Carpal Tunnel and other related injuries

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vdecampo
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Carpal Tunnel and other related injuries

Postby vdecampo » Jan 10, 2010 19:41

Several weeks ago I suffered a severe injury to my arm and wrist that made it extremely painful to sit down and use my computer. The pain and mobility issues I have arise from a pinched nerve in my neck and carpal tunnel syndrome. I have been a professional developer for the last 15 years and a hobbyist for another 10 prior, yet I never really gave any thought to injuries associated with this type of profession.

I was curious to know if anyone else on this board suffers from carpal tunnel or similar injuries, and what measures (if any) you use to mitigate potential injury or alleviate problems with pain in the neck, back, and arm. Is there a special desk/chair setup that someone can recommend? What about mice or keyboards? I'm not a big fan of the split keyboard.

Anyway, I am in the process of redesigning my office environment and I was looking for some suggestions.

Thanks in advance...

-Vince
D.J.Peters
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Postby D.J.Peters » Jan 10, 2010 21:00

Years ago i got from time to time havy pain in my back
as a result after sitting 10-16 hours per day.
After I used a large ball chair the pain was gone.

Now I ride my bicycle every day it's good for my back muscles
(same result if i would often go swimming)

Now I can use a normal office chair 32 hours per day. :-)

Joshy
nobozoz
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Postby nobozoz » Jan 10, 2010 21:04

Vince,

Sorry to hear that you are suffering pain. Doubly hard hitting when it affects your livelihood, too.

Here in the states, there are some large employers that take occupational health and safety very seriously - I happen to work for one of them. You may be self-employed, but many of the same steps we take here can be applied universally.

We have safety specialists on site at most large facilities whose responsibilities include providing ergonomic assessments of employee work areas to prevent or mitigate repetitive stress injuries in the workplace.

We have instituted voluntary instructor-led stretching periods open to everyone each morning. Periodic micro-breaks for office workers are encouraged.

Some employees have received customized chairs, desks, fully adjustable computer monitors - even multiple monitors - lighting fixtures, screen filters; all in an effort to prevent injury.

We have had expert speakers come and give seminars related to workplace injury, stress reduction, changing of work habits, etc, etc.

I can summarize by saying that there is a lot of help available if you know where to look for it.

Jim
bfuller
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Postby bfuller » Jan 10, 2010 22:40

Some years back, I developed pain in my right shoulder and arm caused by the outstretched arm holding the mouse. I did two things that have both helped------i occassionally hold the mouse in my left hard to give the right a bit of a rest (bit hard to use, but still I can get work done), but the other thing was get an "L" shaped desk and sit in the corner. That way, my PC is in front of me, and both elbows are resting on the legs of the "L". Now the weight of my arms are on the desk, and not being held up in the extended position by my shoulder muscles. It took many months for the pain to subside, but is OK now.

Unfortunately, I have developed another problem, this time with my fingers and the tendons that go over the back of the hand and up into the forearm. This seems also to be caused by grasping the mouse, especially the new "wheel' mice where the middle finger is lifted up in an unnatural way. It was Ok until I aggravated it playing World of Warcraft for extended periods at night. I suspect a little bit of arthritis may be present due to the passing years as well. I have almost given online games up completely as a result. I have tried all sorts of ergonomic mice, trackballs, penpad input but they are just gimics and don't really help. I haven't found a cure for this problem yet, other than rest. I think my mind is benefiting from the rest as well, I know my family life is.
Sisophon2001
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Postby Sisophon2001 » Jan 12, 2010 16:10

I have a pinched nerve in my neck that causes the small fingers of both my hands to go numb if I stay in one position too long, like when driving a car for more than two hours or sleeping with a bad pillow. It was very bad at first, when my hands were going numb every night, but it got better while never going fully away.

I cope with it my doing the exercises my doctor recommended and by not staying in the same position too long. You can easily train yourself to keep moving even when you are sleeping, and stretch your neck and shoulders while driving. At work I am fortunate that I move around the office frequently, so it is less of an issue.

I am lucky to have avoided carpal tunnel syndrome, but my "mouse hand" has seized up more than once with piercing pain after a bout of day-long cutting and pasting in excel. I got rid of the pain each time by using a sling and working one handed for the weekend. Because of this I have learned to use the mouse with my left hand, and now always use my desktop computer at home left handed to vary my position.

I think you will learn to find your own ways to cope with the "change".

Garvan
Zippy
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Postby Zippy » Jan 12, 2010 17:49

[I'm posting my personal pathology partly as a response to Garvan]

I woke one morning in 2002 convinced I was having a heart attack (if you have these symptoms seek medical attention to preclude cardiac and pulmonary problems, first. No $%#@.). I had most of the symptoms, albeit on my right side (still can be cardiac with symptoms on the right side). I live in the boonies. I went through two medical doctors, a chiropractor (desperation), another medical doctor, physical therapy (BAD mistake, they didn't know what my problem was), and then finally a Pulmonary Specialist (!) who offered the correct diagnosis. 10 months of hell:

I have "radiculopathy". A pinched nerve(s) at the spine (mine cervical, something like sciatica but different part of the spine and.. different nerve bundles). I had somewhat random manifestations: shooting pain down my arm, tingling/numb/painful fingers (random, and random fingers), a "dead spot" in my back, and then after being mangled in PT I had fasciculations (muscle twitches) in my chest/back. Something hurt (badly) always, I could only get relief by lying supine with my upper body elevated (which should have been a MAJOR clue that it was my neck but was missed by 3 docs). Oddly I never had pain IN MY NECK (chiropractor told me it was my neck, he couldn’t fix me after 2 months, I discounted his diagnosis..).

In retrospect this was caused by bad ergonomics. I had been on an extended project away from home. I was working in a lab not designed for extended computer use, I was working after-hours in a motel room.. not designed for extended computer use.. I've had neck problems (unlike this) sporadically since age 40, surely caused by bad ergos. This "project" was the final straw.

The mainstream non-surgical "cures" for radiculopathy are:

1. Get in a position where it doesn't hurt, stay there/don't move until the nerves settle down, don't repeat the bad behavior.
2. Traction. Which I didn't try.

Adjunct: If your nerves are "lit up" like mine were after PT, something like Neurontin (Gabapentin) helps if you don't mind staggering around drunk-like for weeks..

@Sisophon2001

I have to avoid any work over my head (hands above shoulder level can be problematic). Painting eaves would paralyze me (but unfortunately not without pain). I can bring on numbness in my fingers by tilting my head, bracing to shave my neck (which is all I shave, and now that the hairs are freaking white I don't have to do that often).

I was reffered to, superficially, a "Physiatrist" but at the time there were none in the area. A Physiatrist is a medical doctor who specializes in rehabilitation (with sub-specialites, like "sports medicine") but doesn't do surgery. My ultimate resolution was/is to not do what causes the problem. I'll probably need surgery in the future.

My problem is unilateral, only my right side.

-----

I too alternate "mouse hands". I'm a mixed-lefty (which translates to partial ambidexterity) so this isn't a problem, wasn't a problem to learn. The mousewheel is the killer for me. I've learned to use the mouse "horizontally", crosswise in my hand, this varies what fingers I use on the crazy wheel (love that wheel).

Get away from the computer as often as possible - this is the best advice I've received.
bfuller
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Postby bfuller » Jan 12, 2010 23:03

I got rid of the pain each time by using a sling

Yes, this sling idea worked for me too, but I was too vain to use an actual sling so I used to walk around with my thumb hooked in my shirt front, between about 2nd and 3rd buttonhole, or alternatively hooked in my belt. This took the weight off the shoulder muscles and neck and allowed them to rest a bit.

The trouble with these problems is that they sneak up on you, over many years. A young acquaintance uses a computer a lot more than I do, but doesn't (yet) suffer any problems. I have warned him about posture, taking frequent breaks, stretching exercises etc but seems to be "in one ear, out the other". If the younger members of this forum want some free advice, it is to pay attention to the above posts, and avoid sitting in the one position for extended periods without a break as the human body just wasn't designed for it.
vdecampo
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Postby vdecampo » Jan 13, 2010 1:42

bfuller wrote:The trouble with these problems is that they sneak up on you, over many years. A young acquaintance uses a computer a lot more than I do, but doesn't (yet) suffer any problems. I have warned him about posture, taking frequent breaks, stretching exercises etc but seems to be "in one ear, out the other".


Unfortunately I was one of these youths that did not put much stock into the whole ergonomic wave. Now at 40 I wish I had been taking care of these things before having any sympoms. I used to be able to sit and code for 24hrs at a time. Now I am lucky to be able to sit at the keyboard for an hour before having to get up and shake off the pain in my wrist and arm.

I will be ordering a Gaiam Balance Ball Chair later this week. I hope that helps with my back issues.

-Vince
Zippy
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Postby Zippy » Jan 14, 2010 0:05

vdecampo wrote:<snip>
Now I am lucky to be able to sit at the keyboard for an hour before having to get up and shake off the pain in my wrist and arm.
<snip>

-Vince

If you continue to irritate the nerves associated with your carpal syndrome (cubital and/or wrist) then you WILL suffer permanent nerve damage. You WILL be pounding that keyboard with a (very painful) CLAW. I hope this gives you pause, Vince, do something about this NOW. Best wishes.

I know, who would have thought that a keyboard (et al) could cripple you. I didn't.
Richard
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Postby Richard » Jan 14, 2010 1:40

@Vince. There are a number of forms of RSI that are described as Carpal Tunnel Syndrome but that have quite different causes. To positively identify CTS you need confirmation by nerve velocity measurements. If nerve velocity is normal then investigate other things such as viral / chronic fatigue by a check of B12 level, low B12 effects nerve maintenance. Some autoimmune problems show as RSI. If you have any other neurological symptoms you should work quickly to identify the cause before damage accumulates, nerve recovery can take decades, if ever.
vdecampo
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Postby vdecampo » Jan 14, 2010 2:35

Richard wrote:If you have any other neurological symptoms you should work quickly to identify the cause before damage accumulates, nerve recovery can take decades, if ever.


I just have the arm and wrist pain, and short term memory loss. Could be worse though. I could have short term memory loss. :)

-Vince
Richard
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Postby Richard » Jan 14, 2010 4:23

Numbness or tingling in hands is a primary symptom of CTS. Pain in wrist is much more likely to be trauma or RSI. RSI comes not from activity but from health problems that prevent repair of accumulated injury due to activity, hence my suggestion of a B12 test etc.
P.S. I lost my short term memory so recently that I can almost remember losing it.
marcov
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Re: Carpal Tunnel and other related injuries

Postby marcov » Jan 14, 2010 10:43

vdecampo wrote:
I was curious to know if anyone else on this board suffers from carpal tunnel or similar injuries, and what measures (if any) you use to mitigate potential injury or alleviate problems with pain in the neck, back, and arm. Is there a special desk/chair setup that someone can recommend? What about mice or keyboards? I'm not a big fan of the split keyboard.


I've had problems but am not really diagnosed. I just have had periods with constant pain (specially after getting up, and late in the evening) or a strained feeling in my (upper) left arm and shoulder, and could even fan out to the left side of the rump (Doctor first thought it was the heart). When it was acute, I had wrist problems too, but that was more the satelite problem (I'm not really a mouse guy, and have always minimized mouse use)

A ergonomics advisor I consulted then at my previous job advised me

- to get a chair with adjustable arm-rests,
- adjust these so that you can sit straight up in the chair, and the arm rests are then about level with the table.
- increase the monitor in height so that you look straight at it, not a bit down.

I more or less followed his advise, and now the problems are gone if I use this working space setup. I sometimes still feel a kind of strained feeling when I'm several days working in some corner at a customer in non-optimal posture, but in general I'm fairly problem-free now. More or less the same as bfullers advise, something to rest arms on, and level monitor.

I also used the program workpace (that forces minibreaks) a lot, till the problems were gone, (the acute problem), but while my current job forces me to leave my desk more often, so I don't really need that anymore. If you use this kind of software, FOLLOW INSTRUCTIONS and don't try to minimize it, it really is the little breaks (preferably combined with minor stretching exercises) that help. As little as 1min/hr break already helped me.

Avoid working on laptops days at length without making amends (a decent keyboard, a laptop stand etc).

For back related problems I simply try to walk more (at least 10-20 minutes a day consecutively), and that helped.(was advise from my GP after I complained about constant minor lower backpain) I found out that biking doesn't help there (too much like sitting?). This is longer ago (10 years+), and I never had any serious back pain problem since. Stupidly simple, but hey, if it works?!?

Oh, and I gave up playing (M)Angband (which is like WoW, but then 15 years back :-)
ssjx
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Postby ssjx » Jan 14, 2010 19:09

Hi, i replaced my mouse with a Logitech Trackman Wheel a few years ago when i started to get concerned about RSI/CTS. It reduces wrist movement to nothing as your thumb does all the work. I would definitely recommend one.

I would not get one of the 'centre ball' track balls as they seem to require much more movement to use.

I also use an ergonomic keyboard (Trust Ergo Track, quite old now). I do not really know how beneficial they actually are, but I do think they are better due to the slightly extra height and the rest bit in front. I think the hand separation is better for typing than any real medical reason.

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