Carpal Tunnel Syndrome and Repetitive Strain Injuries. A Guide for Wellness, Recovery and Prevention.

Transcription

1 Carpal Tunnel Syndrome and Repetitive Strain Injuries A Guide for Wellness, Recovery and Prevention

2 Copyright 2007, All Rights Reserved UK Copyright and International Laws apply. Copyright Notice You may not reproduce any part of this publication, store it in a retrieval system, or pass it on in any form or by any means, electronic, mechanical, by photocopying, recording, scanning, or otherwise, without the prior written permission of the Publisher and Author. Any unauthorised broadcasting, public performance, copying, or transfer or material constitutes infringement of copyright. This book and all the information here are provided to you for information and education purposes only. The author, creator and publisher of this guide are not medical providers. You should not construe the information herein as medical advice. The information presented in this guide is not meant to replace the advice provided by your GP. No warranty may be created or extended by sales representatives or written sales materials. The information and strategies enclosed may not be suitable for your situation. You should always consult with a medical health professional when dealing with any medical condition. The same is true of any program involving your health and wellness. Information about health cannot be generalised to the population at large. Keep in mind you should consult with a qualified physician when suffering from any illness. Neither the Publisher nor Author shall be liable for any loss of profit or any other commercial damages resulting from use of this guide. You agree by reading this to protect and hold harmless the author, publisher and owner of this guide. You waive all rights about any circumstances negative or otherwise that arise from use of this book, including emotional or physical distress. The author, publishers and associated contacts are not medically qualified to treat or provide education and direction about specific health conditions. You recognise that you take and use all information as is. All links are for information purposes only. We do not warrant for content, accuracy or any other implied or exact purpose. Brought to you by 2

3 Table of Contents Introduction...4 The Purpose of this Guidebook...4 Overview of Carpal Tunnel Syndrome...6 Glossary of Terms...6 Cumulative Trauma...7 Signs and Symptoms...7 Who is at Risk?...8 Treatment and Prevention of Repetitive Injuries...10 Exercises to Help Prevent Strain...10 Dietary and Lifestyle Changes...11 Computing Industry...12 Construction Industry...13 Treatment of Injuries...13 Review...14 Myths and Mysteries Surrounding RST...16 Conclusions...22 References...23 Brought to you by 3

4 Introduction Many studies reveal repetitive strain injuries or (RSI) including Carpel Tunnel Syndrome (CTS) are reaching new and epidemic proportions, at least according to Medical News Today and Body Aches News. Dennis Downing of BackSafe.com reports millions of people suffer from RSI injuries every year, mainly because of the increasing use of computers and technology in daily activities. Those most at risk are individuals who spend multiple hours each day in front of a computer, working with a keyboard, or individuals on assembly lines that perform repetitive tasks daily. However, computer users are not the only people at risk for injury. Construction workers, healthcare workers, musicians and work or form of play requiring repetitive motion can result in injury and chronic pain. RTI injuries, especially CTS result in billions of dollars of lost work time, pain and suffering every year. Most injuries are difficult to heal, especially if you become injured but have to continue working. With proper education and evaluation however, most people can recover from and prevent future repetitive strain injuries. We will show you how. The Purpose of this Guidebook This guidebook will help you understand CTS and RSI injuries, and help you understand steps you can take to treat symptoms, relieve pain, and even prevent future injuries from influencing your ability to feel your best and avoid permanent suffering. Most people with repetitive strain injuries experience feelings of depression, discomfort or fatigue. This is normal, and treatable. Using the tips outlined in this guide and medical advice provide by your GP, you can learn to lead a healthier, more productive and better quality of life, no matter your diagnosis or condition. Even if you have not yet been fully diagnosed with an RSI injury, this book will teach you how to prevent injuries from hurting you and compromising your ability to work, play and enjoy your life. Brought to you by 4

5 We recommend you read this guide from beginning to end learning as much as you can about CTS and other repetitive strain injuries. Since CTS is THE main repetitive strain injury suffered by workers, this book will focus on describing this injury and providing details about how to treat it and improve the quality of your life following a diagnosis with CTS. It will however, also contain a wealth of information about other types of injuries, so you understand CTS and RSI from a much broader perspective. We begin our journey with an overview of CTS and RSI injuries. Brought to you by 5

6 Overview of Carpal Tunnel Syndrome Carpal Tunnel Syndrome is one or many illnesses or injuries grouped under what researchers refer to as repetitive injuries, or injuries caused when we repeatedly use or misuse certain tendons, muscles, or ligaments in the body. More often than not, these injuries result from occupational illness or hazards. Keep in mind as we go along in this guide however, that anyone can suffer from a RSI or carpal tunnel syndrome. To understand what CTS is, you need to understand some common definitions associated with this injury and injuries related to CTS, or those commonly grouped as repetitive use or repetitive strain injuries. Glossary of Terms Here are some terms used to describe carpal tunnel syndrome and related disorders. Understanding these terms will help you understand how to treat your condition and prevent future injury from affecting the quality of your life. Repetitive Motion Injury or Trauma A repetitive motion trauma occurs when someone injures the living tissue in the body. Usually this injury happens when you apply movement to muscles or joints in a certain way consistently over time. This causes fatigue and increases the muscle s susceptibility to injury or tearing. Repetitive strain injuries often involve greater damage to the tendons and muscles surrounding the joints. They result from repetitive use usually, but can happen as a single injury or incident occurs, causing lasting pain when a person reuses the part of the body often. Carpal Tunnel Syndrome Describes a specific injury or syndrome, resulting when a nerve in the wrist becomes compressed in the exact location it passes through the wrist to the hand. The syndrome results in weakness, pain and sensation disturbances in the hand. Many people mistake CTS for various other RSI injuries. Cumulative Trauma Disorder Often shortened to CTD this disorder results from repetitive motion and overuse of muscles when someone uses them in an incorrect position. CTD usually refers to chronic cases of CTS and other injuries that do not resolve permanently or go into remission with traditional treatment measures. A GP may also use this term to describe an injury occurring in multiple locations throughout the body. Brought to you by 6

7 Cubital Tunnel Syndrome CBTS, which is different from CTS, results from compression or an injury to the ulnar nerve in the cubital tunnel. This is the passage between the bony part of the within the elbow and the tip of the elbow. So, rather than suffer wrist and hand pain alone, the individual affected is likely to experience pain, tingling, numbness or weakness in the elbow and surrounding area. The idea of cumulative trauma or injury that builds up with time is an intriguing one. Understanding cumulative trauma is essential for combating CTS and RSIs. Cumulative Trauma CTS and all other repetitive injuries qualify under the general terms cumulative trauma or repetitive motion disorders. What exactly do these terms mean? To understand, you must understand how the tissues and tendons in the body work to help produce movement. Usually, tissues and tendons in the body slide easily back and forth to support movement of the wrists, fingers, elbows and other joints in the body. A synovial sheath, a capsule enclosing the tendons in the body, covers these soft tissues to protect them. Typically, movement does not result in pain, even when someone engages in the same movement daily. Consider for example, walking. Most people do not suffer RSI injuries by walking, and this is a repetitive task you engage in daily. However, when an individual engages in repetitive movements or injures to certain parts of the body, like the hands, wrist or elbow, this sheath, the synovial sheath, will fill with fluid and place pressure on underlying nerves. This results in pain, which pay spread to the fingers (with CTS) and the wrist. Signs and Symptoms Patients with repetitive use injuries often display the same or similar symptoms. CTS typically results in the following: Burning in the hand, fingers or wrist and thumb. Pain on movement of the hand, fingers, wrist and thumb. Prickling or tingling sensations that attend movement. Swelling and irritation of the fingers and other attachments. Other pain, tenderness or discomfort depending on the areas affected and the overall health of the person affected by the injury. Brought to you by 7

8 Repetitive injuries like carpal tunnel are more common among people who work in certain occupations (computer work, labor or manual labor, assembly etc.) or engage in repetitive sports (like tennis consider tennis elbow for example, a repetitive use injury). Who is at Risk? Some people are more at risk than others for CTS injuries. These include: People who work in assembly, as they often must perform the same tasks repeatedly. Individuals who work in mail services, as they too often must perform the same tasks repeatedly, straining the back, wrists or other areas of the body. People in the manual labor industry, including those engaged in data entry or word processing. Individuals performing data entry or word processing tasks daily are most likely to suffer from CTS specifically, with millions of the working population seeking healthcare and advice from their GP for pain associated with CTS injuries. Any tasks involving repetitive typing, bending and twisting can also result in injury. Did You Know? People who are overweight or obese are MORE likely to suffer CTS and other repetitive strain injuries. Why? Obesity contributes to swelling and edema in the body. This can compress nerves and result in pain and irritation associated with CTS and related disorders. Excess weight also carries with it extra pressure on the body s muscles and stresses the body when a person engages in repetitive tasks or tasks needing twisting and lifting motions. Apart from obesity or overweight, other risk factors for CTS and related disorders may include having diabetes, one s age (the older you are, the less limber your tendons and tissues), one s general health status, gender (women are more at risk than men) and individuals with arthritis. Brought to you by 8

9 Arthritis also results in inflammation of the tendons and tissues surrounding the joints and ligaments, which can lead to CTS or symptoms of CTS. As GPs diagnose more and more individuals with CTS and other repetitive strain or overuse injuries, it is more important than ever consumers educate themselves about the causes, treatments and prevention of these disorders. Doing so will ensure you live a better quality of life, one without pain and discomfort. Now that you know a bit about CTS, it is time you learned more about other RSI injuries, treatment and preventive measures you can adopt to improve your health outcomes. Brought to you by 9

10 Treatment and Prevention of Repetitive Injuries The treatment for many repetitive use injuries like CTS is often the same. Most GPs encourage those affected to engage in an ergonomic evaluation at work. This evaluation will assess any causes contributing to your condition, including poor posture or an improperly set workstation. An experienced occupational therapist can help evaluate your workstation and adjust your chair, desktop, keyboard, or other workstation materials to help reduce any stress placed on your wrists, tendons and other body parts. A competent occupational therapist may also provide you with dietary recommendation and preventive exercises and steps you can take to help prevent injury. Even if someone sets your workstation correctly, if you work long enough hours you are subject to injury. Exercises to Help Prevent Strain Many exercises can help reduce your risk for developing repetitive use injuries or CTS. Exercises are a good idea for anyone engaged in routine activities that involve bending, twisting or stressing of the tendons, ligaments and joints in the body. Construction workers who work with vibrating tools are also at risk for injuries to their hands and their wrists, so they too will benefit from exercises. They may work more on strengthening and flexibility exercises to keep their muscles and ligaments in proper working order. Regardless of your industry, a therapist will usually recommend similar exercises. Most exercises focus on two areas: 1. First, strengthening the wrists, hands, fingers, and other muscles supporting the tendons and surrounding ligaments. 2. Second, exercises meant to relieve pain and discomfort and provide the ligaments and muscles a much-needed break. An occupational therapist or physical or other bodywork therapist is the person most qualified to help you decide what exercises are best to help strengthen supportive muscles that influence the repetitive actions you engage in. Brought to you by 10

11 As far as rest, work breaks are necessary for anyone engaged in repetitive activities, whether they work in construction, at a computer terminal, or in the manual labor industry. Work breaks consist of ten-minute breaks every hour on the hour. Here are some suggestions for good exercises and rest breaks that will help reduce tension and pressure in your joints and ligaments: If you work at a computer station, take ten minutes and step away from your desk. Raise your hands above your head. Flex your fingers open and closed for two minutes. Repeat ten times, two times each ten-minute break. Use a strong form of putty, exercise putty or clay, and roll it around the palm of your hand. This will help massage the tendons and ligaments in your hand and wrist, may help improve flexibility and may help strengthen your wrists and fingers. Be sure you consult with a qualified healthcare professional to select the putty best for you. Repetitive injuries may also involve the eyes. Eyestrain is a common complaint among workers spending long hours in front of computer terminals. Make sure you take time to look away from your computer for a few minutes each hour. Look at a distant wall, a blank wall for a few minutes, then close your eyes for five minutes and let them rest. This will do wonders for reducing eyestrain and may even help remove tension headaches. For workers engaged in other occupations, a qualified ergonomic or occupational therapist will work with you to help develop a sequence of activities that will help strengthen and relax your overworked muscles. These may include bending or stretching exercises to improve flexibility and promote circulating blood throughout various regions of the body. Dietary and Lifestyle Changes It is important you uphold a proper weight and eat a healthy diet to improve your overall health and reduce your risk for repetitive strain injuries. Your GP may recommend you consult with a qualified dietician, nutritionist and exercise health specialist or physiologist to develop an exercise program that will help strengthen your body and help you lose weight safely if you need to. Ergonomic Evaluations Brought to you by 11

12 Many employers will provide workplace ergonomic evaluations to employees at risk for repetitive strain injuries. Ergonomics involves studying how nature and structure affect the space you work in, and how restructuring your workspace using scientific principles can help reduce your risk for injury and improve your comfort. An ergonomic specialist may come sit at or visit your worksite to evaluate you while you work. They will make detailed notes about the way you sit, stand, type or handle equipment or machinery. They will notice postural changes, and recommend slight or major changes to your workstation to reduce pressure and strain on your wrists, hands, back and other body structures. These adjustments may seem awkward or uncomfortable initially, especially if you already suffer from CTS or another repetitive strain injury. However, with time and proper practice, your body will adapt to working in a newer, safer way. The sooner you have an ergonomic evaluation performed, the more likely you are to prevent future injuries from destroying your ability to work. Remember, ergonomic evaluations can be helpful for individuals in any occupation, not clerical or administrative workers alone. If you do plan to embark on a diet and exercise routine, make sure you include plenty of whole foods, foods that are not processed and do not contain many additives or chemicals, in your diet. You might also consider taking a good multivitamin supplement, even if you eat well. Many people do not understand that sometimes, eating well is not enough to aid your body. Some people need a little extra boost. A daily multivitamin will ensure your body gets the minerals and nutrients it needs to thrive and fuel you throughout the day, bolstering your immune system and reducing your risk for injury or illness. Now let us focus on a couple of industries where RSI are more likely to happen. Computing Industry Brought to you by 12

13 Carpal Tunnel Syndrome and other injuries are most common in the computing industry. The practice of ergonomic evaluation is now commonplace among many employers to help prevent injuries before they happen. New employers may spend time with an ergonomic professional, who will evaluate their desk and workstation and adjust it according to a person s height, weight and the work they perform. A specialist may also recommend specific exercises you should follow to help prevent injury. Because injuries are much easier to prevent than treat, it is important you make note of everything the ergonomic specialist recommends when you begin working. Construction Industry The construction industry is another industry where repetitive strain injuries are common. Many workers, including street workers, sheet metalworkers and other construction workers continue to work even with injuries. This can result in lasting neck, shoulder, back and hand pain that you may find difficult to treat successfully. When this pain becomes severe, the person suffering may develop a cumulative trauma disorder. In the severest form of injury, a person may experience lifelong disability from their occupational injury, leading to lifelong stress and the need for lifelong medical treatment and side effects. Manufacturing Industries or Electronics Any industry involving workers that assemble or collect and put small parts together may increase the risk for repetitive strain injury. If you work an assembly line, you may do the same activity repeatedly, increasing your risk for wear and tear on the ligaments, tendons and muscles involved. Now you know about risk factors for injuries, so, how can you treat an injury if you do develop one? There are many ways to treat RSI injuries. Treatment of Injuries If you already suffer from an injury, you must make adjustments in your workspace and routine. You also need to receive medical care to help your body heal. Most repetitive injuries like CTS take a longtime to recover from. Here are some examples of common treatments recommended by GPs for treating CTS and related injuries. Brought to you by 13

14 Anti-inflammatory medications These medications help reduce inflammation in the body. A repetitive strain injury usually results in inflammation in the body. Some examples of this medication include Paracetamol. Your doctor may prescribe some medication and recommend you use it daily until your symptoms become less prominent. Rest For many people, the best treatment initially is rest. Rest will allow the ligaments, tendons and tissues time to recover. This also helps decrease inflammation and swelling. You will need extra treatment however, when you start working again to prevent more strain to the injured site. Surgery In severe cases, where the nerves become compressed to the point where they cause undermining pain, or when a person experiences nerve compression in the spine or other major part of the body, a GP may recommend surgery to help soothe the pressure on the nerves. Usually this involves a lengthy recovery time, and the results may be unpredictable. It is best to try other means of treating your condition before considering surgery. Many GPs recommend surgery as a last resort when other treatments have failed. Iontophoresis Many repetitive strain and other disorders affecting the musculoskeletal system respond well to iontophoresis. In this treatment, a provider uses a drug or ionized substance and applies it to the skin using an electric current. This does not hurt, though a patient may report feeling some tingling sensation during treatment. Treatment typically requires multiple sessions. The result is a decrease in inflammation, which can in turn reduce pain and discomfort. Corticosteroid Treatment A GP may recommend localised treatment where they inject corticosteroids into the affected region of the body to help reduce inflammation and pain. This treatment is temporary and may cause side effects but often helps severe cases. Of course, there are many additional treatment alternatives a GP or therapist may recommend for you. Natural remedies may also prove helpful. These may include supplementing your diet with natural anti-inflammatory agents like flax seed oil or primrose oil. Review CTS and RSI injuries are common. Fortunately, you can treat most injuries with little intervention. The sooner you seek care for the injured or affected body part, Brought to you by 14

15 the more likely you are to recover from an injury without chronic or long-term effects. Since we spent some time talking about injury, we should spend a few minutes debunking some common myths and misconceptions people have about RSI injuries. Understanding these fallacies will bring you, one-step closer to preventing future injuries and treating the injuries you do have successfully. The next section focuses on some of the more common myths people have about repetitive strain injuries and disorders. Brought to you by 15

16 Myths and Mysteries Surrounding RST When it comes to carpal tunnel syndrome and other repetitive strain injuries, many myths and mysteries exist. This section will help you judge fact from fiction when reviewing your risk and treatment methods for these serious disorders. This section looks like a question and answer session to provide you with comprehensive information about each topic presented. Q. Is carpal tunnel syndrome most often caused by on-the-job overuse of the hands and wrists, like among people who work in clerical or computerrelated jobs? A. While carpal tunnel syndrome is common among data entry workers and other professions involving computer use, these types of jobs are not the MOST common cause for carpal tunnel syndrome. In fact, there are many conflicting studies about the causes for carpal tunnel and related repetitive strain injuries. Slater (1999) suggests workers in heavy manual labor or construction occupations are more at risk than computer workers for CTS. However, others report industrial employers are no more at risk than construction workers. i The truth is there is no one major cause for this disorder, there are many causes and many risk factors. The more easily you identify these risk factors and causes, the more likely you are to take action to prevent injury. Your overall health, personality, the time and length of employment, training and your ability to take breaks and engage in ergonomic evaluation may all affect your risk for CTS and related injuries. Some studies suggest certain systemic or total body illnesses, like autoimmune disorders including diabetes and arthritis, predispose people to these types of injuries. These are major causes for CTS, even more so than one s employment. How does this affect you? Use this information as a preventive tool. Consult with your GP and evaluate your risk factor for CTS and other repetitive use injuries. The more you know about your personal risk, the more active steps you can take to prevent an injury from becoming serious or long lasting. Q. What types of jobs other than construction or computer related jobs can result in repetitive strain injuries or CTS? A. There are many unusual jobs that can strain and injure you. Assembly workers who perform the same tasks repeatedly are sometimes more at risk for repetitive strain injuries than others, partly because in some industries they are less likely to receive information and training about the risk of CTS. Brought to you by 16

17 Some researchers note that unusual professions including jewelry making can place one at risk for CTS. This is because individuals who make jewelry often work with small pieces, including gems and beads, and perform tasks repeatedly that need precision, and that may result in strain and pain. Q. Can people not engaged in legitimate work activities suffer CTS? A. Yes! There are many people suffering from repetitive strain injuries resulting from work but also play! Tennis players for example, are more at risk than some other sports athletes for repetitive strain injuries like tennis elbow. Other activities that may result in injury include housekeeping. The act of cleaning floors for example may result in what some refer to as house worker s knee. Gamers, or people who engage in video gaming for sport, may also suffer what some call gamers thumb, which is a repetitive injury to the thumb that may result from pressing a button repeatedly when playing video games. While this may sound humorous, such activities can result in serious and permanent injury if not addressed. Writers, who write manually, without using a keyboard, can also injure their whole arm, their thumb and other parts of their body. Sometimes GPs refer to this pain as a writer s cramp. Anyone who engages in a task repeatedly is at risk for injury, whether you sew something, whether you make jewelry, count money or even sharpen knives for hours on end. Some people realise pain in their neck, shoulders, upper back and even lower back if they sit improperly. Even couch potato people with poor posture may suffer back strain from sitting in an unsupported position for long times. What does this mean for you? No matter what you do, you should strive for balance in your life. You should exercise regularly, take breaks from any activity you engage in routinely, and make sure you treat any injury that appears chronic. If you find you spend countless hours in front of a video game, and your thumb chronically hurts, and then take a week off. You can even visit your GP for recommendations about how to reduce your pain or improve your technique to reduce your risk for serious injury. Q. What is the difference between repetitive strain injuries and overuse syndromes? A. Many GPs classify carpal tunnel syndrome (CTS), repetitive strain injuries (RSIs), cumulative trauma disorders (CTDs) and other injuries as one in the same. They all result when you use or overuse parts of the body, which results in Brought to you by 17

18 short, or long-term injury and pain. Compression neuropathy also refers to CTS, because it results in compression of nerves in the wrists, arms and hands. Q. I am a musician. Could I be at risk for a repetitive use or strain injury? It seems almost anyone is at risk. A. Yes, almost anyone who performs any task routinely is at risk. This does not mean however, that you will develop a repetitive strain injury. It does however, suggest you should take preventive care to prevent an injury from influencing your ability to do what you like best, including playing music. Musicians often engage in repeated physical movements that affect the tendons, nerves and the muscles in many parts of their body, depending on the instrument they play. Some are more at risk for injuries to the hands and arms, while others may be at risk for injury to the fingers and wrists (like piano players) or the shoulders (like violin players). If you are not sure whether you are at risk, research your condition or consult with a GP to find out what types of exercises an other preventive measures you can take to help reduce any damage the tendons and soft tissues in your body may experience from repeated playing. No one wants to give up music. The good news is with proper care, you do not have to. Q. What are the more common exercises used to treat RSI? A. The types of exercises recommended may depend on the types of injury and place of injury you are most at risk for. For example, individuals working at computer terminals may use putty to help exercise and relax the hands, wrists and fingers. A GP may recommend they stretch their shoulders and neck. Other exercises may include back flexibility and core strengthening exercises, which can be helpful for people that must lift or engage in frequent bending during the day. A stabilisation ball is a tool many therapists use to help strengthen the core muscles or trunk muscles in the body (as these support the back, neck and even legs). Q. What are some other injuries or disorders that result in pain similar to CTS and RSI? A. Many injuries may result in pain, tingling and inflammation in a person s body. This is one reason it is critical you consult with a GP if you feel pain, tingling, numbness or discomfort when engaging in any activity. Here are some common injuries resembling RSI injuries. Some of these injuries are injuries that attend RSI injuries, meaning people develop them at the same time they develop RSI injuries. Brought to you by 18

19 Tendinitis This refers to inflammation, edema or swelling occurring within a tendon, according to the American College of Rheumatology. Tendons attach the muscles of the body to the bones, and contract to help move bones. Bursitis This refers to inflammation involving small sacs between the bones and the muscles or skin and tendons, called collectively the bursa. These small sacs are important because they allow the muscles, tendons and skin to glide easily in the body. Inflammation in the bursa of the body may resemble the pain people with arthritis feel. The symptoms are similar, and may include pain, stiffness, edema or tenderness, usually that comes with movement. People may experience more pain at night. People usually experience this pain near the joints more often than in other tendons or areas of the body. Unlike tendonitis, that when treated quickly often heals, bursitis can recur often or result in long-term or chronic pain and discomfort. It does not however, cause deformity but it may restrict the range of motion an individual has. Like may RSI injuries, bursitis often results from overuse or improper use of the body s ligaments, tendons or soft tissues. Sometimes conditions including tendonitis and bursitis go with rheumatoid arthritis or other autoimmune disorders. Tenosynovitis or DeQuervain s Syndrome This condition causes pain in the wrist and the forearm near the thumb. It is commonly confused with CTS. Usually with proper diagnosis, this condition is easily treated. Tenosynovitis affects tendons in the thumb, the abductor pollicis longus and the estensor pollicis brevis both which help move the thumb and connect muscle to bone. Tenosynovium is a slippery substance that lines the tunnel holding these two tendons in place; if this coating becomes infected or inflamed, then a person has tenosynovitis. Actions that can cause this condition include pinching or grasping and squeezing items repeatedly. People with autoimmune diseases including rheumatoid arthritis are also more at risk for this condition. Usually the best treatment for this condition is rest. Many GPs will recommend you work with a therapist to learn proper exercises to help avoid future irritation and work with you to ensure you use neutral alignment of the wrist when engaged in at risk activities like grasping or pinching and squeezing. Rarely when the condition warrants severe intervention, a GP may recommend anti-inflammatory agents or even cortisone injections to relieve pain and inflammation. Brought to you by 19

20 Tendinosis This is another term commonly used to describe tendonitis that is chronic in nature. Thoracic Outlet Syndrome This injury results in chronic neck pain, resulting from compression of the ligaments and tendons located between the cervical spine and bordering anatomy. Nerve roots become compressed and irritated, which may result in conditions radiating throughout the body. Common complaints include: o Inflammation in the arms and hand. o Discoloration of the hand resulting from improper flow of blood to the hand. o Heaviness or discomfort in arms and hands. o Pain in the neck and shoulder not lessened by ordinary means. o Fatigued arms or hands. o Muscle weakness. o Pain in the arms and hands. o Cramping and numbness that may occur in the hand, neck, shoulder and surrounding regions. Poor posture and injury are common causes for the compression resulting in this injury. Other people, including those with osteoporosis are more at risk for this condition. Stretching, strengthening and antiinflammation or pain medications are commonly used to help relieve any discomfort associated with this condition. With proper treatment, this condition dose not become chronic. Trigger Thumb Occurs when the fingers in the thumb (or sometimes a finger or multiple fingers become painful on movement, usually because someone uses the thumb or finger repeatedly, as in when they use a mouse to click repeatedly. The finger or thumb may spasm repeatedly and cause pain or discomfort. Other distinguishing features include a clicking sound when the person bends the affected appendage, and pain and tenderness in the affected area. Some patients with severe forms of this condition may form a nodule, which locks the thumb, or finger into a specific flexed position. If trigger thumb becomes this serious, a GP may recommend surgery to repair the injury and return normal movement to the afflicted area. You may need to use special equipment to avoid injuring the affected area again. Myofascial Pain Syndrome This is a chronic condition resulting in pain or a burning and stabbing sensation in a localised area. Many times what Brought to you by 20

21 happens is someone injures a tendon or muscle in the body that refers pain elsewhere in the body, thus this syndrome may be difficult to diagnose correctly. There is not much research on this specific disorder, other than identifying it by an aching and nagging sensation. It may result in chronic pain not easily treated, causing endless fatigue or even depression in some. Sometimes GPs diagnose the condition by finding trigger points in the body. These are places that when pressed, result in pain and tenderness often within a muscle. Usually patients with this condition have four different trigger point types, including an active point, where pain is most prominent, a latent point, a secondary point that is irritable and a satellite point, which is an irritable spot within a muscle that may be active when the muscle affected is found between other trigger points. Physical therapy can help relieve this condition sometimes, as can corticosteroid treatment. Q. What are the more common symptoms of RSI injuries? A. The symptoms you experience may depend on the type of injury you have or the severity of it. Here are some common complaints reported by people with RSI injuries: Warmth or redness of the affected tendons or joints. Tingling and numbness in the hands, fingers or arms, neck or limbs. Coldness in the hands or feet. Loss of strength in the affected area, like the shoulder, back or neck. Constant pain or pain on movement. This is common in the shoulder, neck, wrists, hands and fingers. Tenderness in the forearms or elbows. Tenderness in the palm of hands or feet. Pain in the upper or lower back or pain that radiates to legs. Q. How are RSI and related injuries diagnosed? A. There are many ways GPs can diagnose conditions including CTS, RSI, tendonitis and related disorders. The more common diagnosis instruments include physical examination, medical history, X-rays to help identify arthritis or other underlying conditions and MRIs or other tools that provide graphical images of the tendons and tissues of the body. Brought to you by 21

22 Conclusions Repetitive strain injuries, disorders, and carpal tunnel syndrome are among the more common injuries suffered today. As more and more people rely on technology to work and as a form of communication, GPs will continue seeing more patients with these types of injuries. You have the ability to overcome CTS and other repetitive use injuries. The key to your long lasting health knowledge. You must understand what to look for, and taking proper action if you feel your body is overstressed. This guide described many of the more common signs and symptoms of CTS and RSIs. If you have any suspicion you might develop these injuries consult with your GP or occupational therapist at work. They can help you develop an action plan that will reduce the odds of chronic injury. With prompt care, most injuries do not become chronic. We hope you enjoyed our guide on CTS and repetitive use injuries. To your health, and your wellness! Brought to you by 22

23 References Armstrong, TJ, Chaffin, DB. Carpal tunnel syndrome and selected personal qualities. Journal of Occupational and Environmental Medicine, 1979; 21:481. Bingham, RC, Rosecrance, JC, & Cook, TM. Prevalence of abnormal median nerve conduction in applicants for industrial jobs. Am J Ind Med, 1996; 30(3):355 Cannon, LJ, Bernacki, EJ, & Walter, SD. Personal and occupational factors associated with carpal tunnel syndrome. Journal of Occupational Medicine, 1981; 23:255. Slater, R.R. Carpal tunnel syndrome: Current Concepts. J South Orthop Assoc. 1999; 8(3):1. i Armonstrong, Chaffin. Carpal tunnel syndrome and selected personal attributes Brought to you by 23