Wednesday, December 4, 2013

Repetitive Strain Pain From Typing

Pain in the forearms, wrists and hands is a modern day epidemic. We cannot live or work without a keyboard and mouse and that results in a constant stress on the muscles and tendons of the forearms and hands. The necessity of the keyboard and mouse in our information age also makes the traditional treatment of resting them inconvenient or impossible.
So what can we do?
The first question we must ask ourselves is whether this is repetitive strain injury, which is an inflammation of the tendons. This will not only cause pain when the hand is moved but also there will be tenderness over the tendon itself, most commonly at the elbow. However, there should be no external signs of anything amiss, like lumps or bumps that may even move when the fingers move. Those may require surgical excision.
The most common problem that mimics repetitive strain injury is a trapped nerve in the neck due to excessive tension in the neck muscles. When a nerve is squashed, it causes pain in the area that the nerve supplies. All the nerves that supply the hands and forearms come through the neck. There may be no pain in the neck itself or it might feel a little stiff. It can also be associated with headaches when using the computer. However, there will be no tenderness at the site of the pain.
Setting up the workstation is the first step in reducing or curing either of these problems. The key is to be in a comfortable position where the stress on the body is kept to a minimum. This not only relaxes the neck and shoulders but also decreases the muscle tension in the forearms since the muscles are not fighting against one another.
Most people type with their screen far too low, especially when using a laptop. For the neck and shoulders to be relaxed, the screen should be at eye level and it should be at least 2 feet (60 cm) away. A simple box under the monitor is the easiest solution. If using a laptop for prolonged periods, it is best to buy a separate keyboard and mouse so that you can separate them from the screen in terms of both height and distance.
Learning to touch type is essential. If you are forever looking down at the keyboard to see what your fingers are doing, you are asking for problems.
You should sit upright in your chair with the upper arms hanging straight down from the shoulders. It is best if the elbows should be supported by a chair with arms at this level. Ideally, the keyboard should be very close to your stomach, a little lower than with a desk which is why keyboard drawers are advisable. Most people can cope with the height of a normal desk so long as they can rest their wrists just in front of the keyboard.
Quick, short term relief from stress during a stint working under imperfect conditions is to lie face up on the floor with a rolled up towel between the shoulder blades. Look at the ceiling, not at the wall behind you. The arms are held at just above shoulder height, palms facing upwards and let gravity stretch out the muscles at the front of the chest while relaxing those of the shoulders and neck for five minutes.

The Next Step
Setting up the workstation for good posture is essential in preventing and minimizing problems but if those problems have set in, other intervention may be necessary to resolve the problem quickly and efficiently.
The first line of professional help in these matters is available from physiotherapists, chiropractors, osteopaths and Chinese physicians trained in acupuncture. All are recognized, evidence based treatments of these conditions. In many ways, they are to be recommended over medical treatments for all but the most intractable of cases because of the relative absence of potentially serious side-effects. In fact, a doctor may well send you off to see a physical therapist for heat or ultra-sonic treatment, even acupuncture with a physiotherapist if you have not tried that first.

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