Coping with Carpal Tunnel Syndrome— and paying attention to symptoms

Wednesday, 29 November 2017, 11:00:02 PM. Carpal Tunnel Syndrome happens when the median nerve running from the forearm to the palm becomes pinched.

For Lydia Coletto, it began with her hands falling asleep.

The tingling, mostly concentrated in her thumb and index finger, would wake her up in the middle of the night. She’d shake out her hands to make it go away.

When the symptoms didn’t improve, Coletto, a receptionist at Northwestern Medicine’s Bartlett offices, asked for help from an orthopedic surgeon. The diagnosis was Carpal Tunnel Syndrome, which happens when the median nerve running from the forearm to the palm becomes pinched.

Carpal Tunnel Syndrome sufferer Lydia Coletto at her workplace in Bartlett, Ill. | Tim Boyle/For the Sun-Times

Coletto, 62, assumed her work, much of which took place on a computer, was to blame. But her doctor, Dr. Thomas Kiesler, an orthopedic surgeon specializing in hands at Northwestern, said Carpal Tunnel’s cause hasn’t been established.

“For the overwhelming majority, we never find the cause,” Kiesler said. “It’s because you’re human, it’s something that humans get and we don’t always know the cause.”

It’s a common belief that using a keyboard and mouse for hours on end can lead to Carpal Tunnel. Kiesler credits “a blitzkrieg” of Carpal Tunnel diagnoses in Australia decades ago that were thought to be caused by computer use as creating the misconception.

While repetitive motion involving wrists is often to blame, no one cause of Carpal Tunnel has been identified, Kiesler said. You can line up ten workers who do the same job, and some may get it, while others may not, he said.

Workers who use vibrating tools like jackhammers or whose work involves repeated gripping could face slightly more risk, but people whose professions require regular computer use shouldn’t assume they will get it, Kiesler added.

Typing and clicking a mouse or texting quickly on a cell phone can cause some pain and fatigue, but not the nerve pain associated with Carpal Tunnel, said Dr. Sanjeev Kakar, an orthopedic surgeon with the Mayo Clinic.

“We weren’t designed to be texting 100 words per minute,” Kakar said. “We do see patients that do a lot of texting that do get tendonitis. In terms of causing Carpal Tunnel, that’s never been proven.”

Dr. Thomas Kiesler is an orthopedic surgeon specializing in hand and upper extremity surgery. | Jon Langham-for the Sun-Times

Carpal Tunnel begins with some tingling in the thumb and index finger, and over time can progress to problems with fine motor skills, Kakar said.

At the height of her symptoms, Coletto said she struggled with her work as she lost feeling in her fingers.

“Even just paperwork became cumbersome, because you’re trying to shuffle through paper [and] you’ve got no feeling,” she said.

Coletto had the symptoms in both hands, although her left hand was significantly worse than her right. Her treatment began with wrist splints that she wore at night to prevent a natural bending of the wrist that happens when we sleep.

After several months and no relief, Coletto decided to have surgery to relieve the pressure on the nerve in her left hand. A small incision was made in the palm of that hand to cut a ligament near the nerve and free up some space.

More than a month after the surgery, Coletto said her hand is totally back to normal.

But for the majority of people who say they have pain or fatigue in their hands and wrists from using a computer, treatments are far more simple, Kakar said.

“The treatment is rest, therapy, and trying to modulate your activity,” Kakar said.

If you text a lot with the same fingers, try using different ones, he said. Poor posture while typing can also lead to pain, he said, so trying a standing desk could also help.

But the first thing to try is a break, Kiesler said.

“If you’re going to spend eight hours a day typing, if you can break up your typing every hour and do something else at your desk and also stretch a couple times an hour, I really do think it does help,” he said.

Diana Novak Jones is a local freelance writer.

SOME USEFUL TIPS:

–If you spend a lot of your day typing and are dealing with fatigue in your arms and wrists, don’t rush out to buy a new ergonomic keyboard, Dr. Keisler said. First, think about your wrist position.

–Wrists should be in a neutral position, not flexed up or extended, Keisler said. Keyboards and mouses positioned higher than where you might rest your arms, like on top of a desk, are common and can result in tendon overuse tendonitis and forearm muscle strain.

–Studies looking at whether ergonomic keyboards can reduce Carpal Tunnel symptoms are conflicting, Keisler said, but posture, proper keyboard height and distance are important to avoiding upper extremity discomfort.

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