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Working on a computer? Read this

By Dr Roopa Nishi Viswanathan
November 22, 2005 13:12 IST
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Does your job involve using the computer keyboard?

Do you use the mouse for long periods of time on a regular basis?

If typing furiously takes up a chunk of your day, you might risk developing a type of repetitive stress disorder called carpal tunnel syndrome.

What's RSD?

Repetitive Stress Disorder occurs due to a gradual build up of the small amounts of bodily damage that occurs on a daily basis. The damage usually occurs due to repetitive motions and sustained postures of a fixed group of muscles.

For instance, regular activities such as typing, computer keyboarding, using a mouse (more so than typing), driving a car, operating a cash register and playing computer games can gradually lead to carpal tunnel syndrome.

In RSD, it is not the physical force used that matters, but the amount of time your muscles and tendons spend under tension.

Repetitive hand action results in swollen tissues in your wrist, which can then compress adjoining blood vessels and nerves, leading to the irritation of nerves and reduced blood supply.

Carpal tunnel syndrome

You might notice the first symptoms of carpal tunnel syndrome when trying to sleep. You could feel a tingling numbness in the fingers (specifically the thumb, index finger and middle finger) initially.

This feeling generally tends to occur towards the evening, after a hard day's work.

If left untreated, this could progress to difficulty in gripping objects and dropping them.

In serious cases, permanent nerve damage could occur leading to intense pain and restricted functioning of the hand.

Symptoms to watch out for

~ Tingling, numbness, coldness or loss of sensation in any part of the hand.

~ Loss of grip strength

~ Pain

Often, early carpal tunnel symptoms are ignored because sufferers mistakenly assume circulation has been cut off to their hands due to sleeping in an awkward position.

Women at higher risk

Females are at higher risk of developing carpal tunnel syndrome, especially if they are overweight.

The hormonal changes of pregnancy, menopause and hysterectomy can cause fluid retention. This restricts blood flow to the tissues, and can affect the collagen (connective tissue) that holds the tendons together.

Coupled with the biological risk is the traditional tendency in many organisations to assign women jobs like typing and secretarial tasks that are characterised by sustained-posture, repetitive-motion activities.

If you are diagnosed with carpal tunnel syndrome

~ Your doctor might recommend cold application. This can provide temporary relief from the pain.

Cold helps numb the area and constricts the blood vessels, thus reducing the inflammation.

~ Analgesics will not only help reduce the pain, but will also decrease the swelling around the nerves.

In rare cases, corticosteroids might be prescribed.

~ You might be referred to an occupational therapist to learn certain exercises, which can help strengthen your joints.

~ For a few days, you might have to use a splint to keep your wrist straight while you sleep.

Carpal tunnel syndrome usually isn't a serious condition. With treatment, the pain usually goes away and there is no permanent damage to your hand or wrist.

Prevent RSD

You do not have to wait till you actually begin to see symptoms of RSD. You can prevent repetitive injury by following these workstation tips:

~ Pay attention to your posture at all times. Do not work with your hands too close or too far from your body. Keep your eyes level with the screen.

~ Adjust the height of your chair so that your forearms are at the same level as the keyboard and you don't need to flex your wrists to type.

~ Do not rest your wrists on hard surfaces for long periods.

~ Avoid tight watchstraps or jewellery and clothes with tight elastic sleeves.

~ Take regular and frequent mini-breaks from using the computer keyboard.

~ Extend your arms out with palms facing out and fingers pointing up. Hold for a count of five. Straighten your wrists and relax your fingers.

Then make a tight fist with each hand. Bend your wrists down and count to five. Repeat these stretches eight to 10 times during each break.

~ Do not press on hard surfaces with the heel of your hand while rising from your seat.

~ Ergonomic (especially designed to suit the human anatomy and facilitate tasks without injury) keyboards are available; these can reduce the stress on your wrists.

~ A wrist rest on your mouse pad or a specially designed mouse might help, though the effectiveness of these measures has not been scientifically demonstrated.

~ Keep the mouse as close to the keyboard as possible and try to move it with your arm and not your wrist.

~ Lose weight if you are overweight.

In carpal tunnel syndrome, as in most ailments, an ounce of prevention is better than a pound of cure.

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Dr Roopa Nishi Viswanathan has an MBBS from KEM Hospital, Mumbai, with a Masters in Nutrition from the University of Texas at Austin. 

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Dr Roopa Nishi Viswanathan