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Carpal Tunnel Surgery?
Kyrrin asks a question all of might have to face if we aren't careful: "I always thought that carpal tunnel syndrome was mostly invented by doctors -- until I started showing symptoms myself. I'm almost convinced of the need for surgery -- is there anyone else out there who has had this done? If so, what sort of recovery time did you have before you were reasonably self-sufficient again? "
My wife had horrible CTS, and surgery didn't help. It kept her from work for almost a month, and it cost us a fortune (no health insurance, I'm an engineer). She has gotten much better by doing three main things different.
"I always thought that carpal tunnel syndrome was mostly invented by doctors -- until I started showing symptoms myself. I'm almost convinced of the need for surgery -- is there anyone else out there who has had this done? If so, what sort of recovery time did you have before you were reasonably self-sufficient again?"
Have you thought of changing the way you do your work. Most likely it caused yoour pain in the first place. any solution for it will have to include changing that. If you don't it is likely your wrists will get worse and that they will be permanently dammaged.
From what you wrote I gather that you are looking for an easy fix in the form of an operation in order to continue working the way you have always done. As far as I know there are no easy fixes. If you go to a doctor he will only do the obvious, that is try to prevent you from further damage your wrists rather than cutting them open rearrange some stuff and declaring you cured.
If you are a programmer (what i suspect) and are planning to spend the rest of your life programming, you might want to start considering that your wrists won't go all the way. I.e. start thinking about ways of reducing the amount of typing you have to do for your work.
Jilles
Not a doctor, but knows CTS all too well:
:)
Okay, here's how it goes. About a year ago I was experiencing the classic symptoms of carpal tunnel.
I'd wake up in the middle of the night with my hands asleep.
My wrists would be in incredible pain most of the time, *especially* when typing.
I lacked the coordination to pick up a coke, or a cup of coffee (what else is there to drink?)
and more pain, pain, and pain.
I looked into many solutions, surgery of course, being an option, here's some information about the surgery of which everyone should be aware:
Surgery to rectify Carpal Tunnel Syndrome has a *very* high fail rate.
I'm aware of a few individuals who went for surgery and now longer have feeling in one hand, the other, or both.
I could go on, but with that said, let's look at our other options....
What i did: surveyed my area.... and learned about what i was looking at, there are many resources on the web, as well as many doctors/people who have experienced CTS (sign language interpreters, writers, teachers, crack addicts...) you'd be amazed how many people have dealt with it. Talk to them about what they did, or don't.
The first thing i did, was cut back on my computer usage, from about 10-12 hours a day (seriously) to 2. That in itself made a world of difference.
Second thing: new chair, one of those really big cool black ones, with arm rests, and a small puppy to stroke so whenever anyone entered my room i could turn around and say "WELCOME TO MY HELL."
Third: new desk, with a keyboard tray, and a mouse tray, the key is having your keyboard level, and your mouse low.... not too low... but just to the point where everything's happy... i've also heard it was bad to have your mouse above your heart. But i don't know about that one.
Fourth: Wrist braces. No, you don't have to wear them when you go out (when do you go out?) or to school, just to sleep. Your hands might get a bit sweaty, but they actually do help. NOTE: on the braces, you can go to some "CTS" site, and spend a hundred dollars on wrist braces, or you can go to walgreens, and spend 20. Same thing, much bigger price.
Fifth: Keyboards. Didn't even change mine... have no "natural" no anything, i just have a nice clickity clackity PS2 keyboard... and i love the thing. Some people will say "having a 2 degree twist in your keyboard will prevent CTS.." i don't believe it. Some people swear by them.... *shrug* one thing i really *would* like is a completely split keyboard, *completely* so i can put one hand somewhere, and the other completely somewhere else...
so, cutting time down (fairly essential) for a while... (now i'm back up to about anywhere from 4-8 hours a day) and changing your environment work really well.
make sure you stretch
Soreness (horribly so) is generally a sign of tendinitis, but it's when fingers start to go numb, or tingle, that's when one of the tunnels are getting too crowded. I've had a few rounds of therapy, but the one that has helped the most has been re-learning how to type. My therapist/teacher was a pianist who had CTS and had to relearn, then discovered she could make a fair living helping geeks and nerds.
The basic method is described in _The Hand Book_ ISBN 1-884388-01-9, but the short summary is to use the largest muscles to do the job that you can. The catchphrase is to use hands "as paws, not claws". Your hands should be moving all over the keyboard, with the fingertips only moving up and down. I find it tough to do all the time, but it's usually OK.
I've had nerve damage (the mylograph method of determining this is one of the more uncomfortable methods of medical torture), but it's holding steady.
As far as equipment is concerned, some things will help, but bad technique is stronger than bad equipment. I have a few old pointing devices that didn't make the cut....
What has worked: The Microsoft "Classic" natural keyboard--have one at home and another at work on my workstation, as well as one of the smaller "elite" ones on a barely used computer at home. I find the Contour Mouse to be the best bet for me, mostly because I have really large hands and most desk rodents are too tiny. (The HP mice on workstations are horrible.) The backup computer has a Microsoft mouse--it's tolerable for a while. Other computers at work use standard keyboards and mice, and I get by.
BTW, going to voice recognition software can lead to a strained set of vocal cords. I was thinking of foot-rodents until I figured out that I'd be trading wrist problems for ankle problems....
Bottom line: surgery works, but there's a lot you can do before it comes necessary. My aunt lives in the wilds of southern Michigan and had to have both wrists done simultaneously. She said it was, er, interesting.
Pete (got no sig worth noting)
Carpal Tunnel Syndrome Home Page
A Patient's Guide to Carpal Tunnel Syndrome
My advise is to use Microsoft Keyboard and/or Microsoft Mouse. They may make a lame OS but they sure know how to design good hardware.
Hasdi
Now, unfortunately, I have noticeable numbness in the outer pair of fingers on both hands. It started soon after I started using the Dvorak layout full-time, and intensified steadily over the next couple of months.
However! Do not run away yet. My wrist pain has stopped almost entirely, and the numbness has now begun to decrease slowly but steadily. Why the strangeness? Well, as near as I can tell, because I had been typing for so long on the QWERTY layout, I didn't have to keep my fingers on the home row--my hands sorta "floated" over the keyboard, and my motion was loose and easy. But in the time it took me to become really proficient with the Dvorak layout (and I am still not quite back to my original speed yet, but close) I kept my fingers glued to the home row like attentive schoolchildren. And my hands were tense, as were my forearms.
But now I'm loosening up, and it appears that I'll wind up better off than I was before. So yes, by all means try the Dvorak layout. Just know that it works better (and faster) for some people than for others. Be aware, not scared.
And please, do what these other folks are telling you--get away from the keyboard and do something totally unlike typing for a while each day. Like masturbating. Or rock climbing. Or whatever.
You do not want to get surgery first. Surgery is a last resort for stuff like this. The reason that you are having a problem is because you are building up scar tissue and/or straining the muscles in your hands and wrist. Surgery can alleviate some of this pain, but it will ultimately make things worse if you wish to continue with the stressful activity (i.e. Typing). The end result of any surgery is the creation of scar tissue and possibly the cutting of muscles. This results in less flexible muscle that can be damage more easily than the pre-surgery muscles. Surgery now is asking to not be able to type 10-15 years (possibly with additional surgery along the way).
You need to stop any activities that cause scar tissue to build up in your hands. Foremost among these is cracking your knuckles. If your a knuckle cracker, you have to stop. The popping sounds is nitrogen liquifying under the pressure. This is bad for your muscles and is the source of your scare tissue.
Another problem with typing is, shall we say, improper technique. Most people assume that the presence of a wrist pad/mouse pad means that they should rest their wrist on it while typing/using their mouse. This is absolutely wrong. Typing or using a mouse while your wrist is resting on any surface (even just the table) puts additional strain on your wrists. This will cause you problems. Although ergonomic keyboard are nice, you can receive great benefit from having your wrist not touch anything while you type.
Another aspect of proper technique is the height of the keyboard relative to your body. When you are typing your forearm should make a right angle (or as close as possible) with your biceps. Anything above or below this puts additional strain on your elbows and wrists. If forced to choose between a little below or a little above, I would recommend a little above because the muslces in your biceps are more able to compensate for the additional strain.
While we are on the subject, monitor placement is also an issue. Most monitor documentation is wrong. They show that "safe" monitor height to be the top of the monitor at eye level. This is absolutely wrong. It puts additional strain on your neck. The center of the monitor should be level with your eyes. Additionally, if you are forced to pick between above and bellow this, above is much better. The reason is that looking above causes your next to arch backwards, which does not degenerate the curve in your spine. Actually, short periods of over-curving the neck are beneficial for the spine (not that you will enjoy long periods of the monitor being to high). Having it lower than this is always bad. It degenerates the curve of your neck and strains the muscles.
As many of the other posters have said, I strongly recommend some form of exercise. The scar tissue in your muscles can be removed through exercise, which also has the added benefit of strengthening your muscles.
I strongly recommend you go and see a chiropractor. In addition to the concerns about school raised above, there are also concerns of technique. There are different kinds of chiropractors, and I am very in favor of biomechanics. I have been going to chiropractors for the last 15 years (and my current biomechanics chiropractor) for the last 10. Please e-mail me if you are interested in additional information (such as the location of a repeatable chiropractor in your area.)
I know several people that were told they needed surgery by docotors and who ended up not needing surgery after seeing a chiropractor. Also, I would like to take the time to dispell some of the myths about chiropractors. Medical school requires a student to put in less credit hours than does chirpratic school. Both schools require the student to have a college degree. Additionally chirporators have to pass a licensing examination to be able to practice. They are not unskilled quacks as some other post have try to portray them.
Dave
dgr116@psu.edu