Typing considered harmful

Many programmers suffer from repetitive stress injury, carpal tunnel syndrome and/or pinched nerves in the neck, and can no longer type without pain. It can even interfere with daily life, making sleeping, opening bottles, and filling up your car with gas difficult.

Causes

• Typing with your wrist resting upon a sharp edge (I'm thinking of Bill G's wooden door desks at Knowledge Adventure :-)
• Letting forearm muscles get weak
• Typing while forearm muscles are sore and irritated (which causes tendon swelling, which irritates nerves that share the carpal tunnel with those tendons)

Treatment

• A course of non-operative treatment is an option in patients diagnosed with carpal tunnel syndrome. Early surgery is an option when there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment.
• We suggest another non-operative treatment or surgery when the current treatment fails to resolve the symptoms within 2 weeks to 7 weeks.
• Local steroid injection or splinting is suggested when treating patients with carpal tunnel syndrome, before considering surgery.
• Oral steroids or ultrasound are options when treating patients with carpal tunnel syndrome.
• We recommend carpal tunnel release as treatment for carpal tunnel syndrome.
• Heat therapy is not among the options that should be used to treat patients with carpal tunnel syndrome.
• We recommend surgical treatment of carpal tunnel syndrome by complete division of the flexor retinaculum regardless of the specific surgical technique.

Non-surgical treatment

• Wear wrist splints at night (I like Modabber's brace; it's the only one I've found comfortable) helps prevent further nerve damage.
• Plunge both arms into ice water for 30 seconds, then hot water for 30 seconds, repeat several times per day; see e.g. this page for similar tip
• Strengthen the forearm muscles
• Stretch the forearm muscles (there are *many* books and web pages on the subject, see e.g. this one)
• Research results
  • pubmed 21477381 looked at seven studies, and found that surgical treatment was better than nonsurgical treatment, but had more complications.
  • pubmed 21153642 found splinting plus phonophresis/iontophoresis of betamethasone helped reduce symptoms more than splinting alone
  • pubmed 19347928, a double-blind study with 17 patients, found six sessions of iontophoresis of dexamethasone no more effective than placebo
  • pubmed 18719003 describes iontophoresis of dexamethasone
  • pubmed 17443508 evaluated 12 studies, and found a single injection of corticosteroids effectively provided some relief for a month
  • pubmed 15668556 found that injection of methylprednisolone was more effective than iontophoresis of dexamethasone.

See Also

• Allen Cypher's RSI page
• Sorehand Mailing list
• Datahand-users mailing list - for users of the Datahand ergonomic keyboard