Repetitive Stress and Carpal Tunnel Injuries

Whether you sit at a desk in front of a computer or do outdoor heavy manual labor you are susceptible to repetitive stress injuries (RSIs) or cumulative trauma disorders (CTDs). The repetition of the work activity you may do every day can cause a cumulative injury to the soft tissues of the body. Over time, this micro trauma can result in pain and the inability to perform work activities. The good news is that most of these injuries can be avoided by improving the environment and technique required to perform one’s individual job functions.

Ergonomics is this study of the relationship between the work and the worker. Nearly 2 million workers per year will suffer ergonometric injuries. Worker’s compensation claims have nearly tripled in the past two decades. A majority of this increase can be attributed to inadequate ergonometric conditions in the workplace.

Carpal Tunnel, tendinitis, and tenosynovitis are the most common disorders we treat as Hand Surgeons. The incidence is only growing as greater numbers of our work force are set behind a computer screen for much of the working day. The repetitive nature of keyboard operations can be minimized by several actions. Detachable keyboards that can be adjusted for comfort and variation of hand and wrist position. Different mouse designs that will allow dispersion of the stress to the upper extremity. Adjustable height chairs, cushioned arm and hand rests to decrease stress on joints and tendons. In addition, frequent short work breaks for specialized stretches have been found to be beneficial in preventing symptoms and improving comfort. When all else fails, a visit to a hand surgeon for a trial of steroid injection can be helpful prior to considering carpal tunnel release surgery.

If conservative treatment fails, carpal tunnel releases will in most cases solve the issue. Whether done open or endoscopically, the results are uniformly good. Expectation is for a full release to work in approximately 3-4 weeks for an endoscopic release and 6 weeks for an open release. The surgery simply enlarges the passageway at the wrist where the nerves and tendons pass. With less pressure on the median nerve, the symptoms resolve quickly.

 

Glenn J. Jonas, M.D.
Worklink Physician Liaison