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Is Carpal Tunnel Syndrome A Hoax?
ZaMoose writes: "It seems as if all of the hoopla re: repetitive stress injury (RSI) in the high-tech sector might just be group hysteria. Canadian officials are quoted in the
following article as saying that many RSI cases have mysteriously 'gone away.'" Hard to deny that extended typing sessions can have painful after-effects, but at issue here is how serious (and permanent) those effects can be. I know plenty of painful typists complete with wrist guards and wincing who probably won't agree that their symptoms aren't genuine.
Even more interesting is the fact that both JWZ and RMS are (or were) both huge Emacs hackers (ever hear of Lucid Emacs).
Now, I am a huge Emacs fan, but I have seen way too many Emacs users with serious RSI problems to think that this isn't more than coincidental. So next time you need to hit some obscure key chord to get emacs to do something cool remember to take it easy, and don't put your fingers in an uncomfortable position.
It's the posture. The problem comes in when you have a hyper-extension of the wrist, which can be caused by a lot of different things. One especially common one is a seat that's too low. Another is people who slouch before their keyboards, placing their palms and wrists *below* the level of the enter key. Ever see a piano teacher? The wrists must be held straight.
The keyboard and mouse wrist rests *work* -- not because they pad the joint, but because they make it impossible to hyperextend your wrist.
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Yeah, that's what one of my former coworkers, a native of Lithuania, thought too. This guy had survived the Red Army and was (is) one of the hardest workers I have ever met in my life.
Then one day, after two weeks of 16 hour/day hacking, his wrists froze up and his wife found him lying on the floor screaming in pain.
Good thing he had that other American excess, health insurance. 6 months of surgery and physical therapy and he can pretty much work 4-5 hours a day now.
It's a strange kind of malingering that strikes the people who are driven to work the most, hardest.
sPh
It seems they've proved that malingering is possible. I guess that means that the disease doesn't exist.
-- Truth goes out the door when rumor comes innuendo. -- Groucho Marx
Take the source for what it's worth. Isn't the newspaper source a decidedly conservative press with an axe to grind against the injured, as well as every other group it sees as a threat?
After all in this country, the US, we have an adminstration that makes pronouncements on the safe level of arsenic in the water not based on safety but on the cost to do it. And it threw out the Americans with Disabilities Act as it applies to municipal facilities solely on the cost to implement? So maybe it's the same thing here - politicized science that lobbyists trot out as truth?
Next thing you know they'll dicount mental illness because it's only in your mind.
...is that the computer programming boom has fallen somewhat, so those who have only heard of HTML can no longer get work, so less people are doing less work at the computer causing less RSI?
Eeh? (Thrown in for the Canadians.)
Consider the facts:
1) People tend to get them at the same time. This is probably because of some kind of "mass hysteria".
2) All of the people striken with colds have had their colds "go away".
If carpal tunnel is a hoax, then so is the common cold.
If tits were wings it'd be flying around.
Carpal tunnel syndrome isn't a disease of the rich. In fact, it took some time before it was connected with keyboard use. The first instances of diagnosis were of manual laborers, especially farm workers and most particularly slaughterhouse employees. In the US, meat processing is pretty industrialized, and it takes mass numbers of minimum-wage employees chopping away at carcasses to produce the cuts of meat we enjoy in our supermarkets. The production increases have led to people banging a cleaver through meat against a cutting board five times a minute, for eight hours a day.
Now, granted, Lithuania may have problems just getting enough jobs for people, or building democracy, but don't imagine it's a class thing or limited to developed countries.
The cynic in me will agree that RSI did not become a "big" problem that people in the US cared about, until higher-paid office workers began to be diagnosed.
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I'm a fan of the Kinesis contoured models, which put all the heavy use keys under your thumbs (Ctrl, Alt, Enter, Space, BS, Delete). Also all keys are programmable, so you can fix any quirk about it that you don't like (e.g. the Caps Lock next to the A can be made to do something useful).
The Maltrox (sp?) looks interesting too. Possibly better, though more expensive (and the Kinesis ain't cheap to begin with).
By the way, I've been a heavy keyboard user for decades now, and I didn't feel any ill effects for the first 10 years or so of typing. So you slash kiddies who're feeling smug because your fingers are never sore, remember that you're just getting started...
In the three years that I have been suffering from this pain (usually just a slight twinge in my wrist and the palm of my hand, but occasionally reaching up to my elbow or even to my shoulder) I have not had to undergo surgery, wear a brace, or even take any kind of pain killer or anti-inflamatory drug. What I have done is obtain a host of assistive ergonomic devices (wrist support pads for keyabord and mouse, and assorted 'ergonomic' keyboards and trackballs) and pay extra attention to the position of my arms and body while I'm working at the computer.
I've spent several hundred dollars on these accomodations (all of it my own money) and I've been able to reduce the pain from the arm numbing agony I was experiencing in 1999 to slight twinges in the hand and wrist. There may be folks for whom CT, and other RSI's, are real debilitating disorders, but not for me.
That said, I wouldn't be suprised to find lots of folk exagerating the seriousness of their problems in order to get some concession out of employers in tight labor markets. Similarly, I wouldn't be suprised to find that, with the loosening of the labor market, there has also been a reduction in CT/RSI claims: the sqeaky wheel quiets down when there's less grease to be had, if it knows what's good for it.
but it got better. It must have been a hysterical illusion, along with the 220lb linebacker who hit me.
Doctors trained with a bias towards intervention tend underestimate the body's capability to heal. I read recently of a meta-analysis study that indicated this is behind the infamous "placebo effect" -- things just get better on their own. This makes total sense to me. Medically trained researchers so underestimate the body's own healing powers that they'd sooner attribute spontaneous recovery to an almost mystical force called the "placebo effect" than thinking of including simple rest and waiting as an experimental group.
In this case, the researcher is invoking "hysteria" in a similar vein. If somebody's keyboard induced RSI gets better, it must be some kind of insidious psychological phenomenon causing the person to report a non-existent condition. <sacrasm>That's certainly a more reasonable explanation than assuming the patient just got better without some kind of heroic action on the part of the doctor.</sarcasm>
One of the worst parenting experiences I've ever had was when my daughter's pediatrician wanted to perform an invasive test for a certain condition. I asked him (a) what the prevelance of the condition was in the population; (b) how the symptoms he saw affected this baseline probability and (c) what the statistical properties of the test were (false negatives and positives). He couldn't answer any of this. It was a hunch. I went along, against my instincts, because he browbeat me into it, even though he could not justify the test on objective grounds nor did he have the statistical information necessary to interpret the test (which in the event was negative as I expected).
The point of this story is that MDs (among which I have several personal friends) practice an art rather than a science. They have to go on what the prevailing standards of practice are and their own instincts much of the time, since they lack the scientific data to make an objective judgement (and in some cases lack the mathematical sophistication, which is somewhat less forgiveable).
The less than scientific nature of medical practice is what is responsible for fads in diagnosis, not defective personalities in the patients.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
In related news, the moon landing was a hoax, the holocaust never happened, and the American Indians are actually the long lost 12 tribes of Israel.
People can call anything a hoax and drag up enough circumstancial "evidence" to "prove" their point. More often than not, it's a case of people not wanting to believe the truth, or creating controversy.
-Ted
I think I agree about the "faking," but not for the causes you site. Not to dismiss the suffering of people who are genuinely afflicted, but I've noticed a strange pattern of RSI among friends of mine.
It seems that many of them are conveniently stricken when they want to get out of the computing industry anyway, but can't seem to admit it to themselves. One guy I knew took an early retirement when he was diagnosed with RSI, and another friend was starting to question what he really wanted to do with his life when he "came down" with it. It's like they're subconciously looking for a way out without having a concrete plan of what they'd rather do, and this malaise gives them cause to quit. They do, and bam, symptoms go away. But of course they can't return to work because it would lead to a flare up of symptoms.
I don't know. Again, I don't mean to dis anyone's particular situation. It's just kind of shady sometimes, from what I've seen.
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Comment: Repetitive stress injuries are real. Even if they are a matter of "hysteria", the pain is real. If a person thinks they are in pain, then they are actually in pain. Pain is subjective. Perception is reality...
Resource: The Facts About Repetitive Strain Injuries
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Edward Shorter is the history of medicine chairman at the University of Toronto that is quoted in the article. Here is a page that seems like a review of his work on RSI. Mildly useful.
From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era
The Kennedy Family and the Story of Mental Retardation
Bedside Manners
So, the point of these links is this: This dude's whole career is based on bashing illness. He seems to think that almost any illness or disease is in the mind.
The pain in your wrist, elbow, arm, and back is fake. Do you hear me? Fake! Just ask Edward...
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I'm tired of all these Karma whores writing "insightful" and "informative" responses to articles they haven't read.
Got Rhinos?
Doesn't Alex Chiu have something to combat repetitive stress injuries?
Got Rhinos?
I spent three weeks in Hoboken, NJ and don't have lung cancer, so lung cancer must not exist.
They have shown that people with CTS have denervations in the median nerve that are relieved with surgery. I find that to be convincing evidence of a condition.
You don't need a 1:1 correlation on cause and effect to establish an existence of a condition. Things besides typing cause CTS and other RSIs.
Fight Spammers!
I don't know why I'm saying this, because /. is perpetually misrepresenting the articles it links to, but the article in question DOES NOT say that Carpal Tunnel Syndrome doesn't exist. Rather it says that there does not appear to be a link between keyboard use and carpal tunnel syndrome. (i.e. Office workers using regular keyboards, have the same incidence of carpal tunnel as the rest of society).
/. were told that they were not infected with HIV, they would conclude that AIDS is a big hoax...
I suppose that if the editors of
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If you have pain in your wrist that doesn't go away after a day away from the keyboard, it does not mean you have permanent RSI damage yet. Change your ergonomics and/or work habits, and you may be back to being your old self. Or you could ignore the pain, pop a couple asprin, and end up crippling yourself. Your call.
BTW: If you have tendonitis, a lot of doctors will tell you to take Advil (or a generic version of it). That's because Advil is an anti-inflamitory drug that actually reduces the swelling in your wrist. Since the swolen tendons is what is causign all the friction (which causes more pain and more swelling), reducing it is a Good Thing. Other pain killers will 1: not reduce the swelling, and 2: ease the pain, allowing you to cheerfully type away and hurt yourself more.
In spite of articles like this... take care of your hands. Getting along without them would be tough.
Information wants to be anthropomorphized.
Definitely some people claim RSI to make their jobs easier unfairly, but I can assure you that this shit is real.
So: Don't overwork your hands, you won't get any new ones!
sulli
RTFJ.
Sure, my pain "just went away"...
After I quit working on the Macintosh keyboards, the puck mouse, and the picnic table "desk" that was up way too high.
Shooting pains are not just imagined. I couldn't write at home because my hand would freak at the slightest exertion of effort. My life is code and paper is my primary resource. I was crippled while working with the Macs. (OS X Server, incidentally, not that the OS matters too much, save with respect to how fast it lets you set your mouse speed.)
This reminds me of an experience with a coworker. He, a staunch republican, noted just how phony environmentalist concerns were. "A while ago, everyone was complaining about how CFC's would destroy the world by now. But see? Everything is perfectly fine." I said, "Well, yah; That's because you are forbidden to produce CFC's now, save in a few developing countries who's time is almost up." I suspect the same sort of thing going on here. We've learned to work around Carpal Tunnel, so well, that people think it's just a myth.
I'm glad that that pain in my wrist is not for real. I can feel it going away already... If it was not for this article, I would still think I am in pain. :)
On the other hand, what struck me about the article was the emphasis on carpal tunnel syndrome. My impression is that very few people have that. The term is used as shorthand for RSI injuries in general, much as people talk about having "the flu" when they get a cold. Tendonitis is far more common, in my experience -- I'd like to have seen that discussed in this context.
Unsettling MOTD at my ISP.
is this.....is this for REAL?
great comedy company.
Well, i do not know what the fuss was about. It seems that the only people that were worried with this kind of thing came from developed countries, and here in Lithuania noone seems to care. I don't even know if there is a direct translation for RSI in Lithuanian. Maybe it is just because we have other more important problems.
Speaking as a sufferer of carpal tunnel and other repetitive-stress-injuries, aggravated by a genetic predisposition to arthritis, RSIs are -not- a hoax. However, for every one true RSI sufferer, there're probably a dozen fakers who smell a big lawsuit/government check, and claim mysterious pains here and there. These cases up and disappear whenever someone bothers to scruntinize them.. "What? See a doctor? Oh, I, uh, feel much better now. My wrists have healed! It's a miracle!". Often, real RSI sufferers are reluctant to seek the help that goes along with a government check. We love our machines too much. I for one, suffer through the aches, stiff joints, numbness, and keep a-typin. I use a wristwrest and try to keep my wrists/arms/hands at happy 90 degree angles like in those oh-so-nifty ergo diagrams, and I may as well own stock in Bayer for all the asprin I consume. And one day, when the arthritis sets in full force, I hope somebody's perfected cybernetics to the point I can buy new hands from Wal Mart. ;)
- Turq - "That's TRON, he fights for the users."
The National Post, the source for this article, is well known as an unashamedly pro-business newspaper. They frequently publish articles which defend existing business practices regardless of their cost - as an example, one of their regular columnists, Terrence Corcoran, is famous for his articles denying the existence of global warming.
In this case, it's likely that the article is intended to reduce the perception of employers' liability for their employees' carpal tunnel injuries, and thereby to dissuade those who are possibly suffering from seeking redress.
Toronto-area transit rider? Rate your ride.
I thought as long as you take breaks from typing every 45 minutes or so with a pr0n break, your wrists should be okay. Or at least one of them.
b (owie) u (ouch) l (ah) l (yikes) s (medic!) h (arg) i (doh) t (uuhhhh)
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