Do You Experience Wrist Pain? How Do You Know if it’s Carpal Tunnel

Have you been experiencing pain in your hand, especially in the thumb, index finger and middle finger area?  Or maybe a fuzzy feeling or pins and needles and/or numbness in the same described area?

wrist pain
Image by FreeImages under FreeImages.com Content Licence

These are all symptoms of carpal tunnel syndrome.

What is carpal tunnel syndrome?  Carpal tunnel syndrome is a problem where one of the nerves (the median nerve) that feeds the hand, becomes irritated and inflamed.  This inflammation of the median nerve in the wrist area results in swelling of the tissue surrounding the median nerve.  Because there is very little space in the area where the median nerve passes through the wrist, swelling in this area causes pressure on the median nerve.  This pressure on the median nerve in turn causes your symptoms of pain, pins and needles and numbness in the thumb, ring finger and index finger and the area in the palm just below it.

carpal tunnel syndrome
“Carpal Tunnel Syndrome” by Bruce Blaus under licence CC BY 3.0

Inflammation of the median nerve is normally due to overuse of the hand, and this condition is also known as repetitive strain injury or RSI.  Office workers and factor workers are both at risk of developing carpal tunnel syndrome.

In office workers,  RSI/carpal tunnel syndrome is quite a common injury.  Not quite as common as neck pain or lower back pain (read my post on 4 computer positions that cause neck pain) but quite common nonetheless.

One of the reasons office workers end up with RSI/carpal tunnel syndrome is due to excessive use of the computer mouse.  Strangely enough, too much typing is not associated with the development of carpal tunnel syndrome.  Another reason office workers are susceptible to developing carpal tunnel syndrome is due to pressure on the underside of their wrist.  People who use mouse pads place themselves at risk of developing carpal tunnel syndrome due to the pressure they place on their wrist when they rest their wrists on their mouse pad.  This is slightly ironic, since the mouse pad was developed to help with carpal tunnel syndrome.  Research has shown though, that mouse pads actually increase the incidence of carpal tunnel syndrome rather than reducing it.  So, please throw your mouse pad away!

Factory workers are at risk of developing carpal tunnel syndrome due to excessive hand use, particularly in activities that cause them to bend their wrists, such as jobs that involve repetitively folding boxes all day.

Sometimes, carpal tunnel syndrome can also be due to mechanical compression that occurs as a result of scarring in the area from a wrist injury.  Injuries result in inflammation, and inflammation always creates scarring in the inflamed area.

One of the reasons it’s always important to get physiotherapy when you have an injury, is because your physiotherapist will help to reduce secondary complications that in themselves can cause problems for you down the line, such as the scarring mentioned above.  Your physiotherapist has many many years of training and specialising in injury management (Find a Physio near you).

How do you test whether you may or may not have carpal tunnel syndrome?  Simply bend your wrist forwards (fingers and hand moving palm downwards towards the forearm) and sustain that position for a few moments (about a minute).  If your symptoms appear or increase, you likely have carpal tunnel syndrome.  If you go see a specialist (e.g. a neurosurgeon/neurologist), they may do a nerve conduction test to see if the nerve is functioning properly and to assist in diagnosing carpal tunnel syndrome.  Ensure that you also go see your physiotherapist for your rehabilitation.  Physios work hand in hand with your specialists to help get you back to normal as fast as possible.

What are common causes of headaches at the computer?

A pounding headache.  Thump, thump, thump….  Who of us, stuck behind a computer for hours, has not experienced this?

headache
“Can’t Concentrate” by Sasha Wolff under licence CC by 2.0

Headaches and neck pain are very common in office workers and have a debilitating affect on our mood, concentration levels and productivity.

Since headaches are so common, it’s worthwhile understanding what can predispose us to developing a headache in the work place.  What are some of the common causes for developing headaches at work?

  1.  Glare on your computer screen

Glare can be a real problem in the office, especially when it causes you a headache.  To resolve glare, you need to first find the source of your glare.  Is your glare coming from the light above you or is your glare coming from a window?  To help reduce glare, you may need to move your computer screen and sometimes even your desk so that the glare is no longer a problem.  If that’s not an option, you can get anti-glare films to put onto your computer screen or even changing the angle of your screen to reduce the glare may help.  If the glare is from a window, consider blinds or curtains to help address the problem.  Speak to your co-workers, I’m sure that they will understand that headaches caused by glare are not fun and then they will be more willing to help you find a solution.

 

2.  A poking chin posture

A poking chin posture is a common cause of headaches for people working behind a computer.  A poking chin posture causes compression of the neck joints just below the skull, which in turn causes your headaches.  A poking chin posture is often as a result of a poor computer monitor position.  Ready my post on 4 monitor positions that cause neck pain or my post on how the how the position of your monitor causes neck pain to learn more about it.  Neck pain and headaches often go hand in hand.

 

3.  Working for too long without a break

Working for too long without a break is a common mistake that most people make.  We forget that we are not robots, and that our bodies require time out to function properly.  Read my post on work breaks to learn more.

 

4.  Tension in your neck muscles

Tension in your neck muscles will most certainly cause both neck pain and headaches.  This tension will be created as a result of stress or poor posture at your desk.  Read my post on stress and neck pain to learn more.

 

5.  Using the wrong spectacle prescription

Using the wrong spectacle prescription while working at a computer or reading will strain your eye muscles that commonly leads to headaches.  When last did you have your eyes checked?

 

6.  Not drinking enough water

When you are dehydrated, one of the symptoms is a headache.  You may be dehydrated because you don’t enjoy drinking water, or because you’ve been drinking too much coffee and tea which stimulates your body to eliminate water.  However, if you drink too much water, and eliminate too many salts from your body in the process, you may also develop a headache.  Moderation is key.

 

7.  Hunger

When you don’t eat properly, you affect the finely tuned equilibrium that your body is constantly seeking and designed to seek.  When you don’t eat properly, you affect the sugar levels in your blood and low blood sugar levels trigger a system of responses that can lead you to experiencing a headache.  Do you often suffer from headaches and do you also eat badly?  Have you had your blood sugar levels tested?  Maybe it’s time to go see your GP and maybe a nutritionist to help you look after yourself better.

 

Overall, working for long hours without a break can cause many of the problems mentioned above.  Too many people tend to neglect themselves at work, without realising that doing so negatively affects their work and their health.  Are you one of them?

 

References:

Johnston V., Souvlis T., Jimmieson N.L., Jull G. 2007. “Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers.” Applied Ergonomics 39: 171-182.

Grimby-Ekman A., Andersson E.M., Hagberg M. 2009. “Analysing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.” BMC Musculoskeletal Disorders 10 (73). doi: 10.1186/1471-2474-10-73.

Helland M., H. G. (2008). Musculoskeletal, visual and psychosocial stress in VDU operators after moving to an ergonomically designed office landscape. Applied Ergonomics, 39, 284-295.

Malinska M., B. J. (2010). The Influence of Occupational and Non- Occupational Factors on the Prevalence of Musculoskeletal Complaints in Users of Portable Computers. International Journal of Occupational Safety and Ergonomics (JOSE), 16(3), 337–343.

Wahlstrom J., H. M. (2004, June). Perceived muscular tension, job strain, physical exposure and associations with neck pain amongst BDU users: a prospective cohort study. Occupational and Environmental Medicine, 61(6), 523-528.

Wahlstrom J., L. A. (2003, October). Perceived muscular tension, emotional stress, psychological demands and physical load during VDU work. International Archives of Occupational and Envronmental Health, 76(8), 584-590.

Why the Spinal S-Curve is Important in Back Pain

Lower back pain is extremely common.  It is so common that 8 out of 10 people will experience it at some point in their lives.

Lower back pain can be caused by many factors.  These include factors such as genetics or birth defects (spondylolysis), trauma (falls or car accidents), infections (bacterial infections or even TB of the spine), and poor posture and movement patterns.  Sometimes a combination of causes is to blame for our lower back pain.  Out of all the factors I’ve listed, the one that we have the most control over on a day to day basis, is our posture and our movement patterns.

Back Pain
Personal Injury Back Pain by SanDiego’s PersonalInjury Attorney’s Photostream is licenced under CC by 2.0

The most at risk postures for developing lower back pain are sitting and bending postures.   These two postures when performed badly put our spines at a high risk of developing lower back pain, and people who do a lot of sitting and people who perform a lot bending are often the people who complain of lower back pain.  Think of office workers, drivers, nurses, machine operators, fatory workers, manual workers and more.  These people and others who engage in a lot of sitting and/or bending on a day to day basis are the people who are at risk and who do develop lower back pain.  Does that sound like most of us?  Exactly, hence the high incidence of lower back pain!

Read my post on driving postures and lower back pain.

One of the most important elements of our posture in helping to prevent lower back pain, is the s-curve of our spine and maintaining the s-curve of our spine in different postures and movement patterns.

Read my post on correct lifting posture for picking up children.

The spinal s-curve consists of 3 different curves.  There’s a curve that goes in at the neck (the cervical lordosis), followed by the curve that goes out in the upper back (the thoracic kyphosis) and the curve that goes in again at the lower spine (the lumbar lordosis).  The depths of these curves may vary in different people, but we all have the 3 curves illustrated below and they are very important for our biomechanics and general spinal health.

spinal s-curve
Vertebral Column by Unknown and is licenced in the Public Domain

The importance of these curves in helping to prevent lower back pain, is that these spinal curves throw our centre of gravity between our feet.  With our centre of gravity lying between our feet, the compressive and shearing forces on our spine which may lead to lower back pain are reduced.  Keeping these shearing and compressive forces as low as possible acting on our spine helps to keep the forces acting on our backs within limits that our body tissues can naturally withstand, which then helps to reduce or prevent lower back pain.

centre of gravity
Center of pressure in relation to centers of gravity while walking by Jasper.o.chang under licence CC BY-SA 3.0

When we change these curves through engaging in poor posture while sitting, standing, lifting, driving, picking up children etc., we increase the forces on our spine unnecessarily causing many problems with the complex spinal biomechanics and anatomy that result in injury and lower back pain.

 

How often do you lose your spinal curve in your activities during your day?  Do you suffer from back pain?  Is your poor posture partly to blame?

 

 

 

 

 

 

 

 

Ergonomics and Work Breaks – Helpful or not?

I recently read an interesting article regarding taking effective breaks at work.  This article stated that the most productive 10% of their surveyed population took a regular work break of 17 minutes out of every 52 minutes.  The authors surmised that this improvement in the productivity of the individuals who took work breaks was due to the fact that as people, we get bored easily, and as our boredom grows, our attention to our work similarly decreases, resulting in lower productivity over time, unless we take a work break.

Timer
Pomodoro Technique by Michael Mayer is licensed under CC by 2.0

I used to study classical piano performance at university, and when one practices for 5 plus hours a day, things can become monotonous and unproductive unless you have a plan.  In addition, the musical works one is learning (which are also many), are long and intricate and require a clear mind and direction.  My piano professor used to make me divvy up my piano practicing day into 30 minute blocks and then divide the musical works that I needed to learn and master across these blocks.  Then, strictly adhering to this schedule, I was required to practice for 25 minutes and then stop and take a 5 minute work break before continuing with the next 30 minute block and piece of work.

I used to think that I would never get anything done.  However, surprisingly, a lot of work was covered over time.  Following this method of taking work breaks, I used to succeed in learning a lot of difficult musical work, faster and better than I would’ve done, had I never followed his model and taken my work breaks.

This is pivotal, since many musicians (and office workers) tend to think that they need to get started with their work and then drive forwards until they hit that sweet spot of concentration and continue until they hit the wall of physical and mental fatigue.  We all know, however, that once you’ve hit that wall, your productivity takes a serious dive.

The problem with this approach to work is that you end up exhausting yourself so that after 2 or 3 hours, your brain is a rag and anything you do afterwards is unproductive and sometimes counterproductive.  When you’re tired and depleted like this, the other downside in addition to reduced productivity is that you also become prone to making mistakes.  This is because your mind is no longer clear and sharp, rather it is clouded by fatigue.

There are other studies that have been undertaken to determine the benefits of work breaks for office workers.  These studies looked at the optimal work break schedule as well as the effects of taking a work break on the participants.

Due to different study models, an optimum work break schedule is hard to pin point, however, some researchers recommend taking a 5 minute work break every half an hour, or 2 x 15 minute work breaks in your day, or 4 x 5 minute work breaks over the course of your day.  What was clear from the research was that it was very detrimental to your health and your productivity if you worked for 4 hours or more without taking any work break.

These studies also found, however, that taking work breaks also helped to improve productivity, reduce fatigue and  reduce phycial aches and pains.

 

Food for thought next time you feel that you’re far too busy to take a work break because of a deadline that you have to meet?  Perhaps, you might find it easier and faster to meet that deadline if you plan a few work breaks into your day?

 

References:

P., Tucker. 2003. “The impact of rest breaks upon accident, risk, fatigue and performance: a review.” Work & Stress 17 (2): 123-137.

Galinsky T., Swanson N., Sauter S., Dunkin R., Hurrell J. et al. 2007. “Supplementary breaks and stretching exercises for data entry operators: A follow-up field study.” American Journal of Industrial Medicine 50 (7): 519-527.

Johnston V., Souvlis T., Jimmieson N.L., Jull G. 2007. “Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers.” Applied Ergonomics 39: 171-182.

Balci R., Aghazadeh F. 2003. “The effect of work-rest schedules and types of task on the discomfort and performances of VDT users.” Ergonomics 46 (5): 455-465.

Grimby-Ekman A., Andersson E.M., Hagberg M. 2009. “Analysing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.” BMC Musculoskeletal Disorders 10 (73). doi: 10.1186/1471-2474-10-73.

Ergonomics – What is it and who is it for?

Vitruvian man by Leonardo da Vinci
“Vitruvian man by Leonardo da Vinci” by Hans Bernhard is licensed under GFDL-CC-BY-SA-all.

Ergonomics.  This is the new buzzword in corporates in South Africa at the moment and its been a long time coming.  The profession started developing around the time of the second world war and has finally been legislated in South Africa in December 2019.

Ergonomics is an important part of health and safety but a lesser known element is how ergonomics is able to streamline the functioning of a system and improve the quality of its output (any output – not only goods) as well as improving work productivity while keeping the people working in the system in high morale and good health.

When looking to improve a system, ergonomics will look at how the system functions as a whole, as well as the interaction between divisions within a system (a system can be a whole organization or a team or an individual work task).   Ergonomists will then look at the physical, cognitive and mental elements involved and how they can be improved to create win-win scenarios for business and individuals.

Member of: Saiosh; ESSA and the HPCSA