Carpal Tunnel.
Anatomy of the wrist. Firstly let us understand the anatomy of the wrist, as that is where changes, that cause carpal tunnel syndrome, take place.
The bony structure of the palm consists of eight small bones called the carpal bones attached to each other by joints, to facilitate the various movements of the wrist. On the palm side, running across the width of the wrist is a strong band of tissue which forms a tendon, and this is attached on either side to the carpal bones.
So, we have a tunnel formed by the carpal bones below and on either side, and the tendon situated above. This is called the carpal tunnel.
Passing through this tunnel are ligaments and the nerve called the median nerve. There is very little room and these ligaments and nerve fit tightly inside the tunnel.
Carpal Tunnel Syndrome.
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Our other posts on Computer and Health.
1) Basic Info. 2) Eye Strain. 3) Cervical spondolysis 4) Carpal tunnel syndrome. 5)Low back pain. 6) Mental stress. 7) Radiation.
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What is Carpal Tunnel Syndrome. If for some reason, the ligament or the tendons get inflamed or edematous and swollen, they then press on the nerve and it gets compressed. This results in various symptoms of carpal tunnel syndrome.
Picture of wrist anatomy.
Carpal Tunnel Syndrome and Computer Use.
Debate : There are two schools of thought on whether prolonged and regular use of computers can predispose to getting carpal tunnel syndrome. There is a debate and results of studies conducted are contrary to each other. The general feeling and belief does indicate that prolonged and regular use of computer does have an adverse effect on the wrist which can predispose to carpal tunnel syndrome.
> The American Medical Association does not agree that the continuous usage of computer can give rise to carpal tunnel syndrome.
> Harvard, too, conducted a study and tends to agree that carpal tunnel syndrome is due to other underlying causes.
Carpal Tunnel Syndrome Causes.
These include
- rheumatoid arthritis,
- diabetes,
- menopause,
- pregnancy,
- obesity,
- occupational reasons for undue pressure on the wrist.
- hypothyroidism,
- acromegaly,
The last two are endocrinal disorders and the result of deficient or excessive functioning of the respective endocrinal glands.
How Computer Use Causes of Carpal Tunnel Syndrome.
As per the school of thought that advocates computer as one of the causes of CTS and considering that to be true , the causes are as follows:–
Repeated keystrokes and long periods of clutching the mouse tightly, cause strain to the concerned muscles, tendons and the ligament.
This damage gets on accumulating over the period and causes inflammation and swelling of the affected tendons, ligaments and muscles, resulting in compression of the nerve .
This compression of the nerve gives rise to symptoms of carpal tunnel syndrome.
Symptoms of Carpal Tunnel Syndrome.
- Stiffness, soreness and a burning sensation in the affected hand, wrist, fingers and the forearm.
- Tingling and numbness in the hand particularly in the area which is supplied by the median nerve. These include the thumb, the index finger, the middle finger and part of the fourth finger.
- Loss of strength in the affected hand leading to inability to grip objects.
- Pain may be felt in the forearm.
- Referred pain in the shoulder.
Tips to Prevent Carpal Tunnel Syndrome from computer use.
- Monitor should be at eye level
- The chair and the keyboard should be so placed that the forearms and the thighs should be parallel and the wrists are at level with the forearm ( as shown in the picture below) and not laterally bent.
Diagram showing the Correct Sitting posture
- Hold the mouse lightly. Do not grip it tightly. It’s not that type of a mouse that is going to run away. Handle it gently so that the pressure on the wrists stays relaxed.
- Try getting used to operating the mouse alternately with both the hands. This will give intervals of relaxation to the wrists .
- Exercise wrist regularly by rotating it clockwise and then anti clockwise.
Diagnosis of Carpal Tunnel Syndrome.
- Signs and symptoms which suggest carpal tunnel syndrome are very indicative of this disorder.
- An abnormal nerve conduction test strongly suggests CTS. In this test, the speed of the electrical impulse is measured as it passes down the nerve. In CTS, there is slowing of the impulse in the carpal tunnel.
- Blood tests are also performed to determine if there are associated medical conditions which are mentioned in causes of carpal tunnel syndrome.
Treatment of Carpal Tunnel Syndrome.
Treatment of carpal tunnel syndrome consists of treating the symptoms and removing the cause.
- Non steroidal anti inflammatory pain killers.
- Rest to the part,
- Using a splint to immobilize the wrist in order to prevent any more aggravation,
- Application of occasional ice packs to reduce the inflammation,
- Pyridoxine or vitamin B6 gives relief of symptoms,
- In more severe cases, oral steroids may have to be given. At times it may become necessary to inject steroids directly into the wrist to reduce the inflammation.
- Surgery for Carpal Tunnel Syndrome. Most cases recover with conservative treatment. In chronic cases, there is a risk of muscle wasting and continuous weakness and numbness. Surgery may then become necessary and it consists of relieving the pressure on the nerve by severing the carpal tendon. Exercise rehabilitation is also advised after the surgery. This procedure is called carpal tunnel release. Rarely symptoms may recur.
- Any underlying cause of carpal tunnel syndrome, which are mentioned above under causes of carpal tunnel syndrome are also accordingly treated.
- Any occupational reason for carpal tunnel syndrome is corrected by modifications in the working style. For example, if you operate the computer for prolonged periods, you could follow the modifications mentioned above.
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