Getting Treatment for Carpal Tunnel?

DeathGripOnMouse asks: "Let me set to stage. I am a 30 something network analyst. I have been electronics / computer industry for the better part of twenty years, most of that time spent behind a keyboard. Like my peers, I am concerned about Carpal Tunnel Syndrome and other injuries that seem to afflict IT professionals. Recently, I began to notice some tenderness in my mouse hand. Deciding that it was time to see a doctor, I asked around the office for a good doctor, as my primary doctor no longer accepts my insurance. At the recommendation of several of my co-workers I called the office of a doctor the next town over. I explained my problem and was told that because this "could" be a work related injury, I was not able to see the doctor until I completed the following. First, I needed permission from my supervisor to seek treatment for my problem, in writing no less! Second, I was told that my medical insurance may not cover the doctor's expenses and I needed permission from my employers HR department to start a workman's compensation claim. All this without even seeing me! I do not want to file a claim due to the stigma that it carries, and I feel that it may hinder my chances at landing another job. I haven't approached my HR department, but what if they refuse to allow me to file a claim? This whole situation just angers me to no end. Anyway, has anyone sought treatment for CTS or some other repeated stress injury? If so, what were your experiences?"

Comments

Here's my IANA* advice

[7-Vodka]

1. Don't go to that doctor.
   It's complete bullshit that you have to do all this before seeing him. You don't know what's wrong and neither does he. You don't even know if anything is wrong. Besides which, fuck work! Your health is more important, you go see what's up, get it treated and only AFTER all this you figure out if it's a work injury or not etc etc.
2. get some exercise. Gentle as you need it. In fact you need to make sure your lifestyle is up to scratch.

Hope that helps. IANA*.

Just a few words

[spineboy]

Well, I am an orthopaedic surgeon, and it sounds like you're having insurance problems, as well as some other issues. First of all do you have an HMO? - If you do get rid of it and get a PPO - costs more, but any doctor will take it. Second of all if you're just having some tenderness in your mouse hand, it may just be tendonitis - an overuse injury which is best treated by rest, NSAIDS(ibuprofen, naproxen, etc.) and improving your ergonomics.

Carpal tunnel syndrome (CTS) is usually characterized by numbness/pain of the thumb, index, middle and the thumb-half of your ring finger. People often report waking up inthe night to "shake out" their sleepy hand, they also may report pain radiating from their hand to their elbow/shoulder. Risk factors include; being a diabetic, pregnant and thyroid problems. Computer keyboarding has NOT, I repeat, NOT been shown or linked to cause CTS. I know that this goes against what most of you have heard, but there are million of people using keyboards, and there are certainly not anywhere near that many people with CTS.

You need to see a hand surgeon - preferably an orthopaedic trained one. Just a small warning - workers compensation patients have an interesting stigma - they typically do worse than non-workers comp patients in all aspects of medicine, for many diferent reasons, i.e. secondary gain, etc.

So go see a hand surgeon in person who knows the facts and don't listen too much to your co-workers (they didn't go to bus driving school - so they don't get to drive the bus). If your hand surgeon does indicate surgery for you, he really should send you for an electromyelogram (EMG) to first to rule out any other causes for your hand problems. EMG's check the nerves in your hand and make sure that the problem is in your wrist, and not in your elbow/shoulder or neck. EMGs hurt like hell (you get shocked with needles in various places), but it's definetely worth it.

Re:Just a few words

[austad]

EMGs hurt like hell

My doctor scheduled me for an EMG because I had numbness in my arm. I didn't really know what it was. So you can imagine the horror on my face when the nurse is pulling out these 4 inch long needles. I asked her, "what the hell are those for?" And she's like "Oh. The doctor didn't explain? You aren't going to like this."

So the first part of the test, they put electrodes up by my elbow, and then stuck these little thumb tack size needles with wires into that tendon that you can see if you put your palm face down and lift your thumb. They then proceeded to send jolts of electricity directly through the nerves. Then they flipped my arm over and stuck the needles into my wrist and did it some more. Needless to say, it was not fun, but it was the best part.

The second part of the exam involved taking these 4 inch long needles, and sticking them all the way into my bicep, tricep, and the top and bottom of my forearm. They did them one at a time, and once it was all the way in, they had me flex and measured the electrical activity. The tricep and bicep did not hurt that badly, but the pain in the forearm was almost unbearable, the needle hurt going in, sitting there, and being pulled back out. Remember, no local anethetic.

In any case, they were checking for muscle and nerve damage, and there was none. Turns out I had pinched nerves in my neck that were causing it. But that visit to the doc definitely sucked.

Switching to a Trackball worked

[Anonymous Coward]

I used to have a pain in my right wrist, and it always startes acting up when I was using a mouse. That was 7 years ago. Since then I've been using a trackball, and no more pain or stiffness. I've never had any problem with the keyboard. And most of the people I know who complain about wrist pain usually use a mouse with the wrist in question.

Cortisone shot he got

[spineboy]

This can actually work in some cases, but only if the carpal tunnel synd hasn't been going on for too long. See my long post on CTS

Re:My experience about 3 years ago

[phantom_programmer]

I thought I'd contribute my experiences as well. I had wrist problems about 10-12 years ago. To combat them, I tried the following:

• Wrist excercises. The ones that worked for me were to position my upper arms horizontal to the ground, position my forearms upwards, and then to rotate my wrists propeller-like, getting as much extension in them as possible. Do 100 revolutions in each hand. I got this tip from a Kaiser Permanente commercial -- best medical help I ever got from them.
• Take breaks. I was working on a Mac at the time, and installed a program called Coffee Break that forced me to take a 5 minute break every 30 minutes.
• Take anti-inflammatory drugs. When things get bad I now take Aleve.

All told, things worked out, and I rarely have problems any more.

Re:It might not even be your wrist

[cmowire]

Because there's considerable proof that scientific-based medicine works, whereas there's very little that most forms of chiropractic medicine do much of anything that massage and physical therapy don't do. This is actually causing problems for Chiropractors because the physical therapists have figured out where some of the techniques can be applied and have been using them in a legitimate clinic where you won't be sold snake oil and given treatments that, at best, do nothing, and have been shown to cause strokes.

The problem is that there are a few good chiropractors out there. But, as a whole, they are either out for money, or are inadvertently selling you treatment that doesn't work. Chriopractors, like spammers, have acquired the reputation of scammer.

And the problem is that the "points out of alignment" as you say is a crock. If you give 10 chiropractors the same X-ray, each one will point out mutually contradictory subluxations and pinched nerves and stuff.

I actually managed to lick my hand problem, long-term with some advice from my old doc. He showed me a simple set of wrist exercises, suggested a few things, and I'm fine. Which is cheaper than manipulations and a new bed.

Uh, you're wrong. Watch the advice you give.

[Jerk City Troll]

I am not a doctor either, but I am someone who used to suffer with CTS and have since all but eliminated most of my problems. I have some disagreements with titaniam.

Ride a bike, play some tennis

Lots of bike riding can further aggrivate Carpal Tunnel Syndrome. Tennis, on the otherhand, can cause it's own set of problems. I am not a tennis player, but I am an advid biker, so I can only offer advice on biking. Biking gloves help mitigate the problem, but they do not eliminate it. Padding anywhere on the grip surfaces is always a plus. However, biking remains one of the worst activities for your hands and wrists.

Then you go on to mention frisbee and masturbation (which is implied by porn). I am not sure either one of these activities is all that great. You see, the fundamental problem with Repetitive Stress Injuries (like CTS) are repetitive motions. (Imagine that?) You want to do engage in activities that have a wide range of motions. Nothing you mention does.

While you're at it, get a laptop or some type of trackball or touchpad, so you can work half the time with a non-mouse pointer.

This is not necessarily true. With a standard mouse, you are forced to a degree to use your whole arm to achieve motion. At least it's an option. With a trackball or trackpad, that motion is reduced to a single digit on your hand, which may contribute to the problem. In this case, ask an ergonomst.

Take care of this problem using common-sense techniques like mentioned above, as going to the doctor for carpal-tunnel will likely not help at all.

Have you considered that when any kind of RSI is diagnosed by a physician early, treatments such as anti-inflamatory drugs can seriously reduce the damage done to your joints? In fact, visiting your doctor early and often regarding this problem can eliminate the need to have surgery.

I think overall we are learning here that a lot of advice on Slashdot is quite bad.