Browsing: Hand Wrist Pain

Treatment Options for Thoracic Outlet Syndrome

Thoracic outlet syndrome is a painful condition in which swelling of the thoracic outlet can compress the nerve and blood vessel bundles that stretch from your neck to your fingers. You can develop thoracic outlet syndrome, or TOS, through sports- or work-related repetitive movements or even after suffering from a traumatic accident such as a car wreck. There are several different ways in which doctors can help you alleviate the pain caused by TOS.

First, it is important to know how TOS starts. The thoracic outlet is a space between your collar and your first rib where nerves and blood vessels travel from your neck, under your collar, through your armpit, and down your arm. Repetitive motives and injuries can cause swelling in the thoracic outlet, which compresses the nerves and blood vessels there, resulting in TOS.

There are two main types of TOS as well as one type that is still under debt. If the swelling affects your nerves, it is called neurogenic or neurological TOS. If it affects your blood vessels, it is vascular TOS. If there is no discernable cause yet still pain in that area, it is nonspecific TOS. Although some doctors do not believe that nonspecific TOS is a true condition, others argue that it is very common.

For most people with TOS, doctors will start you with a conservative treatment program. This involves physical therapy, relaxation techniques, and anti-inflammatory medication such as ibuprofen. You may also receive muscle relaxants.

However, if these treatment plans do not alleviate your suffering, you may have to undergo more serious treatment methods. First, for vascular TOS, you can have surgery with an anterior supraclavicular approach. With this, a doctor makes a cut just under your neck and then examines you for signs of trauma. The surgeon can repair blood vessels here as well as remove any fibrous bands that may be interfering with your circulation.

Also, another surgical method of treatment is the transaxillary approach. This time, the incision is closer to your chest so that the surgeon can remove the portion of your rib that is compressing your tissue. If you have developed thoracic outlet syndrome, your road to recovery may be very long and painful, as well as costly.

If your TOS is the result of a work-related injury, you may be entitled to financial compensation to aid you in your treatment and healing. To learn more about your legal options, contact a knowledgeable New Jersey workers' comp attorney from Levinson Axelrod, PA, today.

{ Comments are closed }

Types of Thoracic Outlet Syndrome

Thoracic outlet syndrome, or TOS, is a painful vascular and neurological disorder that occurs when nerves or blood vessels in the thoracic outlet become compressed. This problem can be the result of repetitive stress, such as work- or athlete-related motions, or inflammation that occurs due to an injury.

The thoracic outlet is an area of ​​space between your collar and first rib. Nerves and blood vessels run from your head and neck, under the collar, through the armpit, and down your arm to your fingers. Thus, if anything happens to this bundle of nerves or blood vessels, it can cause serious damage to a large area of ​​your body. If the thoracic outlet becomes inflated through repetitive stress or injury, it can compress these tissues.

First, if just the nerves are affected by swelling in this area, you can develop neurogenic (neurological) TOS. This can cause your arm and hand to ache as well as tingling or numbness in your fingers. Overall, this can cause you to lose the strength of your grip. Additionally, you may have pain in your neck and shoulders.

Next, when your blood vessels are compressed, you may have vascular TOS. Because the swelling brings or even cuts off the blood supply to your arm, your hand and arm may become bluish or lose color completely. Additionally, you may notice black spots on your fingers. Your arm may feel heavy, painful, and swollen as blood is trapped in the limb. Lastly, you may experience a throbbing lump near the collar where fresh blood gets dammed up.

Lastly, some people develop a nonspecific thoracic outlet syndrome. Although some doctors discredit this form, others believe it is a common problem. Nonspecific TOS causes pain in the thoracic outlet area, but doctors are unable to pinpoint the exact vascular or neurogenic cause.

If you now suffer from TOS due to a work-related repetitive motion injury, you may be entitled to workers' compensation to aid in your treatment and recovery. To discuss your case, contact an experienced Raleigh workers' comp attorney from Scudder & Hedrick, PLLC, today.

{ Comments are closed }

Trigger Finger – What Causes My Finger To Lock And Catch And Get Stuck?

Trigger finger is a common problem in the hand that causes locking and pain in the implied finger or thumb. The technical name used to describe trigger finger is stenosing tenosynovitis. Stenosing means a narrowing of a tunnel or tube-like structure (the sheath of the tendon). Tenosynovitis means inflammation of the tendon.

Your fingers flex (make a fist) and extend (straighten out). Two sets of tendons make this possible – flexor tendons (on the palm side) and extensor tendons (on the back side of the hand). Trigger finger involves the flexor tendons of the hand.

Flexor tendons are typically smooth, white bands of tissue that start as muscles in the forearm and connect to the bones in your fingers. As they go from the forearm into the wrist and fingers, they pass through tight tunnels (sheaths) that keep them close to the bones of your hand.

The sheath is lined with a lubricating tissue called synovium. This tissue sets between the tunnel wall and the tendon. Trigger finger is caused by inflammation of the synovium, enlargement of the tendon, and thickening or narrowing of the sheath itself, usually in the area of ​​the palm closest to the fingers.

The name of the tendon sheath in this area is the “A1 pulley”.

These problems with the tendon's lining, the tendon, and the sheath, all combine to make it hard for the tendon to glide smoothly through the tunnel as your finger bends and straightens.

As the patient tries to flex (bend into a fist) the affected finger, the enlarged tendon has trouble passing underneath the sheath's tight opening. When the patient grips enough enough, the swollen tendon is suddenly poked through the sheath with a painful snap, which may lock the finger in a bent position (it will not straighten except with help from the other hand). The action of straightening the finger from its locked position creates another extremely painful snapping sensation as the enlarged tendon passes back through the tunnel.

What are the Causes?

The cause of trigger finger can not be known for sure in all cases. Work or hobby activities that involve repetitive gripping or holding tools strongly for long periods of time may strain the tendons and cause swelling and irritation of the tendon synovium (lining) or the tendons themselves.

Some patients with other medical problems like diabetes, rheumatoid arthritis, or gout may develop trigger fingers more frequently than the average person.

What are the signs and symptoms?

Pain in the area of ​​the inflated tendon lining or sheath may be the first sign of trigger finger. Sometimes the pain may shoot or extend into the finger on the top side (back side of the hand), but is usually focused on the palm side at the base of the finger or thumb.

Painful locking or snapping of the finger is the next stage of symptoms that most patients experience. This is often worse in the morning but may be worse at the end of the work day.

When symptoms have been going on for several months, the locking may stop, but patients may be left with a stiff finger that does not bend or straighten like it used to. The pain may or may not subside as the locking stops.

How is it treated?

Non-surgical treatment is a good first step in treating trigger finger. Surgery may be a reasonable first step if the finger is locked in a painful, stiff position and can not be “unstuck” by the patient without extreme pain. This is unusual.

The first step in treatment is to avoid or decrease the activity that appears to aggravate the locking and pain. Warm water soaks, anti-inflammatory drugs, and over-the-counter rubs and creams may help with the symptoms of trigger finger.

A steroid injection may also be recommended. The injection places a small amount of anti-inflammatory cortisone directly where the problem is – in the tendon sheath. This brings swelling and inflammation in the tendon sheath and may cure the problem forever. Success rates with injections are close to 60% in most cases.

Surgery may be appropriate when these non-surgical treatments fail to cure the problem. I usually recommend no more than two steroid injections in the same finger, but this rule is not absolute.

Trigger finger surgery is outpatient surgery. It is done under local anesthetic, with or without sedation. An incision is made in the palm of the hand at the base of the finger or thumb.

The surgeon cuts the swollen, tight tendon sheath at this level, and this frees up the tendon to glide smoothly through the finger.

After surgery a small dressing is placed on the hand to protect the incision but allow flexibility and motion for the fingers. In most cases the dressing can be removed in five days and the patient may lightly use all the fingers the day after surgery. If there are sutures on the outside of the skin, they are removed in 10 to 14 days.

{ Comments are closed }

Hot Cure for Carpal Tunnel That Works


You can not even hold your bag strap or hold your bag for long. These carpal tunnel techniques are not hard to do and by following these easy tips, you'll have freedom from pain for the rest of your life. Those nerves in your hand needs to be softened and relaxed again to get rid of the pains. Everyone is wishing for a foolish life and that can be done.

Symptoms of this disease include weakness of force in picking up light objects such as bags, pulling or pushing such as doorknobs, feelings of numbness in the thumbs and the fingers, usually at the palm side of the thumb, pain from the wrist up to the elbow. The median nerve passes through the carpal tunnel to receive sensations from the thumb, index, and middle fingers of the hand. While a tendon is a tough band of fibrous connective tissue that usually connotes muscle to bone and is capable to withstanding tension. The tunnel is a narrow and a rigid passage for median nerve and tendons.

The dominant hand is usually affected first and produces the most severe pain. If carpal tunnel is untreated, the muscles at the base of the thumb may be wasted. Some people are unable to tell between hot and cold by touch. Persons with diabetes or other metabolic disorders that directly affect the body's nerves, make them more susceptible. Most people experience numbness, tingling and aching in the hands and wrist.

Spend the day outdoors rather than long hours of physical carpal tunnel therapy. You need to cure these pains so you can continue to live normally just like before you had these pains. Live your life the way you have always wanted without the worries of being hurt or training your hands too much. A wide range of motion stretching that exercises the wrist are advised. If there is a hand fracture, then orthopedic management is required. Do not let carpal tunnel stay with you and ruin your sleep which can make you a grouchy person in the mornings. Soon you will be able to feel your hands and wrist as you pass the day away. A computer programmer who suffered from this wave his testimonial. You can again play racks and ball games as well and feel excellent with each sway of your arms and hands. You have to find out first if you're really suffering from this carpal tunnel syndrome or not. Have no more second thoughts about playing physical sports or activities with your family and friends because of fear of you hurting your hands and wrists in the process.

COMMON QUESTIONS: You want to find out why steroid and cortisone injections can cause muscle tissue layers to thin and weaker which puts more stress on other muscles and tendons forcing them to work harder. You have hand and wrist pain and want to learn simple stretches and exercises to instantly relieve the tension, burning and tingling.

Let it eliminate your pain. As when you feel tired of typing, you can pause a while and start to rotate your wrists clockwise and reverse to let the blood circulate well and relax those carpal muscles. Some simple exercises that are very helpful in curing the discomfort, will help your carpal muscles to relax a bit before any strenuous activities. Refrain from these activities until you begin to feel the pain subside.

Most of those who suffer from these symptom just let them pass and are taken for granted not knowing that this is a serious health issue. Do not wait for the hours to pass, imagine how fresh you will feel once you get free from the pains. Do not continue to suffer and suffer from the costs of endless trips to physical therapists, or weekly spa and massages in the therapeutic shops.

{ Comments are closed }

Local Anesthetic – What Hand Surgeries Can Be Performed With This Technique?

Local anesthesia involves numbing up an area of ​​the hand or wrist before a procedure is performed. This can be used in the office or in the operating room to create a pain-free finger or hand.

I usually use a combination of quick-acting and long-acting local anesthetic medicine – lidocaine and bupivicaine. Many hand surgeries can be performed under local anesthetic. Here are some examples:

  • carpal tunnel release
  • trigger finger release
  • DeQuervain's tenosynovitis surgery
  • fingertip surgery (fractures or amputation surgery)
  • other hand fracture surgery or manipulation

Just because these surgeries can be performed does not mean they should be performed under local anesthetic – that's a decision you'll have to make with your treating surgeon.

What can you expect in the operating room during a surgery performed under local anesthesia?

When only local anesthesia is used, you will be awaken during the nerve block (giving the shot of anesthetic medicine and numbing up the area) and during the surgery. Sometimes taking a mild sedative pill the morning of surgery will help some of the anxiety associated with the shot and the surgery.

In surgery, you will hear everything going on inside the operating room. This may involve the sound of

  • people talking
  • drills and machinery
  • the surgeon's music

You will not see the surgery – there will be a sterile drape between you and the surgeon working on your hand. During the surgery, you will feel the pressure of the surgeon working on your hand, but will feel no sharp pain.

I always test the surgical incision area with something pointy to see if you feel sharp sensation or just dull pressure on your skin.

After you've been numbered up, the surgeon may touch you with something pointy and say, “Does this feel sharp or dull?” If you still feel sharp pain, he'll just add some more anesthetic – usually through the previously numbered-up skin and re-test you before starting the surgery.

The most common reason local anesthetic does not work is because the surgeon did not allow enough time to let the medicine work. Often the nerve block will take five to ten minutes to work completely.

Very rarely a patient will be resistant to local anesthetic medicine. If you have trouble getting numb at the dentist's office be sure to tell your surgeon before any type of local anesthetic procedure.

Here are several advantages of this anesthetic technique:

  • no drowsiness from general anesthetic or intravenous sedation
  • you do not lose control
  • the surgeon can ask you questions during the surgery
  • depending on the specific situation, you may be able to drive yourself to and from surgery
  • pain relief for hours after the surgery – may cut down on use of pain pills afterwards
  • limited and rare side effects (reaction to the injected drug is rare)

Disadvantages of local anesthetic:

  • you hear everything that goes on in the operating room
  • the pressure you may feel when the surgeon is working may be unnerving
  • there is some brief pain during the numbing shot before surgery
  • most big, complex surgeries are not possible under local anesthetic

Ask your surgeon if your surgery can be performed with local anesthesia!

{ Comments are closed }

Exercises For Your Hands to Relieve the Pains of Carpal Tunnel Syndrome

The following exercises are intended to help prevent the carpal tunnel syndrome or lessen its painful effects on the patient. In order to gain most benefit from it, start with relaxing your body from the top of your head to the tip of your toe, feel the body completely, and then take a moment to look deeper into your body, into your entire wrist and hand .

What sensations do you feel and how much awareness can you put in that body parts?

Feel the space between your fingers and relax there, then feel the entire hand:

Is there any tension or pain? Relax there and breathe in deeper, let the deeper inhalation affect your hand and your wrist, let your breath see into your hand, in order to release any tension there.

This carpal tunnel exercise is a gentle combination of physical and mental practice.

So when you feel more at ease and calm within yourself, start with the following movements.

First, let your whole arm stretch away from your body. You can do that while sitting, standing or even lying down, just make sure you stay relaxed.

Imagine your whole arm is like a balloon getting pumped up.

Then feel into your wrist and hand, let especially this 2 parts of your body take part in the stretching. Let go of any tension inside your joints. Finally you reached your limit of flexibility and you reverse the stretch, let your arm come back to its original condition and stay there for a while.

Feel your breathing again, before you start a new stretch.

Do at least 5 loops of this carpal tunnel exercise and make sure you relax more with each round. That is very important. Do not overexert yourself.

Do not try to force that carpal tunnel exercise to do anything, especially not to undo any pain, incline to visualize your tissue, or even better, feel your tissue while slightly stretching.

That stretch is meant to be a very tender “opening” of the tissue in your arm, wrist and hand, to release the nerves being compressed and irritated deer within the layers of the tissue.

Feel deeper into that stretch, it should always be gentle and not cause any additional pain.

Let your arm expand away from your torso more and more, do it very slowly to let your awareness awareness follow that expansion.

Then, the next step of the carpal tunnel exercise will focus on the reverse movement after the stretching part.

This time you do not want to just passively relax the arm back to its original position, but to “suck in” the space of your joints. Your fingers and hand is closing by that movement, as you would build a fist, but again: do it very slowly, imagine your hand will catch a ball in slow motion, so you can stay alert of every single inch of the “reverse” part of the exercise, which I call the “closing” part.

Again: Do not overexert yourself, do not reach your limit, stay safe and move gentle. Take your time, make sure, you relax deeper into your body.

So to make that carpal tunnel exercise most effective for you 'benefits, do at least 10 very relaxed loops, start with the “opening” part and then take the “closing” part to merge both parts into one nice movement, do it fluently without stops.

If you want to learn about this carpal tunnel exercise, join a Qi gong or Tai Chi class to deepen your knowledge, to create a certain body consciousness, that allows you to really relax the nerves deeper within the carpal tunnel.

{ Comments are closed }

Avoiding Repetitive Strain Injury

Repetitive Strain Injury (RSI), can be a very painful and debilitating condition if ignored. RSI can manifest as tingling, numbness, a burning pain, swelling, and often a feeling of weakness in the affected area (s) and in extreme cases where the damage is severe, can even require surgery. People from all walks of life can, and often do, experience these symptoms, but it's usually typists and other keyboard operators that suffer the most. Personally speaking, I work much harder than I did 20 years ago and in these fast-paced days, employers and clients alike very very want the work done now!

While prevention is always better than cure, there are however ways of minimizing the risk of suffering from RSI:

– Always use a wrist rest and be sure to keep the palms of your hands parallel to the keyboard. A wrist rest will flatten out your hands and provide the necessary support. If you move your hands erratically over the keyboard, you'll suffer.

– Adjust your chair. Your forearms should be horizontal to the keyboard so ensure it's adjusted to the proper height as necessary. Many ergonomic chairs are adjustable to meet individual needs. Add or remove extra cushions as needed and arm rests are optional.

– Ergonomic keyboards may help pain to prevent pain. If you do not choose one that's ergonomic, do make sure you get one that is not stiff and causes you to pound the keys. Using a trackball instead of a mouse and an adjustable keyboard tray for both is also a good idea and depending on your height, a good footrest can also alleviate neck and back discomfort.

– If you do feel pain, stop. It's also a must to take regular breaks, move your fingers and shake your wrists. Get up and walk around, although depending on the type of job you do, it's often hard to do that; but do try and do not have your coffee breaks “on the go”. Take at least 10 minutes away from the work station – it will save you pain in the long term, give your eyes a break and you will not be nearly so exhausted at the end of the day.

Some employees and employers often fail to realize that not taking time out in the working day can also affect not only a person's health but their ability to do the job properly, so it's in everyone's interest to take those much needed breaks and do bear in mind that employers are required by various working regulations to ensure that workers do take proper rest periods.

While I have absolutely no medical training whatsoever, I do however know all about typing for long periods at a time and the detrimental effect it can have on you, so if you find yourself suffering from any of the above symptoms, be sure to seek medical advice straight away. Like everything else we take for granted in life, we will not miss our hands until we can no longer use them properly or sometimes not at all.

{ Comments are closed }

Carpal Tunnel Misdiagnosis – Median Nerve Entrapment

Carpal Tunnel Syndrome is a debilitating condition that affects over 8 million Americans, but often similar symptoms mistaken for CTS are attributed to an incomplete examination of the additional structures that may compress the median nerve. An incorrect diagnosis can leave sufferers to face an unnecessary surgery, only to be provided with no relief.

The Carpal Tunnel is a structural canal in the wrist formed by the 8 carpal bones and the transverse carpal ligament, permitting the passage of 9 flexor tendons, blood vessels, and the Median Nerve, which allows function, circulation and sensation to the palm and fingers . True Carpal Tunnel Syndrome involves a compression of the Median Nerve inside of the Carpal Tunnel caused by a narrowing of the space inside the canal. This can be caused by inflammation of the tendons, fluid retention, wrist injuries, bone spurs, pregnancy, and repetitive wrist motions.

The Median Nerve is one of the 5 main nerves stemming from the brachial plexus. It is responsible for both sensory and motor function; therefore a compression anywhere along the nerve may cause a deficit in sensation, movement, or both, down the length of the nerve. Median Nerve Entrapment is often misdiagnosed as Carpal Tunnel Syndrome. They share the same symptoms; numbness, tingling and weakness of the wrist, hand, thumb and first 3 fingers. The difference between the two is the location of the compression.

There are 8 sites along the median nerve's pathway, including the carpal tunnel, where an impingement can take place:

1. Beginning at the spinal cord, the Median Nerve may become impinging at the cervical spine at the level of C5-T1. Bone spurs, small growths or tumors, and vertebral misalignments are responsible for pressing on the on the nerve. In this case, a realignment of the vertebrae will take the pressure off the nerve root.

2.4. Following the Median Nerve's pathway, compression may take place between the middle and anterior scalene, between the clavicle and the first rib, or under the pectoralis minor tendon against the coracoid process. These three compression areas may have a complication of something more accurately called Thoracic Outlet Syndrome. TOS may also present with reduced circulation in the arms and hands, neck or shoulder pain, or paresthesia in the neck, shoulder, arms and hands. Poor posture, trauma, or repetitive motions could have been the cause of this condition. After a detailed evaluation, the TOS can be treated with chiropractic adjustments, soft tissue manipulation, physical therapy and stretching exercises.

5. The next area where the Median Nerve can become impinged is just proximal to the elbow along the medial epicondyle and humeral shaft. Although uncommon, a purposeless structure called the Ligament of Struthers found in less than 3% of the population may be the source of compression in this area. Surgical release of the ligament has been proven effective in this case.

6. The bicipital aponeurosis, or lacertus fibrosis, is a fibrous tissue that connects a small portion of the biceps brachii to the ulna. The Median Nerve could become compressed here, more likely while the biceps are contracted. Surgically releasing the thickened fibrous tissue can relieve pressure on the nerve.

7. Moving distally from the elbow, as the Median Nerve runs between the two heads of the pronator teres it may become compressed here in a painful condition called Pronator Teres Syndrome. Pressure on the nerve is caused by repetitive movement of the pronator teres or trauma to the elbow.

A similar condition called Anterior Interosseous Syndrome shares a similar presentation to Pronator Teres Syndrome. The Anterior Interosseous Nerve is a branch of the Median Nerve, and controls motor function to the flexor pollicus longus, pronator quadratus, and the lateral portion of the flexor digitorum profundus. As a result, a weakness in the first 3 fingers will present when compromised. Performing the Pinch-Grip Test should confirm both of these assessments.

Courses of action for Pronator Teres Syndrome and Anterior Interosseous Syndrome include massage therapy and bodywork, ultrasound therapy, corticosteroid injections, and non-steroidal anti-inflammatories.

8. The final compression site of the Median Nerve, as indicated earlier, is the carpal tunnel. Performing Phalen's Test will confirm that the nerve impingement is coming from the carpal tunnel. Manual circulation of the area can reduce water retention in the area, and immobilization splints to keep the wrist from flexing are helpful in keeping pressure off the nerve. Corticosteroid injections and NSAIDs can effectively provide relief by reducing inflammation in the area. In several cases, a surgical procedure is indicated.

A thorough examination by your health care provider should narrow down the cause of this intolerable neuropathy. Several tests, including Phalen's Test, the Pinch-Grip Test, and Tinnel's Test, as well as X-rays and MRI's, can be implemented to find the focal point of the Median Nerve Entrapment, allowing the compression to be properly trated.

{ Comments are closed }

Carpal Tunnel Syndrome Guide

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition brought on by increased pressure on the median nerve in the hand. The median nerve controls muscles used for gripping and the coordination of fine movements. The nerve passes through the carpal tunnel, a passageway in the base of the hand that is also a conduit for the flexor tendons of the fingers.

It occurs when the median nerve is compressed as it passes through this tunnel in the hand. When compressed, the median nerve causes numbness, tingling, weakness and pain in the hand and wrist.

It is the most common peripheral nerve compression syndrome.

What are the symptoms?

Common symptoms include pain and numbness in the hand, including the thumb, index, middle and half of the ring finger. More severe cases may also lead to a weak grip and pain in the hand and wrist. Often patients suffering from it have difficulty sleeping at night due to the pain and numbness.

What are the Causes?

While the majority of cases of are idiopathic (unknown), there is some evidence that an individual's anatomy and occupational exposures may play a role in the development of it.

What are the treatment options?

Treatment usually begins with wrist splints, especially at night, and anti-inflammatory medications. Steroid injections into the carpal tunnel may also provide relief of symptoms. Ultimately, surgery may be necessary to relieve the pressure on the median nerve in the carpal tunnel and the good news is that there are some minimally invasive options available which you can choose and one of these options is “the endoscopic technology” which allows the surgeon to dramatically reduce the incision size. Patients who undergo this minimally invasive procedure experience a faster recovery time and less pain, and most importantly equal clinical results to traditional surgery.

{ Comments are closed }

Health And Safety Tips For Working With Computers

When you work in an office environment, you do not normally worry about occupational hazards like getting a limb chopped off by a machine or being crushed by heavy equipment. Nonetheless, this does not mean that office jobs are without risks and hazards of their own. If you work long hours behind a PC, you have probably already experienced that feeling of bleary-eyed fatigue which comes with the territory of being an office worker.

Most office jobs require you to spend at least 8 hours a day watching at your computer. Here, it makes sense to make sure that you at least spend those 8 hours comfortably and hopefully avoiding any injuries.

On the bright side, most problems which come from computer use are preventable and minor. Unless there is something drastically wrong with your workplace set-up, you are not really likely to do something like electrocute yourself in most situations. Also, contrary to technological superstition there is actually no evidence that electromagnetic radiation from computers causes problems like miscarriages or cataracts.

If you just consistently follow the guidelines below, you'll probably be less weary at the end of the day. And you may just have enough pep to want to do it all again tomorrow.


It may sound obvious, but not everyone practices good posture while working. Poor posture might be in fact the start of back problems in years to come. Good posture starts with a properly adjusted chair and computer height. Make sure that your chair is adjusted so that it supports your lower back, your knees and hips are level, and your feet are flat on the floor. At the same time, adjust your computer screen so that your eyes are just level with the top. If your feet do not reach the floor, make sure that you have a support such as a foot rest. You should be able to ask for one from your employer if there is not one around.

Eye Care

Remember those anti-glare screens that were popular 10 or 15 years ago? The good news is that on most LCD monitors, anti-glare is already built in.

The light that comes off computer screens is tiring in itself to look at for an extended period. The anti-glare is there to prevent additional reflections off the surface of the screen straining your eyes. Make sure you do not wipe down your screen with wet wipes or anything else that can dissolve the chemical coating which is used for anti-glare in some screens. Also, position your computer so that you are not facing a window and light does not bounce off the screen towards you.

Give your eyes a break by focusing every so often on objects in the distance. Blink frequently.

Repetitive Stress Injury

If you spend a lot of your time pounding away at a keyboard, you may wish to consider using devices that help prevent repetitive stress injury. Using an ergonomic keyboard and mouse helps avoid repeated movements at awkward angles. Wrist pads take the strain off your wrists by keeping them level with your keyboard and can help prevent injuries like carpal tunnel syndrome. Your arms and wrists should be parallel to the floor as you type.

Rest and Exercise

It's important to give yourself a break every now and then. Get up and stretch, walk around for a while. If possible, do this once an hour. Frequent short breaks are better than longer, less frequent breaks. It's also fairly important that you do not let your sedentary 8 hours creep into the rest of your life.

Health and safety around computers may be tiresome but necessary. At worst, it may be true that a stitch in time saves nine, especially if those stitches are surgical ones for your repetitive stress injury. Go on and save that click-ey finger! You may need it sometimes when you're old.

{ Comments are closed }

How Do They Fix a Broken Collar Bone?

Lance Armstrong broke his collar bone (clavicle) on March 23, 2009. He was competitive in a race in Spain when he and several other cyclists were involved in a bad crash. Doctors in Spain diagnosed him with a fractured clavicle, one of the most common orthopedic cycling injuries.

The injury

Clavicle fractures are very common – up to 5% of all fractures that occur each year. Most of these are fractures through the middle of the shaft of the bone, called mid-shaft clavicle fractures.

Most of these happen when someone falls directly onto the shoulder.

The treatment

Over the years, the vast majority of these fractures have been treated non-surgically with a sling and some early therapy exercises. The bone usually heals on its own in six to eight weeks total.

Lance Armstrong had surgery to fix his broken clavicle. This was done using a plate (flat piece of metal with holes in it) and several screws. The metal stabilizes while they heal together.

Surgery allows patients to return to low-impact activities faster than letting the bone heal on its own. The clavicle usually stops hurting immediately after surgery, though some incision soreness is normal for a few days.

Pros, cons, and expectations of clavicle fracture treatment

Should you have collar bone surgery after a fracture? Only you and your surgeon can decide for sure.

Surgery for a fractured clavicle has risks such as infection, injury to nerves and blood vessels, and the risks that go along with anesthesia. You can have bone healing problems wherever you have surgery or not. Sometimes patients want the plate taken after the bone heals.

Some patients want surgery to avoid a weird-looking bump on their shoulder from the shape of the bone as it heals. The problem is that after surgery, you'll have a scar in the place of the bump, and the bone may be prominent because of the plate on top of it. This may be more noticeable the thinner you are. clavicle bump and clavicle scar

There are both proven and theoretical advantages to fixing these fractures with metal hardware. Some problems with non-surgical treatment are as follows:

* weakness and pain in the shoulder

* loss of shoulder motion

* loss of endurance

* neurologic symptoms like numbness or tingling

* cosmetic deformity

If someone you know has broken their collar bone recently, make sure they discuss all these details with their doctor.

{ Comments are closed }

Understanding and Preventing Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that affects people who indulge in hobbies or are in professions that keep the wrists immobilized for extended periods of time or use the hands and wrists to perform a series of repetitive movements for long periods of time.

The carpal tunnel is formed by the bones of the wrists on the bottom, with an inflexible ligament forming the top. Through the middle of this construct runs the median nerve, which carries messages from the brain to fingers, hand and wrist. When this nerve becomes pinched or constracted from constant pressure or it gets damaged from repetitive motion, it causes pain, numbness and tingling whenever the fingers, hand or wrist are moved. This is known as carpal tunnel syndrome.

Symptoms of Carpal Syndrome

Carpal Tunnel Symptoms can vary from person to person, but the following are some of the most commonly reported:

Hand pain: This is most often reported as a pinching kind of pain that radiates out from the wrist and into the palm of the hand, and sometimes into the fingers themselves. This can often be mistaken for arthritis pain.

Finger pain: It is usually described as intermittent waves of pain within the tendons of the fingers, not in the joints themselves. Finger pain is often mistaken for arthritis pain, even though the joints themselves are unaffected.

Weakness: The muscles and tendons in the hand seem weak and gripping or holding onto small objects becomes difficult. This will often happen in conjunction with numbness of the fingers, another symptom of this particular condition.

Numbness and Tingling: This is characterized by sudden loss of sensation in the fingers, with an inability to grip small objects. More often there will be sessions of tingling feelings throughout the wrist and hand, as if circulation had been cut off, then recently returned. Often described as a feeling of pins and needles.

Causes of Carpal Tunnel Syndrome

The most common cause of carpal tunnel syndrome comes from leaving the wrists lying immobile on a desktop or keyboard for long periods of time, while typing. The constant pressure will eventually cause the median nerve to become compressed or pinched because the carpal tunnel itself is rather inflexible, and there is no movement within it under pressure.

Another cause of this condition is repetitive motion. Athletes and industrial workers are the most liable to create symptoms of this syndrome by simply performing necessary motors required by their crafts. This usually involves a constant turning of the wrist or flattening of the palms to perform whatever task before them.


The damage that can lead to people developing this sometimes debilitating condition can be prevented very easily with the help of a few devices, as well as some common sense. For typists and others who rely on keyboards or adding machines for their profession, put some ergonomic wrist support to use to tie the pressure on your wrists. The use of these will also raise your hands into a more comfortable position, as well as extending the reach of your fingers on the keyboard. This, combined with frequent breaks will prevent damage from occurring.

For those who risk injury through repetitive motion, prevention is as simple as strapping any one of many types of wrist brace appliances available for supporting and preserving the flexibility of that joint. Performing simple stretching exercises before, during and after any activity will also help prevent injury to that area.

Diagnosis and Treatment

This condition is often mistaken for arthritis, especially since the age group most affected is that of 40 years of age and up. there are two simple tests that your doctor can do to determine whether or not your symptoms are caused by carpal tunnel syndrome or arthritis.

The first test, called Tinel's Sign, is done by tapping the median nerve along its path through the wrist. A positive result occurs if tapping it causes pain. The second test, known as Phalen's Sign, is done by pushing the back of your hands together for one minute. Pain indications that you have been experiencing carpal tunnel symptoms.

Treatment will usually involve anti-inflammatory medications, combined with some physical therapy, depending upon the severity of the condition. If these do not help, it is also possible to relieve the pressure on the nerve through surgery.

{ Comments are closed }

Wrist Pain Relief After Computer Mouse Use – Practical Solutions


The original computer mouse was not invented recently by an ergonomics expert or a medical professional commissioned to design a device for millions to use every day for long hours without causing health problems. It was invented in 1963 by Douglas Engelbart, an electrical engineer and computer scientist who just wanted to control his computer. Engelbart was interested in its immediate practical application and he did not consider long-term health risks. His device was not tested for years to see if regular use could cause temporary repetitive strain injury or even permanent injury.

Unnatural position

Although the scientist must have thought it was a clever idea at the time, the human wrist was not designed for a computer mouse. Engelbart's first bulky, awkward mouse was crude and wooden; Many refined plastic versions have been created since then in the last fifty years. But they all have one common denominator which is a problem: they essentially require the hand or wrist to be twisted or turned into the same basic position.

Standard computer mouse use forces the hand and wrist into positions which are unnatural. Operating a mouse is awkward and becomes uncomfortable, because the wrist is turned up to 90 degrees from its most comfortable natural resting position.

Is it therefore surprising that continuously forcing the wrist into such an unnatural position for hours every day at work can cause damage or injury? Mouse use, indeed, strains your wrists and, if it happens often enough, causes chronic pain – even after staying off a computer for a few days.

Switching sides

Several years ago I solved the problem of wrist pain from regular mouse use by switching my mouse and mousepad to the opposite side of my keyboard. Instead of using my right hand to move the mouse, I gave it a rest; I used my left hand. I am not ambidextrous but adapted to the change easily. After a few weeks when the left wrist hurt, I switched back to the right. Alternating every few weeks like this worked fairly well for several months, but it was not a good long-term solution. In fact it ruined both wrists instead of just one!

Wrist rest

A wrist rest can provide some relief. It did help me but only when I used a computer for a few hours a day. Once I started using a computer all the time at work, it was not good enough. Depending on how often you use a computer, a wrist rest could be the perfect, cheap solution. Modern Mac users are lucky; the Apple keyboard is very ergonomically well designed. It has a very low profile, so you may not even need a wrist rest, although personally I use six square coasters (two rows of three) to raise it just a little (5/16 “).

New technology

Health guides from the government advise computer users to avoid repetitive strain injury by proper posture, frequent breaks, and correctly holding the mouse. But that is not necessarily an option for very busy people with demanding jobs. Technological advances have included the wireless mouse which relieves users from needing to use a mousepad, and an ergonomic mouse which allows the hand to sit in a pretty natural, relaxed position. These were valuable improvements, but why should computer users even have to use a mouse? Is not there a simpler, safer and better way to control a computer?

Mouse alternative

I bought a Wacom Tablet after reading a review on where one owner said it provided relief for carpal tunnel syndrome. He said he used it for surfing the internet. The tablet uses a pen instead of a mouse. If you do not experience wrist pain when using a handwriting pen, you should not experience any pain with the Wacom pen.

I have now used the Wacom pen for over a year, and I've never felt any pain or discomfort, because the hand position in holding a pen is very close to a natural resting position. It causes very little stress. I have not thrown out my mouse but now I only use it very rarely, and when I do, it still causes discomfort.

There are several different kinds of Wacom pens which are used primarily by digital artists and graphic designers. One key difference between them is thickness. I started with a thick pen which digital painters use, but found it too bulky, so I downsized to a regular pen, which is just a little larger than a bic pen. I wish somebody had told me about it many years ago. I believe all new computers should be sold with pens instead of mice.


The risk of repetitive strain injury from using a pen is much lower than using a computer mouse. The original computer mouse idea was conceived decades before people started using their computers every day at work and on the internet after work. There was there was no data on carpal tunnel syndrome or repetitive strain injuries in the workplace. Now that we as a society have gradually since the 1980s been using computers and mice more and more often, and the data has shown the damage, it is time for everyone to rethink computer mouse use. Just because almost everyone uses a mouse and it is cheap does not make it safe.

{ Comments are closed }

Ganglion Cyst – The Most Common Tumor in the Hand and Wrist

A ganglion cyst is the most common soft tissue tumor in the hand and wrist. The most common of these benign tumors is a ganglion cyst appearing on the dorsum (or back) of the wrist, just past the skin crease where the wrist bends back and forth. This cyst comes from a specific joint between two bones in the wrist called the scaphoid and lunate bones.

These cysts almost always come from joints and may start in any joint in the hand or wrist. Another one of the most common places for a cyst is the dorsum of the finger between the skin creases of the end knuckle (DIP joint) and the start of the fingernail.

Most hand surgeons believe that the majority of cysts happened after some sort of trauma to the involved joint. A small hole develops in the joint lining and allows fluid to escape – the fluid forms a cyst.

What Is A Ganglion Cyst?

A ganglion cyst is a very common bump or mass that usually appears near joints or tendons in the hand or wrist. Common locations include the dorsal (back side) surface of the wrist, the palm side of the wrist, the base of the palm side of the finger, and the dorsal surface of the end joint of the finger.

You can envision what a ganglion cyst looks like by picturing a balloon filled with clear jelly, attached to a hollow stalk that comes from the joint or tendon lining. Fluid travels from the joint or tendon sheath into the stalk, and fills the balloon with fluid.

Constant motion of the hand or wrist keeps fluid pumped into the cyst and it can not get back out. Ganglion cysts can be uncomfortable if they put pressure on nerves, tendons, or skin.

The good news is that they may go up and down in size or even go away completely on their own, without any needles or surgery. They may not be painful. Ganglion cysts are not malignant (they are not made up of cancer cells) and they do not spread to other areas, though they may get larger or more lobulated (more lumpy).

How is the diagnosis made?

Diagnosis is based on the patient's history (how he or she noticed the mass), where the lump is and what it feels like. Sometimes patients say they remember injuring the hand or wrist several weeks before noticing the cyst, but most patients can not remember a specific event.

Cysts are usually round and firm. You can usually feel the smooth edges of a ganglion cyst, and you can often move the cyst around under the skin with your fingers. Cysts at the base of the finger are usually firm, pea-sized bumps that hurt when gripping narrow objects, like a steering wheel or suitcase handle.

Putting a flashlight on the skin around the mass will make it “light up” in a darkened room (transillumination), indicating that the mass has clear fluid inside.

Cysts at the end of the finger (DIP joint cysts) near the fingernail may push on the growing nail, causing a groove in the nail. Sometimes these may drain if the skin above them gets too thin.

I usually get x-rays to look at the bones and joints around the cyst. Sometimes I can see some nearby arthritis that explains the source of the cyst fluid, but in young people there is rarely an obvious source of the mass on x-rays. Rarely a cyst will be a sign of a serious ligament injury that has not been diagnosed yet.

What is the best ganglion cyst treatment?

There are non-surgical treatment options for ganglion cysts; for cysts on the wrist and cysts on the finger. The first option is to do nothing – the mass may just go away on its own. If the cyst is not painful, not limiting activity, and not too big or uncomfortable, this is a good option.

Puncture or aspiration is the next thing to consider. Putting a needle in the mass may decompress it and allow the fluid inside to escape under or through the skin. Depending on where the cyst is, it may be near nerves or a major artery – make sure the doctor or nurse putting a needle in your cyst knows where these structures are.

I use the term puncture because it's very difficult to draw out the thick clear jelly that's often inside ganglion cysts. Usually, if the cyst is close to the skin, the jelly comes out through the hole made by the needle. I use a numbing shot first, then a larger needle to make a small hole in the wall of the cyst. I recommend a splint after this to allow the cyst wall to seal off. This is done in the office.

In my experience, cysts usually come back after puncture. The longer the cyst has been there, the less likely non-surgical treatment will work.

Finally, taking the cyst out in surgery is the most reliable way of getting rid of it. Ganglion cyst excision is not just a matter of opening up the skin and “lopping it off”; the joint or tendon sheath must be exposed to get out the stalk, or root of the cyst.

This can be done with a small incision over the cyst or through a wrist scope (camera inserted into the wrist joint). The exact method used depends on the size and location of the mass. Recurrence rates (chances of the cyst coming back) are very low – close to 3%.

Restrictions after ganglion excision surgery

For patients with wrist ganglion cysts, I recommend using a wrist splint after surgery for two weeks while the soreness from the surgery goes away. During that time, I advise patients to come out of the splint three times a day and do some stretching exercises. Patients can type and do light activities with their hands during this time.

Activity is rarely limited after finger or tendon cyst excision. Full use is usually allowed when the skin is cured after a few days.

{ Comments are closed }

How to Know If You Have CTS With Carpal Tunnel Tinel Test

As you read through this article, you'll soon find out how to do the carpal tunnel tinel test, or known as Tinel's sing, named after the French neurologist Jules Tinel whom lived in late 18'th century.

The neurologist, Jules Tinel, made many new discoveries which are now put into practice. The sign test is a way to detect irritated nerves, the symptoms is caused by that the median nerve is compressed. We can use his simple technique to root out, and to make sure if one really has carpal tunnel syndrome.

So how does one perform the test? Continue reading and I will explain how exactly one does it, it's pretty easy to execute, it is harmless and can be done by anyone.

This is what you do:

Lightly tap over where the median nerve, which is at your wrist. The “positive” response for carpal tunnel syndrome will be a tingling in the thumb, index and middle finer or a sensation of “pins and needles”.

If you experience any of the following symptoms, it's very likely you have CTS. Perhaps you already knew this, but I'm going to write this anyways. The cause of CTS is because of continuous repetitive actions, that causes inflammation to occur within your wrist.

Anything from work to hobby related can be taxing for your median nerve. Simple things as typing at the cash register, excessive typing on your keyboard or constant use of your mouse. If you play games a lot, then I suggest you let your have a nice break.

You can avoid pain at night by immobilizing your wrist, which can be done by a brace or split support. If you do decide to use a wrist supporter, make sure it's not strapped too tight. Your your median nerve is already compressed enough as it is.

{ Comments are closed }