So who else in the online world is dealing with Repetive Stress (or Motion,
if you like) problems?  I Have been staving off tendonitis and/or carpal
tunnel syndrome for a while now, mainly by constant tweaking of workstation
setup and occasionally changing mouse hands, and so on.  Having a background
as a musician helps, since I was already familiar with the symptoms before
most people were.

77 responses total.

i have some  problems witrh that with my fibromyalgia and the fact that i
gripped a frozen door lhandle and pulled  my wrist  a good one..if I write
too much my arm and wrist aches but it seems typing isn't as bad.
i don't use somethig to rest my wrist on though I don't care for it.  Of
course I rest between sentances  when I type.

I think I'm showing beginning signs, though I have not gotten a diagnosis.
In what part of the wrist does it start (how do you describe a wrist??)?
I also got serious tendonitis of the feet from highland and scottish-country
quite some time ago. I've just had to learn to live with it. I went
through some studies, and got special shoe inserts, foot exercises, etc.,
but nothing really made it possible to dance again. 

I knew we'd get here sooner or later. How familiar are we with the anatomy
around here? The carpal tunnel is the narrow spot at the base of the hand
through which pass many/most of the nerves and tendons that control manual
function. (Most of us have a few deep lines/wrinkles there, just for
reference.) There is a "band" around this bundle of goodies, near the carpus.
(The wrist bone that you can see when looking at the back of your hand.)

When a tendon gets irritated and swells (repetitive motion syndrome is the
current "biggie") it crowds things within the carpal tunnel, causing pain and
numbness, usually in the fingers.

>>>How am I doing, nurses?<<<

If correction can't be made through rest, physical therapy, steroid
injection, and/or behaviour modification, (the list goes on and on) the
solution is usually surgery. The "band" is cut to relieve the pressure on
the nerves. Sweet and simple, usually on an out-patient basis, and most
folks are up and functioning in about a week.

Hope this basic info helps. Feel free, everyone, to add to or correct what
I've posted here; it's been a while since my personal experience with the CTS
merry-go-'round. (3 operations, 6 years of physical/occupational therapy,
countless casts and splints, more nerve conduction studies than I want to
think about, and I *still* have a fairly useless hand with two numb fingers.
Bonus: I have NEVER HAD CTS!!!)

Have a nice day. <insert emoticon for dripping sarcasm here>
Testy, ain't she!

Let's have some definitions: the "back" of the wrist is posterior,
and the palm-side is anterior. Does one feel CTS on the anterior or
posterior side of the wrist? (Mine is anterior.)

anterior, clustered around the part of the wrist right by the hand. 
Tendonitis tends to be spread over the area further back along the arm, and
I describe it as a sensation where you can actually feel that you have tendons
in there.

Which I hope you do....OK. I have CTS. What do I do to treat it, besides
keeping away from a keyboard?

What otter said, hopefullly not that far.  First thing is to make sure that
your keyboard is in a good position, which helps a great deal.  Bascially,
you should be able to type with straight wrists.  One of those new fangled
"ergonomic" keyboards that are split into two sections (like the Microsoft
Natural Keyboard) can help, but all this stuff is just tweaks.  If you use
a mouse a lot and than hand is worse, try switching mouse hands.  Wrist rests
are popular, but don't (in my opinion) do much, since you are much better
supporting your arms than your wrists.

Part of the "good keyboard position" is often setting things up so that the
keyboard is lower than before... a standard 30" desk height is too high for
most people.  An extension about 4-5 inches lower can help a lot.

Actually, CTS is felt in the hand/fingers.  The nerve to the skin
overlying the carpal tunnel (over the flexor retinaculum, to be precise)
in most people comes off the median nerve in the forearm.  In a few
people, it travels with the nerve through the carpal tunnel and swings
around the other side.  Keeping the wrist straight helps to maximize the
volume of the carpal tunnel, and thus reduce the pressure on its
structures.  That is how carpal tunnel braces work.  They should
especially be used at night to keep your wrist from flopping around in
your sleep.

So what am I feeling right around the wrist joint then...a different variety
of tendonitis than I am familiar with?

There are many things which can mimic carpal tunnel, and its counterpart in
the foot - tarsal tunnel.  Once irritated (compressed) you can feel symptoms
anywhere along the involved nerve(s), correctly stated as median nerve (most
commonly involved in CTS).  Even high blood pressure can be a factor, since
vessels enter the hand along with the nerve, and a bulging vessel can compress
the nerve in the cramped canal.

Conservative treatments include lowering your keyboard, changing the heights
of your seat and making sure you keep your hands/wrists/arms as straight as
possible.  Spints work well for minor cases, and you can do isometric
exercises to gain muscle strength and flexibility around your wrist, reducing
some of the stress in the carpal tunnel.  Some people have said ice massage
of the area works for them, while others prefer moist heat.  Vitamin B12 and
B6 have also been helpful for some.

There are other related anatomic structures in the area which can also become
inflammed with repetative motion or even minor trauma.  The joints can swell
up and you can get arthritis, or synovitis.  You can get synovitis of the
tendon sheath(s) as well (tenosynovitis).  There could also be (much more
rarely) a variety of benign or malignant bone tumors.  If asprin takes away
the pain you might want to have an x-ray to rule out osteoid osteoma...but,
again, these are far less common than neuritis, arthritis or tenosynovitis.
You might even see some swelling in the area which could be a ganglion cyst,
sometimes called a "bible cyst" (anybody know why?).  These, too, are benign
and may even resolve on their own.  May need to be aspirated (with a needle)
or removed if they remain a problem.

Re: 11 (I do :-)

Re: 10  I would guess (based only on anecdotal reasoning) that the pain
was caused by direct irritation of your wrist, by mashing it against your
tabletop.  At least, that is the cause of the pain for me.  A
foam wrist rest did me a world of good.

Along with proper positioning of the wrists and such, remember to take regular
breaks from keyboarding to do something else for a few minutes. Two different
OT's have recommended resting your hands on top of your head, but I'm not sure
of the reason.

Beats me, but I just tried it, and it seems to put the wrists in the
proper position.  As well as stop the wrist and fingers from moving...

This response has been erased.

Re: 15:  Yes you are.  :(

resting your hands on the top of your head does flex your wrists and takes
pressure off the carpal tunnel.  You can do the same thing by just folding
your hands in front of you and interlocking your fingers.  That way, you don't
have gravity pressing the top of your head into your carpal tunnel  ;)

i use a brace like wrap on my wrist whenit gets bad..it sort of rests it ina
flexed position....

I"ve come to the conclusion that the right hand is forced to do twice as much
as the left hand in computer work.  The mouse, the arrow keys, and all the
important punctuation are on the right hand.  I've moved to left-handed
mousing (now doing it right-handed feels strange!), but where can I get a left
handed keyboard?  I think I need to take some load off my right hand.

left handed mousing is a good idea.
has anyone used that ergosomthing or other keyboardthat has the pads out at
the sides

Turn the keyboard over (left to right), and type upwards. This will both
give you a left-handed keynboard, but also confuse the hell out of your
carpel tunnel and it won't give you any more trouble.

I do have a keyboard with lots of extra reprogrammable keys, so I'm going to
set it up for some left-hand arrow keys and see how well that works.  There
are also those extra number keypad kyboards you can buy, and maybe one of
those can be a left-hand extension.

It's really striking me as strange how much functionality is reserved for the
right hand on keyboards.  As I type this response, my left hand is all the
way to the left of the keyboard while the right is actually a little left of
center!

Finally!! Someone else noticed! I've been hollering for a left-handed numeric
keypad for years, just because I am better co-ordinated on that side for small
motor stuff. If you find a good source, scott, do let us know. . .
>>>Good one, rane!

So far it's been pretty dry trying to find a number keypad.  I've found ones
in catalogs that use a serial port and custom software, but that's a last
resort.

Of course, with a Mac you could simply plug a stand-alone numeric keypad
into the left side of your keyboard, instead of the right... <zook smirks>

yeahm but mc's are evil!!!  :)

Except that we use PC's at work.  :/

I've juggled my keyboards around to put my split "ergonomic" keyboard on my
DOS/Windows machine, which I'm now using much more than my UNIX machine the
keyboard started from.  I also bought a different pointing device (a little
touch pad thingy for a mouse).

I'm also going to stop keeping up with Agora, and probably stop weight
lifting.   :(

At least until this clears up, which it will, based on past RSI-job problems.
A couple weeks if I'm careful.

you do know that there are left-handed mice?  i have seen them...

Well, after a week my tendonitis is much better.  I don't need to limit my
work typing, although I'm still not doing much on Grex and haven't gotten back
to any musical instruments yet.  :)

I've been having some wrist pain lately, sometimes just in the bottom of my
wrist, and sometimes extending along the bottom of my arm all the way from
my wrist to my elbow.  No tingling fingers yet, or anything.  This seems to
happen after about ten hours at the keyboard, which unfortunately is
considerably less than what I usually do per day.  It's really starting to
get in the way.  Maybe I should cut back on my computer use, but I've tried
doing that before and I don't have the discipline for that.

Sounds like tendonitis.  You can probably do a lot to fix up your
workstation(s), but ten hours a day might also be a bit of a limitation in
itself.

Make sure your workstation is ergonomically designed, and take frequent
stretch breaks.  Not just time out for coffee/etc, but a regular series of
stretching exercises which you can do right in your chair.  There are even
some software programs which will now interrupt you at pre-set intervals and
walk you through an exercise program.  That should go a long way to keeping
you in shape and pain free.

One of the ergonomic details you might want to look into are wrist supports
which you wear to slightly immobilize your wrists.  I've heard they can help
quite a lot.

wrist supports are great scg.  if you need a catelog, my husband dave is a
rehab counselor, and has that sort os info as part of his job.  what about
curved keyboards?

Elizabeth, can your husband get me a catalog?  I am looking to replace my
wrist thingy...I only use it when my wrist starts to hurt and then continue
with it for a couple of weeks.  It has kept me from having to have the
surgery, but is getting rather worn out.  TIA for any help.

Trivium, FWIW: there isn't *a* carpus bone, in the wrist, but rather
8 metacarpal bones through which this tunnel passes on its way toward
however many carpal bones are in the hand.  I once, for at least a few
weeks, knew their names.

Quite contrar' grace.  The arm ends at the wrist.  There _are_ several carpal
bones there (collectively called carpus), and they articulate with the bases
of the five metacarpals, which in turn articulate with the phalanges.  I won't
bother you all with the details of all the individual
bone/joint/ligament/tendon/nerve/etc names...if you have questions, mail me.

Is that http://bone/joint/ligament/tendon/nerve/etc  ?

heh...try it    8=]

My employer has agreed to split the cost of an ergonomic keyboard and any
other special equipment I want to use to make typing more comfortable. Does
anyone know of a source for a condom for this type of board? I haven't been
able to find one, and it is *absolutely* necessary in that environment.

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