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

Get some alternate exercise

[titaniam]

IANAD, but I suggest that you take up some hobbies that involve using your hands. Ride a bike, play some tennis, throw a frisbee, surf for pron. Do anything you can to stimulate your muscles in a way that doesn't involve clicking a mouse. 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. I feel variety is the key to avoiding these types of maladies and I wish you luck. 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. Dealing with HR and irrationalhealth care requirements will only lead you to a need for psyciatric treatment, it seems, and how will that look on your job application.

Re:Get some alternate exercise

[joshsnow]

, surf for pron. Do anything you can to stimulate your muscles in a way that doesn't involve clicking a mouse

But, to surf for pr0n requires a mouse..wait..oh you mean exercise the left hand...

It might not even be your wrist

[Gary Destruction]

I've had very painful wrist problems before and my chiropractor said it was because of my neck being stiff. He said it was pinching the nerves which was causing my wrists to hurt. You can have symptoms of carpal tunnel and not even have the disorder. A chiropractor which who I'm assuming you saw is the best person to ask. Needless to say, I sleep on a contour pillow now and my wrists are better. I remember reading in my chiropractor's office that obesity, thyroid problems and diabetes can all contribute to carpal tunnel as well. So it might not be work related.

Re:It might not even be your wrist

[BigZaphod]

Have you ever gone to a chiropractor? I've only been to the one my family has known, but I get the impression they practice a different style than most. Perhaps that is the difference. In any case, there does seem to be a huge number of people who think that chiropractors are like witch doctors or something. I don't understand it. At my last job there were a few people who had back troubles, neck problems, etc. As did I. I started going to the chiropractor (which, ironically, was like a mile from the office). After a couple months of regular visits I was feeling far better than I had in ages--and not just my back but nearly everything. Even in better moods. And yet they wouldn't go even once to try it out. Too afraid and they usually got a little smile on their face when I'd tell them to give it a shot--like I was a silly kid who just didn't know any better.

I did have one brief incident where my back gave out entirely. Got rushed to the chiropractor and was fixed up in minutes. A painful day on my couch, a couple more visits, and since then I've been fine. I haven't had to go back in more than six months. I also got a new bed/mattress on the recommendation of my chiropractor as well. I think that made the bulk of the difference, really.

The thing about chiropractors is that they basically just fix the immediate problem. In other words, they aren't a final solution to what causes your bones to get out of alignment or whatever. They can just put it back together. But how is that any different from other medical professions?

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.

Health Insurance Sucks

[mcelrath]

This is why health "insurance" is a joke. In the normal operation of the system, the natural drives are for the insurance company (employer, workman's comp insurer, etc) to give as few benefits as possible, while collecting as much money as possible.

The system is not designed to give you easy access to health care. On the contrary, it is designed to make it as difficult as possible.

-- Bob

See a Massage Therapist

[olcrazypete]

Massage is often overlooked as an option for many types of ailments like this. Many back, headache, and repeditive motion injuries like carpal tunnel can be cured with a few visits to a well trained massage therapist. If you work in front of a computer all day, you will have problems that massage can make a real difference with.

I can't say I was any type of beliver in this until I felt and saw the work done myself. While there is a new-agie mystique to some of it, massage has a grounded scientific basis for why it works to fix things like this. Its worth a shot, and I think in the right hands you'll be pain free very soon.

P

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

[Henry V .009]

You're in the wrong forum, spineboy. This is "Ask Slashdot," not "Ask a Freaking Expert." If he had wanted expert advice, he would have gone elsewhere. Post again when you have some groundless conjecture or a conspiracy theory to share.

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.

My experience with Carpal Tunnel...

[NanoGator]

Sorry to hear that you've had such trouble. I worked for a small company and had RSI related problems for a while. Basically I just went to my primary care physician, paid the $10 copay, and was treated. Essentially, he gave me some advice to relieve it, and it worked. I didn't need to file a claim or anything, nor was I out more than the occasional $10 co-pay. Per chance, is this an option for you? Why can't ya just see your doc?

I'll share with you what he told me. Problem number was was that I was holding my elbos off the desk. My shoulders bore the brunt of the work there, and it was causing my neck some serious troubles. My hands also hurt, but I don't remember that we addressed that specifically. In the efforts to keep my muscles from having to hold my arms up, the hand discomfort went away as well.

Well poo I don't know that it's that useful to you. I think my problem has largely gone away, but who knows if it'll come back from the contsant click click of my mouse. I'm just hoping my suggestion to see your doc without making it a "my company hurt me!" claim is useful to you.

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:Wierd...

[zsmooth]

It was almost definitely a steroid, such as cortisone.

See a doctor

[mcb123]

First things first, find a doctor that accepts your insurance and make an appointment. Worst comes to worst, you can always worry about the HR aspects of it later.

I was tested for carpal

[psyconaut]

In late 2002. This is how I did it:

- Went to see my General Practioner
- He referred me to the neurology department at a local hospital
- They ran an EMG test
- I saw neurologist for results

Easy. Never a problem with forms or my employer.

Oooooh....sorry....I live in Canada. Damn our Socialist tendancies and universal healthcare!!

-psy

Several approaches

[furry_marmot]

First, if you have a little pain or tingling after a long session of work, get some *real* excercise and if the discomfort goes away, keep doing it. Squeeze balls help, as do lifting weights, but be careful. You can actually sprain your wrist or hand if you got a case of tendonitis, so don't give in to the urge to think yourself macho. What you want to do is understand that Repetitive Stress injuries come from doing the same thing constantly: sitting in a rigid position twiddling your fingers is tiring on your body. Notice your hands floating over the keyboard and over to the mouse. Shoulders tight? Notice the mechanics. The weight of your arm is hanging from your shoulder while you twiddle your fingers. Not great for the body.

Second, get over yourself. If you are injured at work, you have a right and the company has a legal responsibility to report it. However, they also have a responsibility to make sure there is not fraud and to keep to chain of command. Translation: all the letter-writing and case-filing is normal for a worker's comp claim. When it happened to me 12 years ago and I realized what it was (wasn't as well known as now), I filled out papers, saw state-referred doctors, and eventually got therapy for it. It was a lot of work for the company, but they were more concerned with my well-being (it was a small company and we all got along). I live with the RSI now, but I can usually keep it under control in even the most stressful conditions. Usually...

I'm not sure if there would be a financial impact on the company, but if there is one, that would explain why they prefer you didn't report it (your loss, their gain, and all they had to do was make a face at you).

But I have to ask: what stigma? Are you in some culture where if you have you're arm cut off, you're considered a sissy if you ask for a band-aid? Pleeease! Take care of yourself, 'cause if you haven't figured it out yet, the company is not your friend. They may have nothing against you, but if you think lying down and waiting for someone else to do what's right is going to get you brownie points: a) it won't, b) you'll still have a medical problem.

So, third, HR is supposed to be there for you; that is, to manage you, one of the company's human resources. HR should be very interested in your case. Go talk to your rep. If there's more than one, and you don't get satisfaction, go to another one. Ask him/her to lunch if you can't go through channels. Get advice. Seek help.

If HR refuses to let you file a worker's comp claim, you can sue them and live off the award. There is no way in hell they could get away with it. Besides which, it sounds like they are already doing it. Sorry if I'm grumpy today, but please get a spine.

If they are so incompetent as to try to convince you that there is some stigma attached to this, can you talk to some other manager? If you're concerned with how it might appear politically, make sure it's understood you are seeking advice, not ratting on someone or complaining. But make sure it's real and not in your head.

Oh, and one more thing on HR: They are not allowed to tell any future company you go to anything more than your employment dates and your salary. This "stigma" nonsense of yours can't possibly affect any future job.

Finally, you have some learning to do. Not all solutions work for all people; but you will have permanent nerve damage if you don't learn to take care of this yourself in the long run. Probably all you need is to soak your hands in cold water at the end of the day, try not sleep on them (consider cheap wrist braces from the drug store if you wake up with achey wrists), get lots of movement like aerobics or weight lifting or juggling (jogging won't help your hands), and take a couple of ibuprofen in the morning. But if you don't know this already, a doctor should be consulted, and ultimately filing the worker's comp claim gets you in the system and a lot of people paying attention to you. Take advantage of it and stop worrying about whether you'll get in trouble or be sent to your room or whatever else you're fretting about.

</rant_of_a_corporate_burnout_with_rsi>

Speaking as a professional...

[DynaSoar]

...and make no mistake, I not only work in a health care setting, and have a master's in healtcare administration, and also have more than one disability myself...

"I do not want to file a claim due to the stigma that it carries"

FUCK stigma, FUCK any whining from HR, FUCK any future possible employers who might look disfavorably, FUCK any insurance company that tries to disallow a charge.

Take care of YOURSELF. Get yourself evaluated and treated. By allowing yourself to be bullied by adminimonsters you only increase your chances of ending up with something worse than you have now and letting them off the hook.

Shit rolls down hill. If at any point someone tries to cause you grief, start a few steps above them in the food chain and file a complaint that's tough enough to make their boss's boss cringe, such as an ADA (Americans With Disabilities) suit, and make sure it's publicised. Discrimination of this sort is illegal. That means (1) they'll try to get away with it only if you let them think they can and (2) it can cost them far more money and other problems if you stick it to them for trying to stick it to you. Make them aware you're aware of these things.

The best defense is the BEST offense. If you don't do it, nobody is going to do it for you. They'll be more than happy to rip off your health instead.

It's your HANDS, man. Even if they all got away with their BS, it's not worth your hands.

That being said, consider a thumbwheel mouse. I have a maximal case of carpal because the bones of my right wrist have been replaced with a bar of titanium, and the surgeries really screwed up the tendons etc. I replaced my mouse with a thumbwheel and have had no problems since. Well, none attributable to repetative stress.

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.

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.