Repetitive Strain Injury, Carpal Tunnel Syndrome

People who work at computers or use hand or power tools, often suffer tingling in their hands, or pain in the wrists. Some canoeists suffer inflamed tendons in the wrist if they paddle for many hours in cold weather. A friend and I used to paddle for up to six hours in a day. He showed my how to paddle with a looser grip and open up my fingers between strokes.

Tennis players and writers suffer cramp and inflammation of the tendons in the forearm.

Pain on the outside of the elbow is called tennis elbow. Pain on the inside is called golfers elbow. A golfer might cock their wrist back too far if they cannot rotate their body far enough in the back swing.

Causes of Inflammation

First of all rule out underlying systemic causes. Pain from posture or repetitive strain often affects one side more than the other. For instance osteoarthritis might lead to swelling of the weight bearing joints for instance the last joints in your fingers, or your knees or hips. Pain from inflammatory conditions usually affects both sides of your body.

Ask your GP if they would do a blood test that included thyroxine levels and also check for

ESR (erythrocyte sedimention rate) or rheumatoid factor. ESR is a general test of inflammation in the bloodstream.

Rheumatoid factor is more specific. Inflammatory conditions usually affect joints on both sides of the body.

Posture at your desk

Make sure that your chair has short arms, if at all, so that you can sit close to your desk.

Your neck and shoulders are most comfortable if your elbows can rest close to the sides of your body with your forearms level.

Use a footrest if you cannot reach the floor.

Roughly speaking the top of your computer monitor needs to be level with the top of your head.

That makes your eyes look slightly downwards recruiting more eye muscles than looking slightly up.

If you look down for too long you will end up tilting your head forwards and strain your neck muscles.

Hold your arm out in front of you and make a fist. Your knuckles should just touch your screen.

Important blood vessel run up the inside of the vertebrae in your neck. They loop around at the top just before

entering a network of blood vessels around the base of the brain. If your head is always forwards the tense muscles

might rotate the bone at the top of the neck restricting the blood flow to the brain. This is a very common finding when I

help people who suffer one sided, migraine type headaches.

The nerves that supply your hands originate from the vertebrae in the lower part of your neck. They run between the muscles down

the side of your neck, under your collarbones and down your owns. Three nerves supply the hands and forearms.

If your first finger and thumb are weak and painful the median nerve is involved. It is often called carpal tunnel syndrome.

A syndrome is a collection of symptoms. The carpal tunnel is one of the grooves between your carpal or wrist bones.

More commonly the cause of the strain is in the pectoral muscles in the front of your shoulder and in the neck muscles.

If the pain or tingling is in your little finger (pinkie), and side of your 4th finger the ulnar nerve is involved. It runs through

a tunnel under your elbow. Resting on your elbows too long or overstraining your elbow are possible causes of pain.

Feel the bones at the base of your neck. If there is a 'step' and one protrudes that is another cause of ulnar nerve compression.

The third one is the radial nerve. It winds around the back of your arm bone in the shoulder joint, down the outside of your upper arm

and through your forearm. Pain in the outer, upper arm, around the elbow, in the forearm and weakness in straightening your fingers can all be

signs of radial nerve involvement. Also pain in the area between your shoulder blade and spine might come from a branch of the radial nerve.

What do you do about it?

Open your fingers wide regularly.

Rub one ice cube gently over swelling under the cube melts.

Change your posture and sitting position at work, take regular changes of activity, for instance stand beside a filing cabinet to sign or mark lots of papers.

Walk in your lunchtime, swinging your arms to exercise your shoulders.

Work on your breathing to open up your chest and diaphragm. (Yoga teachers are very good at helping you).

Carpal tunnel syndrome can be related to poor fluid movement in the body through shallow breathing patterns.

Strengthen your hands and shoulders. Swimming, rowing machine, Down facing dog (Adhomukha Svanasana) are all great exercises.

Learn to do press ups with your elbows brushing the sides of your body as you go down. Don't go down too low.

Do press ups against a door with your fingers spread wide apart is another great strengthening exercise.

Side stretching your neck muscles helps to relieve a stiff neck.

Try acupuncture.

If you are still suffering come and see me. We will gently manipulate these areas and go through the exercises very carefully. T: 01980 502015 E: jfperrott@googlemail.com