Get A Grip: Controlling Office-Related Carpal Tunnel Syndrome

Posted on March 1, 2011

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By Lorette Luzajic

If you spend most of your workday at a computer, perhaps you experience burning, tingling pains in your hands. Or maybe you’re losing your grip, finding it difficult to perform simple tasks like holding a pen. That’s how it began for Niagara Falls resident Annie Edwards, who now wakes in the night with excruciating pain. Edwards, who has been an office worker for more than 20 years, is debilitated by Carpal Tunnel Syndrome. It’s so painful that she can barely hold the telephone or work on the keyboard, making it difficult to do her job in classified sales at the local newspaper. “I’ve got about two coffee mugs left and no plates,” says Edwards. “I told my husband that I’m not buying more dishes because I constantly drop them.” Edwards, who has tried every recommended therapy, says she had two choices. “You’re either going to live with it, or you’re going to get the surgery.” She’s scheduled for carpal tunnel release surgery next month.

Carpal Tunnel Syndrome is common in populations who perform repetitive tasks with their hands. The carpal tunnel is a natural trough in the wrist where the nerves and tendons of the hand lie. A thick band of connective tissue, called the Transverse Carpal Ligament, lies over this trough, keeping the nerves and tendons protected and close to the wrist. The space within the carpal tunnel is limited. When the thick band of connective tissue or any of the structures lying within the carpal tunnel become injured or irritated, inflammation, swelling and/or scar tissue may form, resulting in pressure on the nerves and tendons. This results in pain and tingling sensations in the hands and fingers. Usually, to begin with, these symptoms are mild to intermittent. With increased and prolonged pressure on the wrist structure, the pain and tingling become more intense and muscle function may eventually be impaired.

Within the manufacturing and assembly industries, where repetitive tasks are the norm, a whole new industry of wrist splints, magic gloves, ergonomic keyboards and other special devices is springing up.

To confuse matters, few agree on the root cause of Carpel Tunnel Syndrome. Some blame the syndrome on poor posture and alignment of the wrist, which means that when the wrist is bent, the structures within the carpel tunnel become compressed. Others believe the condition is largely hereditary and afflicts people who simply have small carpel tunnels to begin with. Another theory is that there is a link between CTS and obesity.

In 2005, Harvard University sent out a press release announcing, “Computer use deleted as carpal tunnel syndrome cause.” That followed a Mayo Clinic study that found keyboarders, at the desk for seven hours a day, had the same incidence of Carpal Tunnel Syndrome as people not sitting at keyboards.

But droves of office workers know from personal experience that the more time they spend at the computer, the more it hurts. What gives?

“limiting high repetition tasks and improving posture is the only real hope for reducing CTS symptoms”

“Recent evidence has reaffirmed our suspicions that CTS is more related to the genetic makeup of an individual and associated diseases, such as diabetes and rheumatoid arthritis, than physical or environmental influences. Specifically, keyboard activities do not cause carpal tunnel syndrome,” says Dr. Alexander D. Blevens, Fellow of the American Academy of Orthopaedic Surgeons. He says those who already have CTS will experience its symptoms while working with their hands, whether it be typing, driving or brushing their hair and that “special keyboards, wrist splints, gloves will not prevent CTS in the workplace.”

The U.S. National Institute for Occupational Safety and Health’s Dr. Thomas Waters says limiting high repetition tasks and improving posture is the only real hope for reducing CTS symptoms. He recommends using equipment that is correctly adjusted to an employee’s body, and reducing exposure to repetitive tasks. “Allowing workers to control their work place, to take breaks when necessary, and rotating workers between jobs, so that they’re not exposed to high levels of risk factors for long periods of time,” is the best help. He says there are many devices on the market and NIOSH endorses none of them. “The only way to tell if a product will be effective is to determine whether the product truly reduces exposure to the risk factors . . . if the device reduces repetitive exertions, postural stress or force requirements, then it likely will have some level of effectiveness.”

Indeed, good posture, stretching, and frequent breaks are the only things that are recognized as effective across the board, but ergonomic devices are helpful when they improve alignment and reduce frequency of task repetition.

Ellen Serber, a yoga teacher known for her work in repetitive stress injury, says the most important thing to do is to get up and move around every half hour or so. “By getting up and moving, there’s blood flow, and the muscles are kept pliable. Rigid postures at the desk create tense muscles.” She offers office workers a series of hand stretches and movements they can do at the desk as well, on her web site, mydailyyoga.com. “CTS results from the tendency to slump over. The body freezes up.” She stresses alignment, posture, and movement above all else.

Dr. Blevens says that while prevention is difficult, “treatment, however, is very successful and usually begins with avoiding painful activities, non-steroidal anti-inflammatory medications, nighttime splinting to keep the wrist in a neutral position, and carpal tunnel injection with steroids. If these measures fail then dividing the transverse carpal ligament with surgery is extremely effective in most individuals.”

So get your exercise and never skip your breaks again. Now that’s good news!

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