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Carpal Tunnel Syndrome or Repetitive Stress?
|Carpal Tunnel Syndrome or Repetitive Stress?|
|Relative rest will give overused muscles and tendons a chance to heal. What's next is to pay attention to your posture and do exercises designed to strengthen your shoulder
girdle, forearm, and wrist.
To restore good posture, let your shoulder girdles rest on your rib cage. Your shoulders tend to ride upward during the course of a workday. Gently remind yourself to let go
of these tight neck and upper back muscles, allowing the shoulders to assume a neutral position and rest on the upper rib cage.
Shoulder shrugs are a useful isometric exercise that will help relieve painful trigger points. Sitting comfortably, lift both shoulders as high as they can go. Not forcing
anything, just lifting. Hold at the highest position for a moment, then relax, gently returning the shoulders to a neutral position. Repeat three times.
By the time you're ready to "go live" you've begun to notice a dull ache in your wrist (the one that does most of the mouse-ing). There's an annoying tingling sensation in your thumb and the tendons in your forearm hurt whenever you move your fingers.
"Oh, no," you think. "I've got carpal tunnel syndrome."
However, the news is probably not as bad as that. It's much more likely you've developed repetitive stress syndrome, which can be effectively treated by a chiropractor.
Repetitive stress syndrome is often misdiagnosed as carpal tunnel syndrome by family physicians, internists, and even many orthopedists. The doctor thinks, "wrist pain and thumb pain, must be carpal tunnel". This path of least resistance leads to much unnecessary neurologic testing, needless medication, and unwarranted surgeries.
Real carpal tunnel syndrome (CTS) is actually uncommon, usually associated with pregnancy, rheumatoid arthritis, or decreased thyroid activity.1,2 Also, pain is more noticeable at night, rather than during activity. Finally, a quick test for CTS is to place the tips of your thumb and index finger together, forming a circle. Hold the circle closed while another person tries to pry your fingers apart. If your fingers are strong and can keep the circle closed, you probably don't have CTS.
The wrist, tendon, and forearm pain most of us experience after too much time at the computer is due to repetitive stress syndrome (RSS) - basically, too much of the same activity repeated frequently over too long a time. These new pains can be very uncomfortable and cause significant limitation and frustration.
The primary solution is rest and avoidance of the irritating activities. In practice, rest can mean relative rest.3 One key approach for computer-related repetitive stress is to begin using the opposite hand to do mouse or trackpad activities. This may take a while, but it's a highly effective method. And, once your non-dominant hand gets up to speed, you've got two hands that are smart, not only one!
What about chiropractic treatment? Several trouble spots may contribute to RSS, particularly tight shoulder and neck muscles. Your chiropractor will do a complete physical examination and determine the sources of the problem.
Treatment may include gentle chiropractic manipulation to improve the mobility of your neck and remove stress from that area of your spine. Trigger point therapy will relieve pain and relax tight muscular "knots" in your shoulder girdle and forearm.
Treatment combined with relative rest and rehabilitative exercises will likely result in rapid improvement - decreased pain, greater mobility, and a renewed focus on the work you want to get done, rather than the pain that is getting in your way!
1Source: National Institute of Neurological Disorders and Stroke - http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm.
2Piazzini DB, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil 21(4):299-314, 2007.
3Akuthota V, et al. Shoulder and elbow overuse injuries in sports. Arch Med Phys Rehabil 85(3 Suppl 1):S52-58, 2004.
We wish you the greatest blessings.
Dr. Eric Zeiszler