1.
Working without
Breaks
Symptoms: pain,
fatigue,
swelling,
numbness,
and
weakness
in
the
hands,
wrists,
or
forearms.
Suggestions:
It
is recommended that you
take a break to relax
and stretch at least
once every hour. Whenever
working at the computer
for long periods, take
frequent breaks to stretch
and change the position
of your body. Prolonged
typing, data entry, and
use of a computer mouse
can cause carpal tunnel
syndrome if done over
a long period of time.
Solution:
Break
up the routine and help
avoid serious injuries
like carpal tunnel syndrome
with Ergo-Stretch. Ergo
Touch's new software
reminds you to take a
break and relax and guides
you through a series
of simple exercises that
can help prevent injury.
2.
Pressure on your
Wrist or Palms
Indications:
pain, tenderness,
numbness, and
tingling in
the wrist
and forearm.
Suggestions:
While
typing, wrists should
be in a neutral position.
That means there should
not be a crease on your
wrist at anytime. A wrist
pad at the bottom of
your keyboard will help
keep your wrists in a
neutral, almost straight
position.
Solution:
Fact: The
leading cause discomfort
associated with computer
usage, wrist and forearm
pain are generally a
result of extensive typing
without proper support.
3.
Poor Mouse Ergonomics
Indications:
pain,
tenderness,
tingling,
and
fatigue
in
the
wrist
and
forearm.
Suggestions:
Choosing
a mouse that fits the
contour of your hand
will eliminate awkward
positioning or over-gripping
of your mouse. There
is a whole line of ergonomically
designed mice available
in different sizes and
orientations to fit your
hand’s contour.
Choose a computer mouse
that does not require
a lot of forearm movement
or force.
4.
Sitting too Far
away from Your
Mouse
Indications:
pain, tenderness, tingling,
and fatigue in the wrist,
forearm, and elbow.
Suggestions:
Sitting
too far away from your
mouse can also cause
discomfort. When you
outstretch your arms,
you tend to lean forward
and adopt poor posture.
Elbows should rest comfortable
at an open angle when
you’re typing.
Keep upper arms and forearms
at about a 90-degree
angle.
Solutions:
Our
hand held
mouse allows
you to sit
back from
the desk
in a more
natural position.
It will help
relieve and
prevent the
pain and
discomfort
associated
with poor
posture,
RSI, DPI
and Carpal
Tunnel Syndrome. |
5.
Sitting too Far
away from Your
Keyboard
Indications:
pain, soreness, and fatigue
in the wrist and arms.
Suggestions:
Keep the forearm, wrist,
and hand in as straight
a line as possible while
keeping the upper arms
and forearms at about
a 90-degree angle.* They
should not be bent higher
than parallel to the
floor. A keyboard tray
will allow you to move
the keyboard closer to
your body so you can
bring your elbows in
to a more comfortable
position.
Solution:
*Fact:
This
position, known as the “neutral” position,
is the single most important
step a computer user
can take to avoid repetitive
motion injuries to the
wrists.
Tip: Help
achieve the wrist “neutral
position” by either
raising or lower you
chair or work surface,
or by using an adjustable
keyboard tray.
6.
Poor Keyboard Ergonomics
Indications:
pain, soreness, tingling,
cramping, and fatigue
in the fingers, wrists,
and arms.
Suggestions:
Keep your forearms and
wrists in a straight
line placing your hands
on the keyboard at a
45 degree angle. The
best solution is to purchase
an ergonomic keyboard.
Keys on ergonomic keyboards
are tilted 45 degrees,
so that you can type
while keeping your wrists
and forearms in a straight,
natural position.
Solutions:
Fact: Scientific
research has shown that
using alternate keyboard
designs can reduce tendon
stress in the fingers
and wrist and reduce
the risk of musculoskeletal
disorders.
What
is carpel tunnel
syndrome?
Carpal
tunnel syndrome occurs
when the median nerve,
which runs from the
forearm into the hand,
becomes pressed or
squeezed at the wrist.
The median nerve controls
sensations to the palm
side of the thumb and
fingers (although not
the little finger),
as well as impulses
to some small muscles
in the hand that allow
the fingers and thumb
to move. The carpal
tunnel - a narrow,
rigid passageway of
ligament and bones
at the base of the
hand ¾ houses the median
nerve and tendons.
Sometimes, thickening
from irritated tendons
or other swelling narrows
the tunnel and causes
the median nerve to
be compressed. The
result may be pain,
weakness, or numbness
in the hand and wrist,
radiating up the arm.
Although painful sensations
may indicate other
conditions, carpal
tunnel syndrome is
the most common and
widely known of the
entrapment neuropathies
in which the body's
peripheral nerves are
compressed or traumatized.
What
are the symptoms
of carpal tunnel
syndrome?
Symptoms
usually start gradually,
with frequent burning,
tingling, or itching
numbness in the palm
of the hand and the
fingers, especially
the thumb and the index
and middle fingers.
Some carpal tunnel
sufferers say their
fingers feel useless
and swollen, even though
little or no swelling
is apparent. The symptoms
often first appear
in one or both hands
during the night, since
many people sleep with
flexed wrists. A person
with carpal tunnel
syndrome may wake up
feeling the need to "shake
out" the hand
or wrist. As symptoms
worsen, people might
feel tingling during
the day. Decreased
grip strength may make
it difficult to form
a fist, grasp small
objects, or perform
other manual tasks.
In chronic and/or untreated
cases, the muscles
at the base of the
thumb may waste away.
Some people are unable
to tell between hot
and cold by touch.
What
are the causes of
carpal tunnel syndrome?
Carpal
tunnel syndrome is
often the result of
a combination of factors
that increase pressure
on the median nerve
and tendons in the
carpal tunnel, rather
than a problem with
the nerve itself. Most
likely the disorder
is due to a congenital
predisposition - the
carpal tunnel is simply
smaller in some people
than in others. Other
contributing factors
include trauma or injury
to the wrist that cause
swelling, such as sprain
or fracture; overactivity
of the pituitary gland;
hypothyroidism; rheumatoid
arthritis; mechanical
problems in the wrist
joint; work stress;
repeated use of vibrating
hand tools; fluid retention
during pregnancy or
menopause; or the development
of a cyst or tumor
in the canal. In some
cases no cause can
be identified.
There
is little clinical
data to prove whether
repetitive and forceful
movements of the
hand and wrist during
work or leisure activities
can cause carpal
tunnel syndrome.
Repeated motions
performed in the
course of normal
work or other daily
activities can result
in repetitive motion
disorders such as
bursitis and tendonitis.
Writer's cramp -
a condition in which
a lack of fine motor
skill coordination
and ache and pressure
in the fingers, wrist,
or forearm is brought
on by repetitive
activity - is not
a symptom of carpal
tunnel syndrome.
Who
is at risk of developing
carpal tunnel syndrome?
Women
are three times more
likely than men to
develop carpal tunnel
syndrome, perhaps because
the carpal tunnel itself
may be smaller in women
than in men. The dominant
hand is usually affected
first and produces
the most severe pain.
Persons with diabetes
or other metabolic
disorders that directly
affect the body's nerves
and make them more
susceptible to compression
are also at high risk.
Carpal tunnel syndrome
usually occurs only
in adults.
The
risk of developing
carpal tunnel syndrome
is not confined to
people in a single
industry or job,
but is especially
common in those performing
assembly line work
- manufacturing,
sewing, finishing,
cleaning, and meat,
poultry, or fish
packing. In fact,
carpal tunnel syndrome
is three times more
common among assemblers
than among data-entry
personnel. A 2001
study by the Mayo
Clinic found heavy
computer use (up
to 7 hours a day)
did not increase a
person's risk of
developing carpal
tunnel syndrome.
During
1998, an estimated
three of every 10,000
workers lost time
from work because
of carpal tunnel
syndrome. Half of
these workers missed
more than 10 days
of work. The average
lifetime cost of
carpal tunnel syndrome,
including medical
bills and lost time
from work, is estimated
to be about $30,000
for each injured
worker.
How
is carpal tunnel
syndrome diagnosed?
Early
diagnosis and treatment
are important to avoid
permanent damage to
the median nerve. A
physical examination
of the hands, arms,
shoulders, and neck
can help determine
if the patient's complaints
are related to daily
activities or to an
underlying disorder,
and can rule out other
painful conditions
that mimic carpal tunnel
syndrome. The wrist
is examined for tenderness,
swelling, warmth, and
discoloration. Each
finger should be tested
for sensation, and
the muscles at the
base of the hand should
be examined for strength
and signs of atrophy.
Routine laboratory
tests and X-rays can
reveal diabetes, arthritis,
and fractures.
Physicians
can use specific
tests to try to produce
the symptoms of carpal
tunnel syndrome.
In the Tinel test,
the doctor taps on
or presses on the
median nerve in the
patient's wrist.
The test is positive
when tingling in
the fingers or a
resultant shock-like
sensation occurs.
The Phalen, or wrist-flexion,
test involves having
the patient hold
his or her forearms
upright by pointing
the fingers down
and pressing the
backs of the hands
together. The presence of
carpal tunnel syndrome
is suggested if one
or more symptoms,
such as tingling
or increasing numbness,
is felt in the fingers
within 1 minute.
Doctors may also
ask patients to try
to make a movement
that brings on symptoms.
Often
it is necessary to
confirm the diagnosis
by use of electrodiagnostic
tests. In a nerve
conduction study,
electrodes are placed
on the hand and wrist.
Small electric shocks
are applied and the
speed with which
nerves transmit impulses
is measured. In electromyography,
a fine needle is
inserted into a muscle;
electrical activity
viewed on a screen
can determine the
severity of damage
to the median nerve.
Ultrasound imaging
can show impaired
movement of the median
nerve. Magnetic resonance
imaging (MRI) can
show the anatomy
of the wrist but
to date has not been
especially useful
in diagnosing carpal
tunnel syndrome.
How
is carpal tunnel
syndrome treated?
Treatments
for carpal tunnel syndrome
should begin as early
as possible, under
a doctor's direction.
Underlying causes such
as diabetes or arthritis
should be treated first.
Initial treatment generally
involves resting the
affected hand and wrist
for at least 2 weeks,
avoiding activities
that may worsen symptoms,
and immobilizing the
wrist in a splint to
avoid further damage
from twisting or bending.
If there is inflammation,
applying cool packs
can help reduce swelling.
Non-surgical
treatments
Drugs -
In special circumstances,
various drugs can
ease the pain and
swelling associated
with carpal tunnel
syndrome. Nonsteroidal
anti-inflammatory
drugs, such as aspirin,
ibuprofen, and other
non-prescription
pain relievers, may
ease symptoms that
have been present
for a short time
or have been caused
by strenuous activity.
Orally administered
diuretics ("water
pills") can
decrease swelling. Corticosteroids
(such as prednisone)
or the drug lidocaine
can be injected directly
into the wrist or
taken by mouth (in
the case of prednisone)
to relieve pressure
on the median nerve
and provide immediate,
temporary relief
to persons with mild
or intermittent symptoms.
(Caution: persons
with diabetes and
those who may be
predisposed to diabetes
should note that
prolonged use of
corticosteroids can
make it difficult
to regulate insulin
levels. Corticosterioids
should not be taken
without a doctor's
prescription.) Additionally,
some studies show
that vitamin B6 (pyridoxine)
supplements may ease
the symptoms of carpal
tunnel syndrome.
Exercise -
Stretching and strengthening
exercises can be
helpful in people
whose symptoms have
abated. These exercises
may be supervised
by a physical therapist,
who is trained to
use exercises to
treat physical impairments,
or an occupational
therapist, who is
trained in evaluating
people with physical
impairments and helping
them build skills
to improve their
health and well-being.
Alternative
therapies -
Acupuncture and
chiropractic care
have benefited
some patients but
their effectiveness
remains unproved.
An exception is
yoga, which has
been shown to reduce
pain and improve
grip strength among
patients with carpal
tunnel syndrome.
Surgery
Carpal
tunnel release is
one of the most common
surgical procedures
in the United States.
Generally recommended
if symptoms last
for 6 months, surgery
involves severing
the band of tissue
around the wrist
to reduce pressure
on the median nerve.
Surgery is done under
local anesthesia
and does not require
an overnight hospital
stay. Many patients
require surgery on
both hands. The following
are types of carpal
tunnel release surgery:
Open
release surgery,
the traditional
procedure used
to correct carpal
tunnel syndrome,
consists of making
an incision up
to 2 inches in
the wrist and then
cutting the carpal
ligament to enlarge
the carpal tunnel.
The procedure is
generally done
under local anesthesia
on an outpatient
basis, unless there
are unusual medical
considerations.
Endoscopic
surgery may
allow faster functional
recovery and less
postoperative discomfort
than traditional
open release surgery.
The surgeon makes
two incisions (about ½" each)
in the wrist and
palm, inserts a
camera attached
to a tube, observes
the tissue on a
screen, and cuts
the carpal ligament
(the tissue that
holds joints together).
This two-portal
endoscopic surgery,
generally performed
under local anesthesia,
is effective and
minimizes scarring
and scar tenderness,
if any. One-portal
endoscopic surgery
for carpal tunnel
syndrome is also
available.
Although
symptoms may be relieved
immediately after
surgery, full recovery
from carpal tunnel
surgery can take
months. Some patients
may have infection,
nerve damage, stiffness,
and pain at the scar.
Occasionally the
wrist loses strength
because the carpal
ligament is cut.
Patients should undergo
physical therapy
after surgery to
restore wrist strength.
Some patients may
need to adjust job
duties or even change
jobs after recovery
from surgery.
Recurrence
of carpal tunnel
syndrome following
treatment is rare.
The majority of patients
recover completely.
How
can carpal tunnel
syndrome be prevented?
At
the workplace, workers
can do on-the-job conditioning,
perform stretching
exercises, take frequent
rest breaks, wear splints
to keep wrists straight,
and use correct posture
and wrist position.
Wearing fingerless
gloves can help keep
hands warm and flexible.
Workstations, tools
and tool handles, and
tasks can be redesigned
to enable the worker's
wrist to maintain a
natural position during
work. Jobs can be rotated
among workers. Employers
can develop programs
in ergonomics, the
process of adapting
workplace conditions and
job demands to the
capabilities of workers.
However, research has
not conclusively shown
that these workplace
changes prevent the
occurrence of carpal
tunnel syndrome.
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