Carpal Tunnel Syndrome

Many people think that any computer-related injury is "Carpal Tunnel Syndrome." However, CTS is but one of many types of RepetitiveStrainInjury (RSI). Heavy usage of the keyboard and mice may bring on some of these ailments.

A recent-breaking series of related news stories claim that computer use doesn't imply an increased risk factor for CTS as has been previously thought (or universally assumed true?). The rate of occurrence overall is 1 in 10. In the computer industry it's.... 1 in 10. Apparently some people are just more susceptible to these kinds of injuries than others. -- MarkTaylor

News links now expired:

Update (Dec05): CTS specifically not from typing:

http://science.slashdot.org/article.pl?sid=05/12/16/1322255&tid=227&tid=14

As black lung is to miners, so CTS is to programmers.

But no-one ever died of CTS

Sure they did. They died from starvation brought on by lack of money to buy food brought on by inability to work. :)

Stand up, and let your hands assume a relaxed natural position, bend your elbows so that your forearms are level to the floor, if you are like most people your hands will be facing each other with the thumbs only slightly closer together than the little fingers. Now turn your hands so that they are in their normal typing position, notice that the nerves that run along the bottom of your wrist are pulled against your bones, that is the stress that causes carpal tunnel syndrome. Repeatedly keeping your hands in that position for years of rapid typing can actually wear away parts of the protective sheath on those nerves, the truly horrid pain starts when you start getting crosstalk and spurious signals coming from those nerves. This can end your career as a programmer!

Therefore:

Do not spend extended periods of typing without taking breaks and varying your position, take time to learn a stretching exercise that relieves presure on your wrists, invest in an ergonomic keyboard that works for you. Think of it as one of the PhysicalCuesInSoftwareDevelopment that makes you take frequent breaks (every 45 minutes) and reconsider your work so far.

And it's not just typing. Most people have poor mousing posture.

It's ironic that the people who suffer most from RSI are ipso facto the ones who are unable to say exactly why this is so important.

I bought an ergonomic keyboard the day after I took a training class. The trainer was a former programmer who was completely unable to type; the man sitting my right had incisions in both his hands and had to wear braces at night, and everyone else in the class admitted to frequent pains in their hands when they typed. It does happen... and one of the chief places that it happens is in DotCom companies which exist on CrunchTime?, where the programmers aren't aware just what sort of damage they're doing to themselves.

Check out the RSI directory for more information, or Jamie Zawinski's site (http://www.jwz.org/gruntle/wrists.html).

http://directory.google.com/Top/Health/Conditions_and_Diseases/R/Repetitive_Strain_Injuries_-_RSI/

-- WillSargent

This is amazing. A whole page about CTS, and DvorakKeyboards appears nowhere on it. Probably just an oversight - everyone knows the first line of defense against repetitive motion injury is to reduce the amount of motion. >sigh<

Actually, the first line of defense against RepetitiveStrainInjury is to break the repetition, then the strain. Reducing motion doesn't necessarily help.

We have a guy with RSI who hasn't typed in months, but is gaining some relief through acupuncture.

Actually there's a very good reason you don't want to use a dvorak keyboard. Since they're more efficient, you do more typing at a stretch with your hands in the same old extended position. Try the KinesisKeyboard for a design more friendly to your hands. -- WillSargent.

As a Dvorak typist, I insist that I experince far less wrist/hand fatigue since I started typing Dvorak. I don't think it's necessarily true that I type faster, but it's definitely true that the amount of motion is reduced. -- RobertChurch

On a related note, I think that modern notebook keyboards help reduce strain (but not repetition) compared to most normal keyboards or wave keyboards.

I feel much better after spending several hours at my desktop with a notebook style keyboard (complete with notebook style key plunge depth) then I do after a couple of hours behind a wave keyboard.

I think the ideal keyboard is probably the old Apple split keyboard. It has about the same key plunge depth as most note books (if I remember correctly), but like a wave keyboard it allows you to hold your wrists at a more natural angle.

The problem with most "wave" keyboards is that they are in a fixed position, but people are all different. For a fully adjustable keyboard, see http://www.goldtouch.com/. I have two: one for my PC, and one for my Mac.

Of course, nothing is a good substitute for taking frequent breaks to stretch and do minor excersise. Getting a cup of water would also benefit most people.

Copied from 'CarpalTunnelSyndrom?:

A bad wrist condition caused by RepetiveStressInjury?, such as typing all day on a non-DvorakKeyboard.

His doctor knows I'm doing this and while I wouldn't exactly say he's "encouraging" me...he does seem interested in the outcome. I just need to play it by his rules, slow and careful. He says that some people can overdo the b vitamins and cause nerve damage and I have read as much on the web as well. People either seriously overdo it or their bodies for whatever reason just can't get rid of the excess fast enough. There have been reported deaths, usually children, from magnesium overdose as well.

I'm not surprised the doctor isn't encouraging. I had a bad case of carpal tunnel and completely cured it with B6. I also know someone else who had it really bad (he couldn't even work) and he also took the B6, and it completely went away. His doctor (who wanted him to get an operation), was furious and made him feel like he was playing around with stuff he shouldn't be playing around with. You have to take a lot of the B complex vitamins for it to cause damage. I personally take 300 mg. a day and I am fine. I think the FDA recommends 1.6 mg. or something. What a joke!!! In dealing with children, I would be more careful..I agree with you. But I think it's wise that you are doing your own research, as I don't trust the doctors to know as much as I do in this department.

--from somewhere else in cyberspace

I read a very interesting book called Pain Free at Your PC (ISBN 0553380524 ) which says two (correction: three) interesting things: (Nobody expects TheSpanishInquisition!)

[1] Muscles can easily withstand repeated use. What they can't withstand is not being used at all. They atrophy. Since skeletal muscles come in opposed pairs, this means that when you use a group of muscles, the real cause of the pain may be that you are neglecting the opposite muscles in the pair. They atrophy and then when you do try to use them, pain occurs. Ergonomic keyboards which reduce and limit motion can actually make this problem worse.

[2] CarpalTunnelSyndrome is caused by bad posture. If you slump forward in your seat you can apply twenty or thirty pounds of body weight to your wrists. (You don't apply it to your hands because it would break your keyboard.) The carpal tunnel can easily withstand this, so there's no immediate pain, but it can't stand it for eight hours a day, every day. So if you sit with your back straight, allow your hands to hover over the keyboard while typing, and refrain from putting any weight on your wrists, your carpal tunnels will open up and your pain will decrease.

While I agree there should be no weight on the wrists, hovering the whole arm is just as bad, ideally your arms rest on the table between keyboard

and the edge of the table and only your hands hover over the keyboard. The weight shouldn't rest on the wrists but a longer part of the arm

[3] Bad posture is self-reinforcing. Maintaining proper posture requires the use of certain muscles, but if you slump in your seat a lot, and don't use those muscles, they atrophy, and it becomes harder and even slightly painful to maintain proper posture. This lack of proper posture can later cause you to have an accident during exercise or a sport, when proper posture is more important, or even just walking around. Knees and ankles and backs have to be aligned properly in order to bear loads, otherwise they can be damaged.

The book proposes a series of exercises designed to work those muscles which are traditionally neglected during computer use. I personally have never done them, because I don't have the hundred square feet of floor space required. Which is too bad.

IhaveThisBook? - and I would recommend it to anyone suffering from (even intermittent) pain. I don't do everything it recommends - but some of the regular exercises I DO do, I learnt from this book. YMMV. -- BevanArps

I got hurt (feet) doing one of the exercises in Pain Free at Your PC. I'd recommend Conquering Carpal Tunnel Syndrome by Sharon Butler. Massage, stretching, and relaxation techniques are helpful.