Carpal Tunnel and Computer Work
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Clear Lake Chiropractor Comments: Approximately 2/3rds of employees from industrialized countries use a computer on a daily basis and one of five spend at least 75% of their total work time behind a computer. It’s no wonder so many suffer from neck, shoulder, arm pain, including carpal tunnel syndrome (CTS). There are many reasons for the presence of CTS in office workers who utilize a computer. The following is a partial list of causes:
- The computer screen is not positioned correctly in front of the worker forcing the neck to be rotated to the side or the head has to look up or down too far.
- The mouse and/or keyboard is placed on top of a counter, too high to operate without significant bending of the wrist, often against the sharp edge of the counter.
- The shape of the keyboard is flat, forcing the hands and wrists to pronate (roll inwards) too far. This places more pressure on the nerves in the forearms.
- The use of a mouse usually requires the entire arm to move, frequently running off the mouse pad requiring repositioning.
- Paper work data that needs to be entered in the computer is placed too far off to the side and sustained neck rotation is required during the data entering process.
- The chair and computer desk do not fit the person’s height (either too high or too low) and/or the feet don’t touch the floor.
- There is too much glare from windows or overhead lighting making it difficult to see the screen.
- In the aging worker, poor eye sight requires the use of magnifiers which can be quite distorting when the head is moved, even a small amount.
- There are often other medical conditions that the computer operator may have that increase the likelihood of developing CTS such as obesity, hormone replacement therapy, diabetes mellitus, hypothyroid, the use of birth control pills, and others.
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Therefore, the treatment of CTS must be multi-factorial and sometimes address one or more additional health issues that may co-exist. There are also frequently, many similar overuse types of conditions present in addition to CTS such as neck strain, thoracic outlet syndrome, nerve compression at one or more locations such as the neck, shoulder, elbow, forearm as well as at the carpal tunnel of the wrist. Each patient’s case is unique and a careful history is usually needed to uncover these potential contributing conditions so they can all be properly managed in addition to CTS. Because we spend a lot of our daytime hours at work, a careful work related history is important to identify potential “ergonomic” (design) culprits that can be fixed with simple workstation adjustments. These may include mouse/keyboard placement to an under the desk pull out tray to eliminate the need to overly bend the wrists and eliminate the pressure from the counter top edge. Raising a chair and placing a box under the feet while sitting (for shorter workers), switching to a track ball mouse so only thumb movement is needed to move the pointer (or a touchpad as found on most laptops), an ergonomic keyboard (curved, not flat), moving the screen in front and slightly down from eye level, prop paperwork on a stand-up tray close to the screen so only eye movement is needed, wearing appropriate quality eye glasses possibly with bi- or trifocals, are some potential work station remedies. Treatment that addresses all the contributing issues frequently includes neck, mid-back, shoulder, elbow, forearm, and wrist/hand. Chiropractic care is especially well suited to address these issues because of the whole body treatment approach utilized. We are also well trained in evaluating the work related and will work with your employer to cooperatively improve problems that may be perpetuating the condition. If you or a loved one is suffering with carpal tunnel syndrome, sharing this information may be one of most significant acts of kindness that you can give to those that you care about.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with your houston chiropractor by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Suffering from CTS? Prompt Treatment is Best!
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Houston Chiropractor Comments: Many people suffer from CTS (Carpal Tunnel Syndrome) and unfortunately, often ignore the initial symptoms of numbness or tingling in the hand(s). These early symptoms are typically not too alarming and hence, they often do not raise the level of concern until more intense symptoms occur; such as waking up from sleep due to numbness, dropping items, difficulty buttoning clothing, needing to switch hands when driving, difficulty writing, typing, knitting, as well as work related pain. There may also be fear of job loss associated with CTS, especially in these hard economic times with frequent lay offs, prompting CTS sufferers to postpone initial care. Unfortunately, delaying treatment is associated with a longer recovery time when compared to prompt management which usually results in a quicker, less complicated and more satisfying recovery.
There are many causes and contributing factors of CTS. The most prevalent cause is mechanical irritation from simply moving the hands too fast for too long, without enough rest. Another risk factor is age (over 50 years old). In this era of an aging workforce, this may be a significant issue. Fast, repetitive movements of the arms and hands are often a direct cause and can be appreciated by watching someone knit rapidly and/or performing line work using fast, repetitive movements. If the hands/wrists have to bend in awkward positions to accomplish a work task, or if a tool that is frequently used places pressure in the palm of the hand, these can also contribute to the onset or perpetuation of CTS. Other conditions can also contribute to CTS including inflammatory arthritis like rheumatoid, diabetes, pregnancy, the use of birth control pills, obesity and hypothyroidism.
The management of CTS is case specific, and is dependant on which of the above mentioned causes or contributors are present. Management of any metabolic disorder such as diabetes or hypothyroid is important, especially compliance with taking appropriate medication, when indicated. The management of weight, hormone replacement therapy, and fluid retention all play a roll in CTS management. Ergonomic or job-related management strategies are very important and can include work station modifications so that unnecessary awkward arm/wrist/hand positions can be avoided. This may require moving the item being worked on to a less stressful position, using a different type of tool handle (screw driver, etc.), changing the height or reach distance at which the material is worked on, and taking “mini-breaks” every ½ to 1 hour when the lack of rest is a contributor. Frequently, the combination of pinching a phone between the head and shoulder, typing data into a computer where the monitor is positioned too high or off to one side, and excessive arm motions using a computer mouse can contribute to pinching the nerve in the neck and/or arm, resulting in CTS. Remedies for this situation include the use of a head set, repositioning the computer monitor so that it is in front of the worker, and using a trackball type of mouse to eliminate arm motion can be extremely helpful. Treatment strategies offered by chiropractors include the use of night splinting to avoid awkward wrist/hand positions during sleep. In addition, manual therapy to the wrist and the tight muscles in the front of the forearm, as well as other nerve constriction areas such as the elbow, shoulder, and neck, manipulation of the joints in hand, wrist, elbow, shoulder, and/or neck, depending on what is unique and needed for that patient, and the use of physiological therapeutics such as low level laser light therapy, electrical stimulation, and/or ultrasound have all been shown to offer beneficial effects. Nutritional recommendations include Vitamin B6 (150mg/day), magnesium, calcium, Co-Q10, omega 3 fatty acids and vitamin D3. Reducing glutens (wheat, oats, barley, and rye) is also very important due to the inflammatory response of these foods. Surgery is typically, the last treatment resort and is appropriate, “when all else fails.” We welcome you to our clinic and are proud to offer you a non-drug, non-surgical solution for CTS and its disabling symptoms.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
