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Friday, September 14, 2007

Carpal tunnel syndrome - Wikipedia, the free encyclopedia

Helge: Need to take a deeper look into this. The repetitive stress injury (RSI).

Carpal tunnel syndrome - Wikipedia, the free encyclopedia: "Carpal tunnel syndrome From Wikipedia, the free encyclopedia • Ten things you didn't know about Wikipedia •

Jump to: navigation, search Carpal tunnel syndrome Classification & external resources Transverse section across the wrist and digits. (The median nerve is the yellow dot near the center.

The carpal tunnel is not labeled, but the circular structure surrounding the median nerve is visible.) ICD-10 G56.0 ICD-9 354.0 OMIM 115430 DiseasesDB 2156 MedlinePlus 000433 eMedicine orthoped/455 pmr/21 emerg/83 radio/135 MeSH D002349 This article is about the medical condition.

For the anatomical structure, see Carpal tunnel. For the Kid Koala album, see Carpal Tunnel Syndrome (album). Carpal tunnel syndrome (CTS) is a medical condition in which the median nerve is compressed at the wrist, leading to pain, paresthesias, and muscle weakness in the forearm and hand.

A form of compressive neuropathy, CTS is more common in women than it is in men, and, though it can occur at any age, has a peak incidence around age 42. The lifetime risk for CTS is around 10% of the adult population.

Although the condition was first noted in the medical literature in the early 1900s, the first use of the term 'carpal tunnel syndrome' was in 1938. The pathology was identified by physician George Phalen of the Cleveland Clinic after working with a group of patients in the 1950s and 60s.

CTS became widely known to the general public in the 1990s as a result of the significant increase in chronic wrist pain due to the rapid expansion of office jobs. Other conditions may also be misdiagnosed as carpal tunnel syndrome."

RSI is no small matter. It accounts for 34% of all lost-workday injury and illness — and costs almost $20 billion annually, according to the Bureau of Labor Statistics. The National Academy of Sciences has concluded that an estimated $50 billion is lost by businesses every year from sick leave, decreased productivity and medical costs linked to repetitive stress disorders. The Academy has published two reports since 1998 which directly link repetitive motion to workplace injury.

The damage sustained from RSI is due to structural changes in the muscle fiber as well as due to decreased blood flow. Nerves can also be involved. The immobile tissue and surrounding inflammation compress the nerve which can cause numbness or tingling and eventually weakness if the nerve is damaged severely.

For those of you who need evidence, see this study on "Overuse Syndrome." In this study, biopsies were taken from hand muscles of injured and normal subjects, which demonstrated the structural damage in the muscle fibers and correlated the damage with the severity of the injury. In another study, biopsies were taken from neck muscles, and reduced local blood flow was found in the injured areas. The greater the pain difference, the greater the reduction in blood flow.

Some of the most common RSI injuries are tendonitis and carpal tunnel syndrome (CTS). Work-related carpal tunnel syndrome now accounts for more than 41% of all repetitive motion disorders in the United States, says this study. And here's a telling title: "Hard work never hurt anyone: or did it?" -- it's a review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb.

So what should you do? The key to treatment is prevention. Research shows that injuries decrease and productivity increases when employers encourage stretch breaks and stress the importance of ergonomics. See for example this one at at Ergonomics Now.

Here are a few tips: -- Breaks should be taken every 30-45 minutes for at least 5 minutes. If you need assistance there are free downloadable timers that will help remind you to do so.

  1. Stretch your arms, hands, neck, and back during breaks. This yoga site demonstrates some exercises. Other sites are listed below.

  2. Maintain posture alignment. Don't slouch on the couch with the laptop.

  3. Work stations should be reviewed initially and with each office move. Adjust your chair, monitor, keyboard, mouse, laptop. Alternate keyboards and mice periodically.

  4. Shift your gaze from the computer screen to the distance. And don't forget to blink!

  5. Limit non-essential computer use. This may be heresy -- but do give the surfing, gaming, emailing, and text messaging a rest.

-- If pain occurs or persists, see your doctor, who may recommend wrist brace, ice packs, anti-inflammatory medication such as ibuprofen, cortisone injections, physical therapy, and most importantly, rest to allow healing. Don't procrastinate in addressing your symptoms -- the sooner you tend to them, the better off you are.

And finally, here are more sites that may be helpful:



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