If your job requires you to spend long hours working at a computer, chances are you’ve probably experienced a piercing pain shooting up and down your wrist. The pain, though seemingly harmless, could be a precursor to a painful condition known as carpal tunnel syndrome (CTS). While most of us tend to ignore the pain, CTS can have serious consequences if left untreated.
What exactly is CTS you ask? Carpal tunnel is a narrow passage formed by the bones of your wrist and a ligament where the palm and forearm meet. The root of two tunnel is formed by a thick ligament and several tendons. Your median nerve in your forearm passes through this tunnel. The carpal tunnel protects your median nerve as it runs from your forearm into your hand. Although with controlling some movement of your thumb the median nerve is responsible for the sensation of touch in your thumb, index, middle and half of your ring finger. The pain in your wrist after long hours of typing is caused by an inflammation or swelling of the tendons in the carpal tunnel. Ignoring the pain exacerbates the pressure on the median nerve and eventually leads to CTS. “Clinical diagnosis is mainly with pain, decreased or loss of sensation typically in the thumb, index, middle fingers and part of ring finger with no pain and a good sensation over little finger,” explains R.N. Premkumar, Orthopaedic specialist in Chennai.
Who is at Risk?
“While anyone can get CTS, people working on keyboard, typewriter or vibration hand tools are more prone to it. It can also develop in association with pregnancy and some medical disorders. I see approximately 10-15 cases of CTS every month,” observes Anurag Awasthi, Orthopaedic Surgeon in Gurgaon. According to the National Institute of Neurological Disorders and Stroke, women are three times more likely than men to be diagnosed with CTS, regardless of their age and whether they work on computer or not.
Is it a work myth?
CTS is for real. But, does typing or using a computer for long hours really put you at a risk? The theory has been dismissed quite a few times. Dr. Awasthi says, “Typing is not the only cause of CTS. Applying too much pressure while typing is definitely one of the reasons for triggering this.”
CTS can be avoided at an early stage. You can prevent the condition from deteriorating while working on computers or keyboards. The wrist should be placed properly on the table and not at the edge. Wrist movement should be done at regular intervals. Take frequent breaks while working, giving your wrist a chance to relax. You can also practice wrist exercises to prevent CTS.
“I developed what my doctors called trigger fingers a few years ago. Symptoms came, stayed for a while and sometimes disappeared as quickly as they developed. Sometime the pressure began to make typing rather uncomfortable,” recalls Vishnuram, manager with a private firm. His wife suggested he make an appointment with an orthopaedic specialist.
He was diagnosed with the CTS in a beginning stage and was advised to wear a wrist splint and given vitamin B supplements along with exercises and was cured relatively fast.
Identifying CTS
Phalen’s Sign Test Hold your arms out in front of you and then flex your wrists, letting your hands hang down for about 60 seconds. If you feel a tingling numbness or pain in your fingers during these 60 seconds, you may have CTS.
Tinel Test The doctor will tap or press on the median nerve in your wrist. If you feel a tingling in your fingers or feel something like an electric shock, you may have CTS.
If you are diagnosed with it, you will have to undergo physiotherapy which will include gliding exercises like moving your fingers in a specified pattern of exercises which may help your tendons and nerves glide more smoothly through your carpal tunnel. Ultrasound directed at the carpal tunnel helps reduce pain and numbness, and also improves hand strength. Splints that immobilise the wrist in a neutral (unbent) position are most likely to relieve discomfort.
The carpal tunnel is the widest in an unbent wrist. So, a splint to keep your wrist in this position reduces pressure on the median nerve, relieving your symptoms. The sooner you start treatment, the better your chance of stopping symptoms and preventing long term damage to the nerve. Surgery is an option only if the symptoms persist and treatment does not work.
