As a board-certified musculoskeletal specialist physician, one of the more common conditions that I diagnose in keyboarders is called carpal tunnel syndrome (CTS). It’s a painful hand condition that is caused by pinching of a nerve (the median nerve) as it courses through a bony tunnel in the wrist. Since “carpus” is Latin for “wrist,” you can understand why the condition is called carpal tunnel syndrome. (I threw that FASCINATING bit of etymological trivia in there because this is a writer’s blog, and, well…..I was just trying lighten up the medical jargon and appeal to your fascination with words. Did it work?)
The symptoms of CTS include numbness, tingling, pain, and swelling, usually in the index, long, or ring fingers, but sometimes the symptoms extend into the thumb and up into the forearms and even the shoulder. Patients tend to say their hands go numb while fixing their hair, putting on make-up, or driving. They also say that the symptoms wake them from sleep at night and cause them to shake out their hands, and that the associated numbness causes them to drop small objects, like pens, spoons, and coffee cups.
Though these symptoms may be intermittent at first, eventually, if the condition is left untreated, the symptoms may become constant and/or severe.
Though CTS can occur in healthy individuals, it is even more likely to occur in those who are diabetic, hypothyroid, or heavy consumers of alcohol–especially if they keyboard excessively.
The main diagnostic test for CTS is called an electrodiagnostic study and is sometimes abbreviated as an “EMG.” I’ve personally performed many thousands of these tests and I can assure you it isn’t a fun test. In the first part of the EMG, I have to zap your nerves with electricity to see how well they conduct, and in the second part, I have to insert a fine wire through your skin and into your muscles to determine if the muscles are electrically unstable due to an underlying nerve problem.
Early treatment for CTS generally consists of wrist splinting at night along with non-steroidal anti-inflammatory medicines. Carpal tunnel steroid injections may be utilized for diagnostic purposes in some cases (like if the EMG is equivocal) but those injections don’t seem to fix things for long. In most cases, surgery is an excellent alternative–especially if it’s done by an experienced orthopedic sub-specialist hand surgeon or neurosurgeon.
Like with many other conditions, an ounce of prevention is worth a pound of cure. Optimize your chair and desk height so that your wrists remain in “neutral” position (i.e. straight) as you keyboard, maintain tight control of your blood sugar if you’re diabetic, minimize alcohol consumption, work with your physician to optimize your thyroid hormone levels, avoid bending your wrists at night by wearing wrist splints, and take frequent rest breaks from keyboarding—like I’m going to do right now!