Carpal Tunnel Syndrome Treatment

So you want to prevent or fight CarpalTunnelSyndrome (a RepetitiveStrainInjury). What can you do?

Maybe try this exercise:

http://www.orthohelp.com/exercts.htm

(Above has been removed, wayback machine to the rescue: http://web.archive.org/web/20040828075639/http://www.orthohelp.com/exercts.htm )

Maybe work on your ergonomics (though a skeptic would point you to StaticCling)

Maybe get some brace-like thing and strap it on your wrists.

Gaah! Don't strap on anything unless a doctor has prescribed it! Over time, you can do more harm than good. -- JonReid

Try qigong along with your other treatments. This has eliminated my need to worry about RSI. I routinely use computers for long periods of time with bad ergonomics, and my pain has still gone down to nearly nothing (not that I recommend this). The system I practice is Pan Gu Shengong.

        * http://www.qi.org/

This page is, by design, devoid of sure facts. If anyone has had successful experience with any of this please fill in the blanks (and remove some of the "Maybe"'s).

I was diagnosed with CTS in 1994. Having lived with it now for over 7 years, the above advice is reasonably valid.

The exercise does work. You don't need to stand up to do it, though, and you can do it one hand at a time. I find that doing one or two hand clenches whenever I stop typing works better than extended clenches every few hours. YMMV. However, don't try and build up the muscles in the wrist. It sounds good as it would counter the reduced strength, but it aggravates the problem enormously.

Ergonomics are important. However, there's a lot of "ergonomic" gear out there that's utter crap. Get a nice padded wristrest for your keyboard, and that will solve a lot of problems.

I wear a wrist brace on the bad days, as prescribed by my doctor. You need to get one that actually has a support splint in it; preferably metal, as you'll want to bend it to suit your wrist. The idea is that it should keep your wrist locked into a position that puts minimal pressure on your carpal tunnel tendon. This is not your wrist's preferred rest position, which is why you need a splint. Don't try and do anything much with your fingers (like typing) when wearing it, though.

In the early days of my condition, when it was really really bad, I was prescribed anti-inflammatory drugs. These worked incredibly well. However, you can't stay on them long-term, nor do you really need to once the initial damage is repaired. I've been on them twice, in total, for three months (one bottle) at a time.

Surgery is the ultimate solution. However, it's a delicate operation. The trick is to abrade the carpal tunnel tendon so that it's not quite so strong. Do it too much, and it will snap, which will cause a loss of nearly all strength in your wrist, permanently. Don't do it enough, and the tendon heals and scars over, aggravating the original problem. For some reason, though, this operation is often given to junior docs to do, apparently. I haven't had surgery to correct my condition, and I will not as long as it is tolerable.

-- RobertWatkins.

Surgery is something to wary of on the whole. Its never the same after its been cut open and modified. Choose surgery only when you believe it is absolutely necessary.

But be careful, wristrests are for resting only. Your wrists should float when actually typing. See http://www.engr.unl.edu/ee/eeshop/rsi.html

(Link is now dead http://wayback.archive.org/web/19970614164621/http://www.engr.unl.edu/ee/eeshop/rsi.html)

Try this guide for size:

How To Avoid The Office RSI Trap

http://www.esedirect.co.uk/articles/post/How-To-Avoid-The-Office-RSI-Trap.aspx

Yes, but when you're not typing, it's good to lower your hands and have the rest there. Programmers spend a considerable amount of time not typing. I have taught myself to place my hands in my lap at these times.

Furthermore, "floating" is actually very stressful on your arms for a long period. And that is a good reason to take frequent breaks. The breaks don't have to be long to be effective. Maintaining your body in a static position is like keeping your car engine idling; it wears things down.

This can lead to other forms of RSI. The best thing to do, in fact, is get a wristrest such that when your hands float, they're just barely in contact with the rest; this lets some of the weight of your hands get absorbed by the wristrest, easing pressure on your forearms, and keeping your hands in the appropriate posture.

In other words, a good keyboard wristrest actually rises slightly above the level of the keys. I use the gel-padded ones from Fellowes, and it fits in quite nicely.

The single greatest factor in my recovery was the Muscle Learning Therapy I received from Dennis Ettare and his associates (http://ettareclinics.com/). Basically, it's biofeedback. When I first heard "biofeedback," I thought it was some flaky thing, and was surprised when my doctor prescribed it.

On my first visit, they attached some sensors to various points of my shoulders and upper back. Then Mr. Ettare told me to relax, and I said, "I am," to which he pointed to the display and replied, "No, you're not. Relaxed is down here. You're way up here." He proceeded to teach me how to stand, how to sit, how to walk, how to eat, how to drive, how to carry things, and eventually how to type and mouse. It sounded strange to focus on my back when my injuries were in my elbows and right wrist. But by golly, over time, it worked! At my last session, we compared my initial "relaxed" readings with what I had learned, and the difference in the overall strain I put on my muscles was incredible.

So I highly recommend it to anyone in the SF Bay Area. See http://www.tifaq.org/articles/muscle-learning-therapy-mlt-1.html for a speech Mr. Ettare gave about Muscle Learning Therapy. The Q&A at the end is especially informative. -- JonReid

Suggestion: stop contributing to wikis to rest hands :-)

Or just use DvorakKeyboardLayout?, to reduce finger travel...

I have found my doc in the bay area, dr. kahan, who wrote the "mouse key do" manual for keyboard technique, to be unhelpful. the physical therapist he referred seemed to be very helpful at first but symptoms came back. now i am guiding my own treatment by following the advice of the book It's Not Carpal Tunnel Syndrome!: RSI Theory and Therapy for Computer Professionals. basically i am doing massage to release the trigger points (why i didn't get better), stretching, and strengthening. i have already incorporated ergonomics, breaks, speech recognition, attitude, meditation. --khs

CategoryErgonomics