RSI & Carpal Tunnel

[alunr]

One of the staff at a customers has been diagnosed with the early signs of RSI/Carpal Tunnel Syndrome

Any experts who can give us some advice?

[Podie]

Firstly, who has diagnosed them, and what job / function are they performing?

[bikerkeith]

I'm not a medic, but this is something that a lot of top bike racers had problems with, particularly when upside down forks first started being used. They are stiffer than "ordinary" forks, so putting much greater strain on the wrists and lower arms. I think (but would appreciate confirmation from any madics) that the carpal tunnel is where the tendons passon their way to the wrist and fingers. Extra stress causes inflammation, thus making grip hard to maintain.
Cure seems to be rest or an operation.

[Podie]

I'd always leave an operation as a last resort.

ULD's usually ocurr due to poor working practices. The QWERTY keyboard is not particularly well laid out, given the usage of the letters in the English language - you'd be better off with a DVORAK job... but they're a pain in the ass to use, so a Microsoft "natural" keyboard is a reasonable compromise.

Look at the way they are sitting - have they correctly adjusted their chair? (probably not) - this will lead to further problems.

Do they use wrist rests? Is the screen adjusted correctly in terms of where they are sitting? Do they take regular breaks? Don't lean on the wrist rest, when typing LIFT the wrist above the pad, tilting the keyboard back slightly.

Give me more details on the job and I'll see what info I can pass on...

Is it really RSI or CTS? Could it be tendonitis? Are their working practices trapping the median nerve?

[alunr]

She has been working with QWERTY keyboards for most of her working life (50ish now). She works as an administrator so spends ALOT of time typing, order entry etc.

I've already requested a "Natural" keyboard for her which will arrive in a few days.

I'd also like to review everybody's work spaces as it is something that concerns me a lot - the company does lots of Solidworks/Autocad stuff.

Thanks for your input so far.

Was diagnosed by her GP

The main reason for my concern is that the lady in question is my girlfriends mum (who suprisingly i get along with we'll - although that'll probably change after the wedding )

>> Edited by alunr on Friday 4th April 13:44

[beav]

No expert, just a lowly 1st year medical student, can answer most of the q's about CTS that you want to throw at me due to having had to do various case studies on these- will probably have to consult the books though. But won't be able to help on treatments, sorry!

CTS caused by inflamation of tendons passing through the carpal tunnel where the tendons maybe inflamed for various reasons- eg a small infection in the hand. The tendons then press on the median nerve which is in a tight position due to passing into the hand under a fiborous band containing the tendons and nerve.

RSI is a repeatitive strain injury due to just that.

Don't really know what you want to know but if I can help I will try my best.

Richard

>> Edited by beav on Friday 4th April 13:57 to add some stuff

>> Edited by beav on Friday 4th April 15:33

[alunr]

What I really need to know is - Whats the best way to stop this getting worse - any treatments I should get her to talk to the GP about, Workspace setup etc.

[beav]

Treatment as has been said is rest or an operation where the fibrous band is cut and allows the nerve pressure release but I think this would only be in pretty severe cases.

As i said I am no expert and am only a student so can't give any advice really, obviously the best thing to do would be go on the professionals advice.


Sorry for not being any more help,

Richard

41

>> Edited by beav on Friday 4th April 15:48

[Podie]

OK, personally I'd steer clear of operations and GP related treatment to begin with. The vast majority of these things can be solved with a better workplace environment.

There should be some guides available on "workplace design" and "computer health" - they cover all the relevant bits and pieces.

The key here is not just to provide fancy keyboards and chairs, but also an understanding of how to use the equipment properly!

I'll have a dig around and se what I can find... but have a look and see if you can find something.. the HSE are bound to have something..

[fatsteve]

I read somewhere that 80% of RSI cases in men were the result of self abuse rather than keyboard related strains!!

[beav]

But statistics show that more woman than men get CTS/RSI either its due to extratisual fluid build up or men are getting a little more demanding of late

>> Edited by beav on Friday 4th April 16:46

[Podie]

Alun...

www.hsebooks.co.uk or [phone]

Ask for;

ISBN 0 7176 2599 0 - Understanding Ergonomics at work
ISBN 0 7176 1504 9 - Working with VDUs
ISBN 0 7176 2600 8 - Aching arms (or RSI) in small business - is ill health and sickness abscence due to upper limb disorders a problem in your workplace?

This should give you enough of a point in the right direction. IIRC a single copy is FREE, but multple copies cost... but it's also worth checking out www.hse.gov.uk as I'm sure there are leaflets that can be downloaded - again, for nowt.

Hope this helps.

[mechsympathy]

Also look at her seated posture. The median nerve or its roots can get trapped higher up leading to tightness, which can manifest as carpal tunnel. Getting a decent chair, making sure that the top of her screen is at eye height, she's not over reaching for her keyboard or mouse.

If this has started recently, then what has changed?? If she has been using a key board all/most of her working life then she should have adapted. Has she had an increased or changed workload? Has she got a new hobby? Has she become a PHer??? That'll do it. She (& you) need to look at her home life too.

The op, while drastic, can be very effective (As with all these things, not always). But in the meantime she should try a wrist brace at night (It's normally worse in the morning) and find someone with an understanding of neural dynamics and ergonomics. Probably a physio, but possibly an osteopath.

Hope this helps

[DanH]

I had (and still do to an extent) tendonitus problems that had me unable to use a keyboard for about a month (not good as I'm a software developer). In my case it was a combination of desk setup and poor posture. Natural keyboard helps as it limits the compression on the outer bit of the wrist - i.e. you can keep your hands in a more neutral position from the wrist rather than having a bend there.

Also mice are pretty bad.

I've never understood why the numeric keypad has to go on the right, it makes you reach further for the mouse which isn't good.

The other important thing is quality of desk and chair. Keboard and screen need to be dead ahead of you, you can't be twisted when you are working which is something I've seen a lot in smaller companies.

Frankly she'll probably need to see a specialist. Hope she has some health insurance as frankly the national health is fecked.

[ford prefect]

I had CTS and was advised to have the op on both hands. This was carried out as a day patient and involves an incision about 1.5 inches long down the centre of the palm just above the wrist. The op was a complete success and I have had no problems whatsoever since.

Mine was probably caused by working with my hands a lot and caused me serious problems when driving as I would lose the sensation in my hands apart from my third and little fingers. By using my hands less the symptoms were less severe but as I was assured that the op is something like 99% successful and very straightforward I decided that I would rather have my hands working properly than intermitently losing the sensation in one or both hands.

I was also advised that once you have CTS, although you can reduce the symptoms, you won't completely cure the problem without decompression i.e. the op.

By the way, I had both hands done at the same time and before you go for this option you need to make sure your partner really loves you cos you are a bit limited in terms of what you can do for yourself with the equivalent of a pair of boxing gloves on!!!!

I need to add a little more this posting - Firstly, I went to see a specialist who assessed the extent of my condition by passing an electric current down through my nerve and measuring the difference after passing through the Carpal Tunnel - laymans descrption for what was actually some quite sophisticated kit. Completely painless by the way except for a few tingles and twitching fingers during the assessment.

I would agree with a previous comment that waiting for Carpal Tunnel decompression on the NHS is like waiting for the next blue moon. I did the whole thing through private medical insurance - big advantage being that I spent time finding the right surgeon - one with a lot of experience of this particular op.

I think you need to assess the severity of the condition and if it is causing problems then have it evaluated professionally and get a prognosis before going to a surgeon with your cheque book in your hand.

>> Edited by ford prefect on Monday 7th April 00:15

>> Edited by ford prefect on Monday 7th April 00:17

>> Edited by ford prefect on Monday 7th April 00:44