Protect your wrists from typing

Learn to identify the signs of carpal tunnel syndrome

By Jane Doucet

As director of client services for the Arthritis Society Nova Scotia division, Joanne Bernard spends between six and eight hours a day on her computer. In 2002, she began experiencing pain in her right wrist — her mouse-clicking hand — but after visiting her doctor, it subsided.

A few months later, the pain returned. “It starts in between my thumb and index finger, radiates down through my palm and through my wrist and sometimes travels up to my elbow,” says Bernard. “At night my hand goes numb and tingles.” Bernard was diagnosed with carpal tunnel syndrome caused by extensive computer use.

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a repetitive stress disorder in which the median nerve — the one that travels down the arm and into the hand — in one or both wrists becomes compressed. The median nerve passes through a “tunnel” of fibrous tissue on one side of the wrist; on the other side is the “carpal,” a set of bones that sit on top of the hand.

What are the symptoms?

Symptoms include pain, tingling, numbness or weakness in the fingers, thumb, wrist, hand and arm. CTS can affect one or both hands, although it’s more common for it to show up in your mousing hand, where you’re constantly arching the wrist and exerting pressure on its ligaments. CTS can also afflict children and teenagers who spend time on the computer or play video games, but it’s not as common.

Can CTS be treated?

“The goal of treating CTS is to relieve pain, restore normal sensation and prevent the condition from worsening,” says Maureen McLaughlin, a spokesperson for The Arthritis Society. If the pain starts disrupting your sleep or your quality of life — for example, if it hurts to lift your toddler or use the computer — you should visit your family doctor.

“If we can fix the problems causing the injury, it doesn’t have to be chronic,” says Rosemary Mooney, an occupational therapist at Nova Scotia’s Capital District Health Authority. “And the earlier we get it, the better.”

What are the treatment options?

After her CTS patients describe their workstation setups, Mooney recommends raising or lowering chair heights or keyboard trays to improve posture and demonstrates how to stretch the neck, hands and wrists. At night patients can wear a resting splint which encases the wrist, hand and fingers, and holds the wrist in a neutral position. During the day, a working splint will stabilize the wrist, but allow the fingers to move freely.

Splints are available at pharmacies for $30 to $40 but they’re one size fits all, says Mooney. The occupational therapist treating you for CTS can size one specifically for your wrist. The cost is covered by provincial health insurance.

In addition to occupational therapists and physical therapists, chiropractors may be able to offer some relief. Yoga has been known to improve strength and reduce pain. And as a last resort, surgery can widen the space inside the carpal tunnel.

Are children affected by CTS?

Parents should monitor and limit their kids’ computer time, encourage exercise to heal tissue damage and ensure that their computer stations are adjusted properly for their height.

“Children should be encouraged to change posture often,” says Margo Fraser, executive director of the Association of Canadian Ergonomists. “Changing positions every 10 to 20 minutes is great.”

For more details about children and computer stations, check out Ergonomics for Children & Educational Environments.

How can I prevent CTS?

Get active. “The more fit you are, the more resistant you may be to this type of injury,” says Mooney. “It helps if you have good overall muscle tone and posture so you sit up straight in your computer chair.” Any exercise that makes you more fit is beneficial, such as running, weight training, yoga, Pilates or tai chi, she says.

Redesign your setup. “Ergonomic keyboards are good for proficient typists,” explains Mooney, “but they may not help someone who types more slowly.” A gel wrist pad can help prevent the wrist from dropping down and compressing the median nerve. Computer specialists can provide more information about these products.

Take a break. To give your wrists and muscles a rest, it’s important to take frequent computer breaks. Mooney advises taking a five-minute stretching break every 15 minutes, preferably away from the computer. If you can’t get away, stretching at the computer is still beneficial.

What else can I do?

Bernard is hoping various treatments will ease her pain. “Don’t wait to see a doctor,” she warns computer users who experience even slight wrist pain. “I didn’t realize the pain could come back and be even worse.” Bernard is waiting to be fitted by a specialist for a splint.

In the meantime, she finds the heat from soaking her hands in warm water in the morning and at night provides relief. At work she has a gel mouse pad and an ergonomic chair, has lowered her keyboard tray to level out her wrist and is taking more frequent breaks away from her computer, at least once every hour for several minutes.