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[mountainguy]

Does anyone have experience with Carpal Tunnel Syndrome or repetitive motion injuries? I fear I may be developing something in my right wrist. It hurts to move sometmes, usually at night. I've not yet decided what to do about it. It doesn't seem to fulfill the classic symptoms of Carpal Tunnel (no pain in my fingers or palms yet) and I'm taking  all the precautions I know of to avoid aggravating it further.

[dept_geek]

Hey, MG.. first, mom's advice - if it hurts, don't do that. Those wrist brace things you can get at your favorite drug store work as long as you are pretty religious about using them (the best one I had went almost all the way to my elbow. comfortable and prevented further injury). Anti-inflamatory meds help. Check around the interwebz for setting up your work area in an ergonomic fashion.   Take a break every 1/4 hour or so and stretch. Don't spend all day working on the keyboards if you can help it.   

[kissa_mau]

I had mild carpal tunnel, and have suffered the beginnings of repetitive stress injuries a couple of times (fine motor lab tasks can really do it). My doctor had me switch things up. In the first case, it was a visit by an ergonomic specialist and a new mouse. The other two times, I did the web thing and rearranged my work situation (in one case, it was just propping my wrist on an old cassette tape and wrapping my probe handle with paper towel and labeling tape-- hey it worked).

My last university would actually send the ergonomics people out at no charge.

[biomancer]

Hi MountainGuy!

Oh yes, that 2" long scar down my right palm would be from surgery for carpal tunnel syndrome.  I had it in both hands but got it to go away without surgery in my left hand.  My dad had it in both hands and had surgery on both.  If you can head it off before it gets bad enough for surgery you'll be a happier person.

- Chime on Dept_Geek's suggestion for a wrist brace.  The ones you can get over the counter are decent, but the one I got through my hand surgeon was much more comfortable.  The more you wear it, the more it helps, and you should definitely wear it when you're working on the computer.  I lined mine with old socks with the toe cut off (and a hole cut in for my thumb to stick out), so that I could wash the sock-liner and not have the brace end up stinky. 

Other things I have found helpful from the ergonomic perspective:
 - ergonomic writing tools - i.e. "fat" pens. 
 - ergonomic keyboard for the computer, wrist rests, etc.
 - if you cook, fat-handled kitchen implements (I'm a big fan of OXO tools)
 - other ergonomic tools as appropriate (I use ergonomic pipetting devices in my lab, but since you're in the writing arts, you're probably already covered by the first two items)
 - avoid using machinery that vibrates your hands as this contributes to the nerve damage.  You probably don't use much here (I'm thinking about most woodworking tools, weedwhackers and lawnmowers, drills and other power tools, dremel tools, etc.) but I may just be unaware of your hobbies or duties.  If you can't avoid using them (i.e. your landlord makes you mow the lawn, or you're doing all the carpentry on a kitchen remodel in your spare time), pad the handles with some pipe insulation held on by duct tape.

If it gets to the point where you hand is waking you up at night; it curls into a fist that you can't uncurl; you start getting numbness in the palm, thumb, and fingers other than the pinky (whose nerve runs outside the carpal tunnel), or the pain becomes unbearable, then it's time to go see the surgeon.  The surgery is actually not bad and the recovery time is reasonably short if you don't let your hand get too bad before you go.  However, the tests that may be required by your insurance (electromyelogram and nerve conduction test) are rather intensely painful (unless your nerves are completely toast), so if you can avoid them, I strongly recommend that you do avoid them.

Rest your hands when you can.  If you get the ergonomic stuff in place and go easy on your hands you may be able to not only keep this from getting any worse, but get your wrists to recover back to normal.

Good luck - and feel free to ask me for more info on forum or PM.  I know WAY too much about this from my own and my dad's experience.

[michigander]

Another chime for the doctor prescribed wrist brace.  I had a visit with my employer's worker's comp doc who said that I "almost" had carpal tunnel.  Wearing the wrist braces that he gave me religiously while sleeping at night cleared the problem right up.  True, it took a few months, but that was much better than the pain and surgery that could have been my fate.  Even now, years later, I sometimes wake up with numb fingers, but if I wear the brace at night for a few consecutive days, it goes away.

I also had a visit from the ergonomics people who got me a new chair with arm rests at the correct height to force me to hold my hands and elbows at the correct angle.  It was hard for a couple of weeks while I adjusted to it, but the chair and the braces solved my problem.

[buy_low]

I also want to chime in that repetitive motion injuries are not something to take lightly.  I've very nearly come to the point of needing to take disability leave, simply because I ignored the pains in my hands and arms. Living near Silicon Valley I have met up with folks with a variety of computer use injuries, many who have been forced to change careers because they can't use a computer for more than a short time per day. I cannot do any work around the house that requires hand and wrist strength.  I have to ask someone to loosen tight screws.  It sucks, but at least I can use a computer. 

One thing to keep in mind is that mouse clicking can be very bad for your mouse hand.  I no longer use a regular mouse, I use a trackpad, also called a "cat," manufactured by Cirque.  If mousing is hurting you, a good ergonomics professional should be able to offer you multiple types of pointing devices, and they may also encourage you to alternate which hand you use for the mouse.

If your employer provides you with an ergonomic consultation, take advantage of it, but don't forget to also fix your home work station.  It is worth the money, especially since once a computer use injury becomes serious, you can end up being forced to go stay off the machine for months until it heals.

[mended_drum]

I developed carpal tunnel when I was a grocery store cashier.  After I ended that job, I had to wear the wrist supports during finals week for the first five or six years I was teaching.   Now I have no pain at all.

So, not doing the repetitive motion that causes the pain is probably the best treatment--not that that helps those who are not in a position to change jobs, of course.

[biomancer]

]Repetitive stress injuries can come from many causes. Other factors should also be considered as contributing to stress in all cases. Being overweight or pregnant or having high stress levels in general can certainly take a toll on certain joints. Once you have been diagnosed with repetitive stress injury, all of these factors must be taken into consideration before the most effective course of treatment can be prescribed by your doctor.

Valid points, GabrielJosh, but I have good reason to believe MountainGUY isn't pregnant.  Stressed, probably.  Pregnant, unlikely. 8^)  

[tinyzombie]

That comment makes this the second thread of the evening to cause me to spit out my gum.

[just_wondering]

I've had a great deal of personal experience with repetive strain injuries. I had RSI that worsened for seven straight years, eventually morphed into RSD (reflexive sympathetic dystrophy). It got to the point where I was truly disabled (unable to drive long distances, cook for myself, turn pages in books, not to mention writing or typing). Then, finally, I found an excellent physical therapist who worked with me intensively for 5 months. Now I am almost completely better. I get a few twinges now and then; I do an upper body exercise routine everyday and I take breaks from writing every couple of hours or so. Beyond that I have no problems.

I don't really have the time to offer any more details. But here's some advice.

1) DO NOT GET SURGERY. The therapist I went to has healed people that were far more disabled than I was ... without surgery.
2) Do not be afraid of the pain. Most therapists do not understand this and suggest that RSI suffers stop and rest frequently when they feel pain. This seems so right and so intuitive. But it is precisely the wrong advice. (This is how my RSI advanced to RSD.) It is far better to adopt a moderate schedule, and stick to it (working calmly) than to "give up" (as it were) whenever you encounter slight or moderate pain.

PM me if you want more info.

[mountainguy]

Biomancer is correct that I'm not pregnant. If I were, I'd have a lot of explaining to do to a lot of people :).

A quick update on my condition . . . I bought an over-the-counter brace for my wrist, which has helped considerably with the pain. I've also adjusted my work station at both home and school to make them more ergonomically correct. The pain has not gone away entirely and I'm going to see a doctor about it hopefully in the next few weeks.

Just_wondering, I will definitely ask about physical therapy if the problem worsens. I need to see a physical therapist anyway about an unrelated condition (it's not causing me any pain at the moment, but it has the potential to do so in the future).

[voxprincipalis]

[SPAM LINK REMOVED]Repetitive stress injuries[/SPAM LINK] can come from many causes. Other factors should also be considered as contributing to stress in all cases. Being overweight or pregnant or having high stress levels in general can certainly take a toll on certain joints. Once you have been diagnosed with repetitive stress injury, all of these factors must be taken into consideration before the most effective course of treatment can be prescribed by your doctor.

Valid points, GabrielJosh, but I have good reason to believe MountainGUY isn't pregnant.  Stressed, probably.  Pregnant, unlikely. 8^) 

GabrielJosh couldn't give a rat's ass about Mountainguy's gender. He's just here spamming his website.

MG, glad to hear you're getting some relief. I've been watching this discussion but haven't wanted to dive in; repetitive stress injuries of the hand, wrist, and elbow are occupational hazards in my profession and I've had several students who have had to deal with them. (Primary in my pedagogy is adjusting the physical setup of the student and removing unnecessary tension so that this doesn't happen in the first place, but students have developed plenty of bad habits before they get to me, and fixing those is far from an instantaneous process.) Remedies have included everything from anti-inflammatories and icing to myofascial massage and physical therapy to surgery. Stretching the hand/wrist/arm before activities that exacerbate the situation (and during or after if you feel the need) is also helpful; massage of the upper forearm can also help.

One thing that hasn't been mentioned yet is that moving your mouse to the side of your non-dominant hand (or using the non-dominant hand rather than the dominant hand on the trackpad) will relieve the dominant hand of some of its workload. If you try this, expect it to be awkward for a little while.

VP

[namazu]

One thing that hasn't been mentioned yet is that moving your mouse to the side of your non-dominant hand (or using the non-dominant hand rather than the dominant hand on the trackpad) will relieve the dominant hand of some of its workload. If you try this, expect it to be awkward for a little while.

I was going to suggest this, too.  When my elbow was bothering me, I found that giving my dominant hand/arm a break helped quite a bit.  Learning to navigate with my non-dominant hand (at least with a mouse) wasn't a problem for me.  You can even switch the button functions for a mouse or trackpad if that makes it easier for you.  I hope the brace and other adjustments will also help. 

[mountainguy]

Thanks for the ideas, VP and Namazu.  At home, I use a laptop with a trackpad, although I do use a desktop computer at work with a traditional mouse. I'll try shifting things around. The weird thing is that the affected wrist is my non-dominant hand.

One more question . . . how tight should I be wearing the wrist brace? It feels better when I wear it very tightly, but I obviously don't want to cut off circulation to my hand.

[voxprincipalis]

The weird thing is that the affected wrist is my non-dominant hand.

That is strange. If you aren't using that wrist heavily, it may be a mild case of peripheral neuropathy. But I am no doctor! If it continues, though, I would advise seeing one.

One more question . . . how tight should I be wearing the wrist brace? It feels better when I wear it very tightly, but I obviously don't want to cut off circulation to my hand.

Yes, I know exactly what you mean. My students have had good luck with starting out with it cinched tightly enough that they feel compression, and then if they develop any numbness, tingling, coldness, or swelling (edema) in the hand, they are to loosen it bit by bit until that goes away. Pretty soon you get a feel for how tight is tight enough, and how tight is too tight.

Doctors have also told my students that you should not sleep with the brace on for that reason: you might cinch it too tightly before bed and then your circulation becomes impaired while you are sleeping and you don't wake up to fix it.

Assuming you are also taking anti-inflammatories, let me just add the reminder that anti-inflammatories work best when taken consistently over a period of several days, rather than a one-shot deal. Also remember that Tylenol is only an analgesic, not an anti-inflammatory.

(And excuse me, I see that buy_low did make a reference to alternating mouse hands. I skipped over this line the first time I read the post. Apologies!)

VP