Sunday, September 11, 2005

Health risks for bloggers: carpal tunnel syndrome

For several weeks, I've been recovering from carpal tunnel syndrome. I should have seen it coming! At the office, I'm on the computer constantly. Each patient visit now requires clicking and typing to access progress notes, med lists, and labs. Each phone message is conveyed by e-mail. All prescriptions are done online now, and that's even more typing and clicking. I'm also writing notes as my patients are speaking. After a full day of this, I would go home and blog. And blog... (Only a fraction of my wrists' work escapes my editorial hatchet.)

But it wasn't just intensive mouse use that knocked me out of the game. It was incorrect mouse use. My set-up was all wrong. My keyboard was too high. My wrist was bent. And as for rest, what rest periods?

Still, I didn't notice symptoms until I hosted Grand Rounds in July. (That's a lot of linking!)

What does CTS feel like? Here's
Carpal tunnel syndrome typically starts gradually, with a vague aching in your wrist that can extend to your hand or forearm. Other common signs and symptoms include:

* Tingling or numbness in your fingers or hand, especially your thumb, index, middle or ring fingers, but not your little finger. This sensation often occurs while driving a vehicle or holding a phone or a newspaper, or upon awakening. Many people "shake out" their hands to relieve their symptoms.
* Pain radiating or extending from your wrist up your arm to your shoulder or down into your palm or fingers, especially after forceful or repetitive use. This usually occurs on the front (palm) side of your forearm.
* A sense of weakness in your hands, and a tendency to drop objects.
* A constant loss of feeling in some fingers. This can occur if the condition is advanced.
More here, here, and here. Here are some prevention tips. (And here's something that will make it worse. If you've ever hosted a carnival, you might feel some deja-vu here.) Many other activities can cause symptoms.

Thanks to all for the kind get-well wishes! My wrist is feeling much better now, and I think I can blog.

But I've had to change a few things. I'm dictating more at work. I've had an ergonomic evaluation of my office. My computer and keyboard have been repositioned, and I'm using a trackball mouse. I switch hands frequently when clicking. I try not to type for extended periods. And on the home front, I've declared a moratorium on knitting mittens, sketching faces from the pages of the New York Times, and painting portraits of my garden.

Is podcasting in my future? Hmmm...


Blogger Maurice Bernstein, M.D. said...

I am glad to hear you are in less discomfort. Wouldn't 100 percent voice activated text entry be the solution to the dilemma.. except, of course, your painting? Oh shucks.. I forgot.. chronic laryngitis.. another overuse disorder! ..Maurice.

7:40 PM  
Anonymous Tom Wigton said...

Glad you're back and doing better. I think voice recognition has to be future, otherwise we are in a heap of trouble.

10:59 AM  
Blogger Dr. Deborah Serani said...

I have those symptoms and have been thinking it is CT. I better begin taking care of it. So glad you are back and feeling better.


1:16 PM  
Blogger Rita Schwab - MSSPNexus said...

Welcome back - the blogosphere just wasn't the same without you!


6:23 PM  
Anonymous Anonymous said...

Carpal Tunnel Syndrome prevention methods are to be taken in consideration by every company, so do the companies are considering such prevention methods to prevent their employees from Carpal Tunnel Syndrome. According to a major survey, 84% have reported that they were modifying their equipments, their tasks and their process, 79% reported that they were buying new equipments and 83% have reported that they were analyzing their workstations and jobs.

There exists no single way of prevention method for Carpal Tunnel Syndrome. The ergonomic methods can help to minimize the risk of work associated Carpal Tunnal Syndrome or other cumulative trauma disorders. There are some other prevention methods like adjusting your workplace or work in such a way the it puts less stress on hands and wrist. Even the exercises those strengthen the fingers, wrists, forearms, hands, shoulders and the neck can help to prevent Carpal Tunnel Syndrome. However there is no evidence that doing the above mentioned things can provide complete prevention from Carpal Tunnal Syndrome.

Carpal Tunnel Syndrome can be prevented using the study of ergonomics, which is the study and control of stress, motion, posture etc., The repetitive activities of a person that causes inflammation in the wrist and hand can be prevented by simply altering the way he performs them. For example going for an ergonomic chair can let a person to sit in neutral posture.

Taking short breaks can also prevent Carpal Tunnal syndrome. A person does repetitive tasks should go for short warm-up period, take frequent break periods and there by avoiding over effort on the finger muscles and hand.

The key cause of Carpal Tunnal Syndrome is posture so utmost care is to be taken to have perfect neutral posture especially for those who are in typing jobs and computer jobs. A keyboard user should sit in such a way that the spine should be against the back of the chair, the shoulders should be relaxed, the elbows should be along the sides of the body, the wrists should be straight and the feet be firmly placed on the floor or on a footrest. The keyboard should be placed within the eye level, so that the neck does not bend over the work. This will help to keep the neck flexible and head remains upright, which maintains circulation and nerve function to the arms and hands. If the office furniture is not ergonomic then it may lead to improper posture, which ultimately lead to Carpal Tunnal Syndrome.

Another key cause of Carpal Tunnel Syndrome is Forceful usage of fingers and hands. The extra force exerted on the fingers, hands and wrist can lead to repetitive tasks which ultimately leads to Carpal Tunnal Syndrome. The tools and tasks should be designed in such a way that the wrist position is same as that when they are in relaxed position will avoid the risk of Carpal Tunnel Syndrome. There should be no task such that the wrist for long periods stay deviated from side to side or to remain flexed or highly extended.

For more information about carpal tunnel exercises can be found at :

11:03 AM  

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