a long latency period—often 20 years or more.” So, it’s not like you were healthy one day, then got cancer the next. You haven’t been healthy—you’ve had cancer growing in you for decades. Indeed, there’s a “bizarre misperception that people are ‘healthy’ until they have actual symptoms of invasive cancer,” but “the barn in which hay is smoldering before it bursts into flames is not a safe place.”
So, what does this professor of pharmacology I’ve been quoting recommend? Drugs, of course. Chemoprevention—putting people on drugs to prevent cancer. The pharmaceutical industry spends tons of money promoting chemoprevention of heart disease and strokes with statins and blood thinners, so why shouldn’t people take drugs every day for the rest of their lives to protect against cancer?
There has to be a better way.
What about using diet and nutrition to prevent and treat cancer? Well, what kind of cancer? There are more than 200 types. But here’s the key: They all share the same hallmarks. In a series of papers cited more than 40,000 times in the biomedical literature, 10 hallmarks of cancer have been identified:
Increased sensitivity to growth factors
Evading your body’s tumor suppressors
Dodging your immune system
Being able to grow forever
Tumor-promoting inflammation
The ability to invade and spread
The ability to hook up its own blood supply
The accumulation of DNA mutations
Disarming the self-destruct mechanisms in place
Hijacking the cell’s metabolism
And, of course, there are classes of drugs to try to counter each one—chemotherapy agents designed to target each piece of the cancer puzzle. You can see them below and at 2:27 in my video Fighting the Ten Hallmarks of Cancer with Food.
Now, ideally, there would be drugs able to target multiple hallmarks at one time, but that’s not how drugs tend to work. Indeed, “this need to target multiple hallmarks is one of the major reasons why, in the context of cancer research, there are many proponents of investigating plant foods as they can deliver a cocktail of bioactive compounds” that may target most, if not all, of the hallmarks of cancer. Below and at 3:00 in my video, you can see a sampling of compounds found in fruits and vegetables—such as berries, greens, and broccoli—shown to be able to target each of the 10 hallmarks of cancer, at least in a petri dish.
Furthermore, they have the qualities of an ideal chemopreventive agent. If you were to design the perfect candidate, you’d want them to be selective to cancerous or precancerous cells while leaving normal cells alone, be side-effect-free, target most types of cancers, be able to be consumed in a daily diet, be conveniently available almost everywhere, and be relatively inexpensive to boot. Plants meet all these criteria. No wonder people who eat more plant-based foods tend to have lower cancer rates.
To be clear, we aren’t talking about taking supplements containing extracts or purified phytochemicals, but rather eating whole plant foods themselves—more of a food system–based approach to targeting the hallmarks of cancer. Foods contain thousands of substances that result in vast numbers of possible interactions, yet much of nutritional science “has long been directed towards the impact of single dietary components.” Yes, this kind of reductionist approach can uncover the role of foods or even individual nutrients in disease development, but let’s think about what the optimal research strategy would be to study the effects of bioactive natural plant compounds on disease prevention. Instead of using isolated phytochemicals to manage cancer, why not try whole foods? Sometimes the whole can be greater than the sum of its parts, a concept known as food synergy.
Check out this study involving the simultaneous inhibition of a series of cancer stages in breast cancer cells using a phytochemical supercocktail. Two breast cancer cell lines were treated with six different plant compounds individually, and then all together, at levels typically found in the bloodstream after eating foods like broccoli, grapes, soybeans, and turmeric. And while the compounds were ineffective individually, together they significantly suppressed breast cancer cell proliferation by more than 80%, inhibited cancer cell invasion and migration, stopped the cancer cells in their tracks, and eventually killed them all off. The plant compounds did all this without having any deleterious effects on the normal noncancerous cells used as control.
No wonder the foundation of cancer prevention—based on an update of the most extensive report on diet and cancer ever published—is not pills, but plants, as you can see below and at 5:28 in my video.
In other words, cutdown on alcohol, soda, meat, and processed junk, and center your diet around whole grains, vegetables, fruits, and beans.
Doctor’s Note
I have dozens of videos on cancer prevention and treatment. Check the related posts below.
Carpal tunnel syndrome occurs when the median nerve is compressed within the narrow wrist passage called the carpal tunnel. This pressure can cause pain, numbness, and tingling, typically in the thumb, index, and middle fingers. Symptoms often start gradually with occasional nighttime tingling or discomfort and can eventually interfere with daily activities like typing, gripping objects, or holding tools.
Several carpal tunnel causes contribute to the condition. Repetitive hand motions, long hours of typing, or assembly-line work increase wrist strain. Health issues such as diabetes, arthritis, pregnancy-related swelling, and thyroid problems can narrow the tunnel. Practicing carpal tunnel prevention by using an ergonomic workstation, taking frequent breaks, and keeping wrists neutral helps reduce nerve pressure and limits long-term hand and wrist strain.
What Is Carpal Tunnel Syndrome and What Causes It?
Carpal tunnel syndrome occurs when median nerve compression develops inside the wrist’s carpal tunnel, a narrow passage that carries tendons and nerves from the forearm into the hand. When swelling or pressure builds inside this space, the nerve becomes irritated and signals such as touch and movement can be disrupted. This can lead to numbness, tingling, weakness, or pain in the thumb, index finger, and middle finger.
One of the most common carpal tunnel causes is repetitive hand movement that places stress on the wrist. Activities like typing, using vibrating tools, or performing assembly-line tasks can increase pressure inside the tunnel over time. According to the National Institute of Neurological Disorders and Stroke (NINDS), carpal tunnel syndrome develops when tissues surrounding the flexor tendons swell and compress the median nerve, interfering with normal nerve signals.
Certain health conditions can also contribute to the development of carpal tunnel syndrome. Diabetes, rheumatoid arthritis, hypothyroidism, pregnancy-related fluid retention, and obesity can increase swelling or affect nerve health. In addition, anatomical factors such as naturally smaller carpal tunnels or wrist injuries may raise the risk, making some individuals more prone to developing median nerve pressure.
What Are Carpal Tunnel Syndrome Symptoms?
Early carpal tunnel syndrome symptoms often begin at night. Many people experience tingling or numbness in the fingers while sleeping and instinctively shake their hands to relieve the sensation. The symptoms typically affect the thumb, index finger, middle finger, and part of the ring finger. As the condition progresses, the discomfort can extend into the palm or even the forearm.
During daytime activities, symptoms may include weakness, clumsiness, and difficulty gripping small objects. A person may drop coins, struggle to hold a phone, or notice reduced pinch strength. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), carpal tunnel syndrome can cause numbness, weakness, and pain in the hand due to pressure on the median nerve.
In advanced cases, long-term median nerve compression can lead to muscle wasting at the base of the thumb. This reduces the ability to move the thumb across the palm, making tasks like buttoning clothes or gripping tools difficult. Recognizing these symptoms early can help individuals seek treatment before nerve damage becomes permanent.
How to Prevent Carpal Tunnel Syndrome?
Carpal tunnel prevention focuses on reducing pressure on the wrist and protecting the median nerve from long-term strain. Many cases develop from repeated hand movements and poor wrist positioning during daily activities or computer work. Making small ergonomic changes and taking regular breaks can significantly reduce repetitive strain wrist stress. According to the Centers for Disease Control and Prevention (CDC), workplace ergonomic improvements and rest breaks can lower the risk of musculoskeletal injuries linked to repetitive motion.
Ways to help prevent carpal tunnel syndrome:
Improve ergonomic workstation setup: Adjust your keyboard, mouse, and desk height so your wrists stay straight and relaxed. Keeping the wrist in a neutral position helps reduce pressure on the median nerve.
Take regular micro-breaks: Stretch your hands and wrists every 20 minutes to release tension in the tendons. Short breaks can help restore circulation and reduce repetitive strain on the wrist.
Maintain healthy lifestyle habits: Managing conditions like diabetes and maintaining a healthy weight can lower the risk of nerve compression. Regular exercise also helps improve circulation and joint health.
Use supportive tools and equipment: Wrist rests, vertical mice, and vibration-reducing gloves can help reduce strain during long work sessions or when handling power tools. These tools help limit repetitive motion stress on the wrist.
Diagnosis and Early Intervention
Early detection of carpal tunnel syndrome helps prevent permanent nerve damage. Doctors check wrist movement, finger sensation, and grip strength, and may use Phalen’s or Tinel’s tests to confirm median nerve compression. Nerve conduction studies, ultrasound, or MRI can reveal swelling or structural issues. Treatment focuses on relieving symptoms and protecting the nerve. Night splints keep the wrist neutral during sleep, while anti-inflammatory medications or corticosteroid injections reduce swelling. Severe cases may require surgical release to relieve pressure and restore hand function.
Protect Your Wrists from Carpal Tunnel Syndrome Risk
Awareness of carpal tunnel syndrome helps people recognize early warning signs and reduce strain on their wrists before symptoms worsen. Understanding common carpal tunnel causes—including repetitive hand movements, underlying health conditions, and poor ergonomics—makes it easier to identify risk factors in daily routines.
Practicing consistent carpal tunnel prevention strategies can protect long-term hand function. Adjusting an ergonomic workstation setup, taking frequent breaks, and reducing repetitive strain wrist movements all help limit pressure on the median nerve. Small daily changes can significantly lower the risk of chronic nerve compression and keep hands strong and functional for years.
Frequently Asked Questions
1. What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition caused by pressure on the median nerve in the wrist. The nerve runs through a narrow passage called the carpal tunnel. When this space becomes compressed, it can lead to pain, tingling, or numbness in the hand. The condition commonly affects the thumb, index finger, and middle finger.
2. What are the early signs of carpal tunnel syndrome?
Early symptoms often include tingling or numbness in the fingers, especially at night. Many people wake up and shake their hands to relieve the sensation. Mild wrist discomfort or hand weakness may also appear during repetitive tasks. Catching these signs early allows for quicker treatment and prevention strategies.
3. Can carpal tunnel syndrome go away without surgery?
In many cases, mild carpal tunnel syndrome improves with non-surgical treatments. Wrist splints, rest, and improved ergonomic workstation setup can reduce pressure on the median nerve. Anti-inflammatory medications and physical therapy may also help manage symptoms. Surgery is usually considered only when conservative treatments do not provide relief.
4. How can I prevent carpal tunnel syndrome while working on a computer?
Preventing carpal tunnel syndrome while working involves maintaining a neutral wrist position and reducing repetitive strain. Adjust your keyboard and mouse so your wrists remain straight and your elbows rest at about a 90-degree angle. Take short breaks every 20 minutes to stretch your fingers and wrists. An ergonomic workspace can significantly reduce repetitive strain wrist injuries.
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Equanimity is often discussed in relation to mindfulness, yet it extends beyond formal practice and into the ways we meet everyday life.
In this conversation, Margaret Cullen reflects on the ideas behind her book Quiet Strength and the five-year journey of study, practice, and dialogue that shaped it.
Angela Stubbs: Quiet Strength has been in the works for how many years?
Margaret Cullen: I guess it’s five now. Five years.
Angela Stubbs: Take us back five years. Set the stage. What was going on in your life when the idea for this book began to settle in?
Margaret Cullen: Oh, thank you for asking. I haven’t been asked that before. I did talk about it a little in the book’s prologue. I had begun teaching workshops on equanimity close to 10 years before I started writing the book, and about five years ago an editor at New Harbinger reached out to me to write a second book. I wasn’t sure if I wanted to do that.
But then the idea came to me: a book about equanimity could be really interesting and useful. There were already so many books on mindfulness and quite a number on compassion. Although I had been teaching and writing about both for years, I wasn’t sure I had anything to add to that literature. Very little had been shared on equanimity. That was part of why I got interested in teaching it in the first place. It wasn’t addressed much in either the Buddhist circles I’d been practicing in for decades or in the mainstream mindfulness world.
It was time for a deep dive into this quiet virtue that’s been hiding in plain sight for 2,600 years.
I got excited and went back to New Harbinger, and they said no. They wanted a workbook. I didn’t want to write a workbook. It wasn’t time for a workbook. It was time for a deep dive into this quiet virtue that’s been hiding in plain sight for 2,600 years.
Angela Stubbs: I really love this sense of inner knowing you had, declining the workbook and following something deeper. It feels like an intuitive process. Can you talk about that, what that felt like?
Margaret Cullen: I found myself led by the book, which was a fascinating and surprising process. Very early on, the book had its own ideas. I discovered that I was following the book’s lead. The book said, “No, not a workbook”, “No, not New Harbinger”, “No, this is what I want to be.” By following the book’s lead, it became something much bigger, deeper, and richer than I could have imagined on my own.
That was quite remarkable. It led me to an agent, a big publishing house, and an editor who had a beautiful vision for the book. I felt like the book led, and I was always half a beat behind it.
Angela Stubbs: As the book began to take shape, you were also wrestling with the lineage and doctrinal differences around equanimity and mindfulness. How did those conversations, including your exchange with Sharon Salzberg, influence the direction the book ultimately took?
Margaret Cullen: Originally, I planned to write a chapter exploring the doctrinal relationship between mindfulness and equanimity. I’ve been tracking that debate for more than twenty years, beginning when I was co-teaching with Alan Wallace, who defined mindfulness quite narrowly as sati, simply as remembering to return to the present moment.
But at a certain point, I realized the scholarship wasn’t helping illuminate lived experience. So I tried to simplify the question.
In the insight tradition, mindfulness includes an attitudinal quality. It isn’t just returning to the present moment. It’s returning in a particular way, with non-judgment, spaciousness, allowing, and non-reactivity. That quality is what we call equanimity.
In one conversation, I asked Sharon Salzberg to imagine a Venn diagram: one circle mindfulness, one circle equanimity. How much do they overlap? Her answer was immediate. Completely.
I remember thinking, Really? Completely? We don’t tend to use the terms interchangeably. Yet many Western Vipassana teachers would say that without equanimity, it isn’t truly mindfulness.
In the insight tradition, mindfulness includes an attitudinal quality. It isn’t just returning to the present moment. It’s returning in a particular way, with non-judgment, spaciousness, allowing, and non-reactivity. That quality is what we call equanimity.
Angela Stubbs: Is equanimity used in traditions apart from Buddhism and mindfulness? You spoke with Tom Block about Judaism and Sufism. Are those traditions using equanimity in the same way?
Margaret Cullen: There are differences, of course, but there are also striking similarities. Equanimity appears in many traditions beyond Buddhism. We find it in Judaism, in Sufism, and in Stoicism, often expressed through a similar concern: how we relate to life’s changing conditions.
In Buddhism, this has the poetic name of the “worldly winds”: pleasure and pain, praise and blame, gain and loss, fame and disrepute. Other traditions articulate the same insight in their own language, but the essential question is the same: How do we meet the constantly shifting winds of fortune?
What surprised me was how consistently this thread runs through different traditions. If you’re coming to this with fresh eyes and know nothing about equanimity, you might be surprised to discover that it’s almost everywhere, even in some of the least expected places.
Angela Stubbs: You’ve said equanimity found you when you really needed it. Can you share what was unfolding then, and how equanimity began to function as a teacher for you?
Margaret Cullen: There have been several times when equanimity has appeared as a teacher for me, but the first was on a retreat with Sharon Salzberg. We had done basic mindfulness and lovingkindness practice, and then spent a week on equanimity.
In the Vipassana tradition, equanimity is often cultivated through reflecting on certain phrases. One of them invites you to imagine someone you love who is suffering and reflect: their happiness and unhappiness are the result of their thoughts, actions, and circumstances, not your wishes for them. And even so, you continue to wish them well.
That was a complete revelation to me.
I worked with those phrases in both sitting and walking practice. One morning after breakfast, I was walking in the desert in Southern California, during that exquisite, fleeting springtime in Joshua Tree. I wasn’t formally meditating, but the phrases had taken on a life of their own.
I thought of my mother, and the phrase arose: I am not responsible for her happiness. And not only that, I could still love her and wish her well. It wasn’t a binary choice between taking responsibility for her happiness and being a bad daughter.
My mother struggled with depression and other mental health issues. As long as I could remember, it had felt like my job to make her happy. It was an impossible task, and by my twenties, I had become more and more depressed myself because I was failing at it.
In that moment, seeing clearly that, oh my goodness, I can’t control her happiness, was incredibly liberating. It sounds obvious now. But at the time, it was a revelation. And, beyond that, it is neither disloyal nor unloving to let go of this futile effort.
We come to believe that loving someone means managing their emotional state…Equanimity is love without attachment: to outcomes, to roles, to what I need from you, to how I need you to be, even to needing you to be happy.
Angela Stubbs: Many of us feel responsible for the happiness of people we love, especially within family. How does equanimity shift that dynamic?
Margaret Cullen: Women, of course, have been inculcated to be caregivers in roles as mothers, wives, sisters, and daughters. Those stereotypical roles, which hopefully my daughter’s generation, maybe your generation, Angela, is breaking out of, have given us distorted pictures of what it means to love.
In my mother’s case, and often with our children, we take on responsibility for their happiness. We come to believe that loving someone means managing their emotional state.
But Buddhism is fundamentally a path of connecting with reality. There’s no safer ground to stand on than reality. And the reality is that I am not responsible for your happiness.
These equanimity phrases expose how easily attachment masquerades as love. In Buddhism, attachment is considered the near enemy of lovingkindness. Without careful attention, we conflate the two. We accuse others of not being loving when they’re not expressing attachment, and we feel guilty ourselves when what we’re feeling is attachment, not love.
Angela Stubbs: Can you unpack that a bit more?
Margaret Cullen: Equanimity is one of the Four Immeasurables in Buddhism, along with lovingkindness, compassion, and sympathetic joy. They’re all aspects of love. So equanimity is love without attachment: to outcomes, to roles, to what I need from you, to how I need you to be, even to needing you to be happy.
It acknowledges your complete sovereignty over your own life. Even that language can be misleading, because I don’t grant or withhold your freedom. I never had that control in the first place. The belief that I do isn’t aligned with reality.
That’s where our ideas about love get tangled. We confuse attachment with care.
The author with her forthcoming book, out March 10, 2026.
Angela Stubbs: In the world we’re living in now, where there’s always something to care about, how do you work with equanimity as a tool in difficult times?
Margaret Cullen: Having just written a book about it and being interviewed about it, I have unique pressures on myself, and from my friends and family, to be equanimous. The good news is we can turn that into a joke. Humor is actually a great doorway into equanimity.
I’m reaching for it a lot these days. There are also a few cognitive hacks that I use very frequently. They’re related to the three characteristics in Buddhism that are very close to my heart and central to my practice.
Angela Stubbs: Tell us about the hacks.
Margaret Cullen: First, I ask: Is this situation as personal as I’m making it? As meditators, we taste non-self, the experience of being connected to all things. And yet we walk around in our separate, contracted egos. It’s a reminder that there’s another way of relating to experience.
Second, impermanence. If I’m caught in reactivity, in a moment of suffering or even joy, I remind myself that things change. I loosen my grip on attachment or aversion. That’s reality. That’s the reality I want to align myself with. Things are usually less personal and less permanent than they seem.
And third, I like this question from Byron Katie: Is it really true?
Given the current political situation, it can feel like the end of the world. We say the world is on fire. It can feel literally true. But if I step back and ask, is it actually on fire, the answer is no. That’s an expression. And that expression amplifies fear, outrage, and anxiety, and pulls us out of equanimity.
Angela Stubbs: People often misunderstand equanimity. How do you describe what equanimity is not?
Margaret Cullen: Equanimity is definitely not indifference. It’s not apathy. It’s not passivity. Those are the near enemies of equanimity.
Equanimity is not withdrawal.
I think for a lot of people who care deeply about the world, even if they understand this intellectually, emotionally, it still feels like a withdrawal. I have friends who are longtime practitioners who are afraid of equanimity. They think the world is in so much trouble that equanimity somehow forecloses their opportunity to be activists and engage with the world’s problems. That’s a very important misunderstanding. It’s deep and pernicious. Equanimity is not withdrawal.
This is part of the beauty and paradox at the heart of equanimity. It’s caring perhaps even more deeply, not less, but draining that love of melodrama.
This is part of the beauty and paradox at the heart of equanimity. It’s caring perhaps even more deeply, not less, but draining that love of melodrama. It’s loving without attachment. We care just as much, perhaps even more, about this beautiful planet and all the people and species who are thriving and suffering upon it, but without the melodrama and the outrage. That frees up our energy to be as effective as possible in whatever way we engage.
Angela Stubbs: Earlier, we talked about the overlap between mindfulness and equanimity. If mindfulness is awareness, where does equanimity fit? You’ve described it as a kind of balance. What does that mean?
Margaret Cullen: The balance we’re talking about is dynamic. It’s not static. We’re not aiming for some frozen state. It’s more like walking. With every step we lose our balance and regain it.
Equanimity is the capacity to recover more quickly, to create space around our experience when we’re knocked off center. It’s not about being chill or detached. That becomes a near enemy. It’s about flexibility. It’s about resilience.
Angela Stubbs: The book is titled Quiet Strength: Find Peace, Feel Alive, Love Boundlessly. It wasn’t always called that. How did the title and subtitle evolve?
Margaret Cullen: I originally wanted to call the book Equanimity: The Quiet Virtue. If it had stayed small and focused only on Buddhism, that might have worked. But once the vision grew, that title no longer worked for my agent or publisher.
They first suggested Quiet Power, which I liked. Equanimity is quiet but incredibly powerful. In martial arts, power comes from fluidity and balance, not brute strength. But politically, “power” felt like a tainted word. So we landed on Strength.
The subtitle, Find Peace, Feel Alive, Love Boundlessly, is not language I would normally use. I have an aversion to telling people what to do. My language as a teacher is more invitational and provisional. This is declarative. I joked that I felt like a circus barker for equanimity.
But the book has a wider vision than my own. I’m one voice among many contributing to what it’s meant to do in the world.
Angela Stubbs: Is there anything in the book that people haven’t asked you about yet?
Margaret Cullen: Surprisingly, I’ve been asked very little about the neuroscience. No one has asked about the time I went to a lab in Arizona and had transcranial stimulation applied to my brain to supposedly engender equanimity.
Neuroscience labs that have studied mindfulness are now adding tools like transcranial stimulation and sophisticated fMRI mapping to reverse-engineer advanced states of meditation.
Angela Stubbs: That feels like a verydifferent angle on equanimity. What happened when you went into the lab?
Margaret Cullen: They stimulated my brain and asked what I was experiencing. I didn’t feel anything. I was disappointed because Shinzen Young was there, along with Jay Sanguinetti, who runs the lab at the University of Arizona. Over lunch, they described extraordinary experiences they’d had using the technology.
I wanted to feel that. I even considered changing my flight home to try again. I believe them. But I didn’t have that experience.
From my perspective, equanimity is part of some of the most cutting-edge research just beginning to unfold. It’s early. Where it ends up, nobody knows.
Margaret Cullen is a licensed psychotherapist and a pioneer in bringing contemplative practices into mainstream settings. She was one of the first ten people to be certified as an MBSR instructor and has taught around the world. As a therapist, she facilitated psycho-social support groups for cancer patients and their loved ones for over 30 years.
She also developed Mindfulness-Based Emotional Balance and co-authored a book about it with Gonzalo Brito Pons. She was a Senior Teacher and Curriculum Developer for Humanize, a contemplative-based dyad program founded by German neuroscientist Tania Singer. Margaret is a Mind and Life Institute Fellow, on the advisory board of the Global Compassion Coalition, and has been a meditation practitioner for over 40 years.You can findQuiet Strength here.
Nicole Dynan is the founder of The Gut Health Dietitian (established in 2014) and one of Australia’s leading gut health experts. After a decade in corporate chronic disease management, Nicole saw first-hand how gut health impacts energy, stress, mood, and overall well-being. Since then, and together with her team, she’s helped over 40,000 people improve their gut health, feel more comfortable, and regain control of their overall health through science-backed nutrition. 
