Slashdot Mirror
Surgery Beats Splints For Carpal Tunnel
Rio writes: "A local6.com article tells us about a study that suggests surgery may be more effective than splints for treating carpal tunnel syndrome. In the study, 87 patients underwent open carpal tunnel release surgery, in which ligaments surrounding the median nerve are cut to relieve pressure on the nerve, compared to 89 patients who wore a splint for their wrists, which reduced movement. The researchers found that the surgery left 80 percent of patients significantly improved after three months. Splints left only 54 percent significantly improved."
My impression is that they can cause your muscles to atrophy and fall out of balance. Anyway, be careful with them.
What I'm listening to now on Pandora...
I started using one of these two weeks ago, and I am experiencing an improvement. I don't know if it's CTS I have, but I have problems sleeping due to swelling. Check them out.
-Kraft
Live and let live
What do you know? A more drastic and invasive procedure has a greater effect. Except, splints cost $6, and surgery costs thousands and leaves you without the use of your hands for weeks.
Funny this article should appear today, last night I couldn't get to sleep because of a really sharp, throbbing pain in my wrist.
Does anybody use ergonomic keyboards at home or work? Which ones are the most recommended? I had a Microsoft ergonomic keyboard at work and thought it worked fairly well. In particular, I was hoping to get some feedback on the Kinesis Contour keyboard. It's way more expensive ($239 to start) than the Microsoft keyboards so I wanted to see if anybody had success with it (or even liked typing with it since it is so different) before I purchased one.
Oh, and does anybody use the Dvorak layout?
I started to get the slight tingling and tightness in my wrists, so I found this exercise which I do a little bit and has made this go away.
1. Start with your arms straight out in front of you, the wrists roughly in a line with the arms, and the fingers relaxed.
2. Bend the wrist upwards as far as possible while also extending the fingers as far as possible. Hold for a count of 5.
3. Return the position in step 1.
4. Make a tight fist, then bend the wrist downwards as far as possible. Count to 5.
5. Return to the position in step 1, and this time hold it for a count of 5.
6. Repeat.
Tim
Omnia vestra castrorum habetur nobis.
According to the JAMA article that this data comes from, and my own searches of Pubmed, there's only been one randomized trial with surgery, and that was also comparing vs splinting. There have been few rigorous studies of the effectiveness of 'conservative' treatments like splinting. I'm pretty surprised by this! My understanding is the surgery actually fixes the problem (at least for strictly defined carpal tunnel syndrome, where the pinched nerve is in the wrist) since the ligament that is pressing into the nerve is actually cut back. To cite a personal example, my mom had carpal tunnel way back in the late 70s when no one had heard of it and has been fine since she got the surgery in about 1980. I think it's very very rare to have repeated surgical treatment.
It also occurs to me that if one was drowning, yelling "Help! I'm drowning and I lost my bikini top" would probably be m
There is an external adapter that allows you to use a Microsoft Ergonomic Keyboard on a SparcStatin/Sun Solaris Box.
You can even mess with xmodmap and invert caps lock and control, the way it is supposed to be on those boxes.
It's $80. I think most of the money is the fact that Sun beeps come from the KEYBOARD not the pc speaker, so the adapter has to intercept ^G and beep itself (it does). Freaky stuff.
It also allows you to use a normal serial mouse (Crystal Trackball!!!!!!).
I forget the part number but if people email me and ask me I can look it up, and maybe even supply my xmodmap file if you're that lazy.
But it exists!
You will hold the envy of your crippled coworkers.
-Clio
Karma: Bad (mostly from not giving a fuck)
Blog: http://clintjcl.wordpress.com
Know this. If you seek medical advice each doctor will recommend his speciality. It's whatever tool is handy. Surgeons think they can cure anything with a knife.
Do your own research by talking to actual patients. If you talk to a few people that have had CTS surgery you will soon be talked out it.
Look into ergonomic solutions, massage therapy, abstinence from computers (that or stop masturbating, your pick), exercise, etc.
Cheers,
Beal
bamph
Since the unnatural contortions and stresses that lead to carpal tunnel seem to stem from typing while resting your wrists in front of the keyboard the absurdly simple solution would be, hey, don't do that.
I've often pondered how it happened that I've managed to use a computer continuously for the past decade without developing CTS while I've had friends have to quit after three years in similar jobs.
The answer? I had shitty computer furniture early on. It was too small. I hated the fucking thing. But, because the keyboard was forced right up to the edge of the desk, I got in the habit of hovering over the keyboard rather than resting my wrists in front of it.
Now, even though I could get a good four inches of desk in front of the keyboard, I still have my hands floating above the table top as I type. Plus, I suppose I get some small amount of exercise by supporting the weight of my arms... heh.
I am not a doctor, o' course, so don' go tryin' this jus' cuz I sez it works fer me.
Simple Machines in Higher Dimensions
From my own experience (and everyone else that I've shared this with) taking Manganese works better than anything else out there. The medical logic behind it is that it will strengthen the ligaments, which will then hold the tunnel in a more open and rounded position, relieving the pressure that causes the problem. You know, solve the problem not the symptoms and all that. My personal (and definitely non-medical-professional, after all I don't even play a doctor on television) suggestion is that you go out and get a bottle of Manganese (NOT Magnesium, Manganese is a little harder to find but any health food/vitamin store should have it) and take twice whatever they say is the suggested dosage for the first week or so and than just take the regular dose every day after that. It'll probably cost you less than $10 to give this a shot.
Yeah, but the 46% of patients who weren't helped by the splints can then go and get the surgery. What do you do if you're the 20% of people who the surgery doesn't work for?
I now work 6 hours a week (ordered by doctor) with an option for more, if the pain doesn't go away.
My suggestion would be to make sure you have good posture (back straight), that you are above the keyboard and in front of it (you'd be surprised how people type) and make a point of stopping and stretching every 5-10 min. (for 30 sec to a min or two.)
All these things have helped, but YMMV.
Oh I also stopped playing drums and guitar for 4-5 day. (though those didn't hurt...hmmm)
Rock more, work less. That'd be swell.
As a sufferer of CTS (fortunately, early stages, meaning I can still recover fully if I don't keep pissing my median nerve off too badly), I looked into quite a lot of the various "ergonomic" crap on the market.
First of all, realize that, while "experts" say these will help, unlike any real FDA approved medical device, these have NO EVIDENCE WHATSOEVER that they will help. Not one whit. A few manufacturers include some "studies" that carry no more weight than anecdote. Do not mistake that for actual clinical trials.
Mind you, I looked into this issue about three years ago and have not repeated it, for the reason I will now give:
You don't need "special" equipment to reduce strain on your wrists/back/neck/whatever. Just rearrange your environment to better accomodate you.
For example, I have personally found that the single most effective (and cheapest, and easiest) way of making my hands hurt less at night requires nothing more than lowering my chair's arm wrests and placing the keyboard in my lap. Yup, nothing more, and it means the difference between waking up in pain, and sleeping well with nary a tingle (or none strong enough to bother me).
I prefer typing to using a mouse, so for the opposite sort of person you might find it works better to putthe mouse in your lap and leave the keyboard on the desk.
Another simple change - place your monitor so if you look straight ahead, your eyes fall approximately 3/4ths of the way up the screen (I've seen suggestions to line your eyes up with the very top of the screen, but that made me *more* uncomfortable in terms of neck and eye strain).
As the only other "important" point, try to arrange yourself so your knees and elbows form an obtuse angle. Sharp bends decrease blood flow to the ends of your limbs, and increased blood flow correllates HIGHLY with increased rate of tissue repair.
Finally, a note on drugs... Believe it or not, most doctors use naproxen (Aleve) as the first-line drug of choice for early CTS. This helps some people, and does nothing for others. Personally, I use it when I *know* I've done too much during the day (or will have to for a big project or the like) and my wrists *will* hurt, and it seems to help somewhat. Some people seem to believe that it will let you damage yourself more by "hiding" the pain. In the case of CTS, that does not hold true... The cause of the pain, the pain itself, and the resulting long-term damage all result from the same thing - inflammation. Reducing that (which naproxen does) reduces the pain *and* long-term damage. Only if you use an opiate painkiller, like Vicodan, do you need to worry about the drug letting you cause more damage to yourself by ignoring the pain (in the case of CTS only... I don't mean that to apply to *all* sources of pain, obviously).
Disclaimer: I do not have a license to practice medicine. I only offer this as an example of what worked for me. It might screw you up even more, for all I know.