Tunnel syndrome is pain in the wrist and numbness of the fingers, which can cause long work at the computer. Candidate of Medical Sciences Andrei Beloveshkin told dev.by what the danger is and why preventing this ailment is easier than curing.
- As popular wisdom says, “where it is thin, it breaks”, and where it is narrow, it is infringed. Our hands can withstand heavy loads, but they also have their weak point, the Achilles heel. This is the carpal tunnel , where through one narrow opening 9 muscle tendons and one median nerve pass (Fig. 2). With prolonged monotonous movements of the hand, the pressure in this channel increases. And since the nerve is softer than the tendons, it is it that is damaged. This condition is called carpal tunnel syndrome, or tunnel syndrome.
This disease is considered professional in many workers, collectors, draftsmen, musicians, butchers, needlewomen. Tunnel syndrome was detected in every six patients examined, working on a computer. Because of the computer mouse, the leading hand is more often affected, but with prolonged use of the keyboard, the other hand suffers. To prevent this condition is much easier than to treat: in advanced cases, a nerve is damaged, which then recovers for a very long time. Therefore, even surgery often does not bring relief.
How does tunnel syndrome manifest
First, a slight aching pain appears, discomfort in the wrist after prolonged work. Sometimes - in the form of itching, trembling. The pain quickly disappears after a break, warming up helps well. The median nerve innervates the greater half of the hand (from the thumb), so a characteristic sign of tunnel syndrome is the absence of pain in the little finger in the initial stage.
For several years, the breaks “between pain” have been shortened, and a slight unpleasant sensation in the wrist during work becomes the norm. After some time, this feeling will cease to disappear altogether.
With a detailed picture of the syndrome, stiffness and a burning sensation in the wrist are added. Often in the morning. Sometimes there is a sensation of the passage of electric current, bouts of burning pain. In some people, pain can be given up the arm, reaching the head: pain in the chest, headache on the right in the right-hander, pain in the neck and shoulder. Because of this, people often confuse tunnel syndrome with osteochondrosis.
In addition - motor impairment. The muscles of the fingers also suffer. A feeling of awkwardness or weakness can limit the execution of subtle movements with your fingers - it is difficult to fasten buttons, tie shoelaces, tie a tie. That infrequent case when alcohol has nothing to do with trembling hands.
If the pain suddenly receded, this is not a reason to rejoice: a decrease in sensitivity occurred due to nerve damage, and then it is restored with difficulty.
How to distinguish it
There are some very simple tests that let you know that you are dealing with tunnel syndrome.
Test "prayer". Fold your palms at chest level, as in prayer. Gently lower the joined palms as low as possible to the maximum position, hold them in a bent position for at least one minute. Normally, pain and sensory disturbances (goosebumps, burning) appear no earlier than one minute.
Hyundai Hoh test. Raise your extended arms above your head and hold them in this position for at least one minute. The same: normal pain and sensory disturbances (goosebumps, burning sensation) appear no earlier than one minute.
The bottle test. Lift the full bottle by the neck with your thumb and forefinger. If it slips, then you have a serious tunnel syndrome. This test is already evident in the later stages.
Correct posture: 30, 90, 180 degrees
The correct position of the hand is very easy to feel: stand up, put your feet at shoulder level and sit down a hundred times lower your hands freely. Now look at how the brush is located: approximately at an angle of 45 degrees to the body. That is, not parallel and not perpendicular to the hips. This is its neutral position, in which muscle tension is the least.
Hence, there are four main rules that allow you to create minimal pressure in the carpal tunnel:
- The angle "brush-surface of the table" = 30-40 degrees. The brush should ideally lie on the mouse just at that angle. The right mouse of your size helps to achieve this (we will discuss this below).
- Angle "shoulder-forearm" = 90 degrees. When working, the elbows should be bent and close to the body. Straight outstretched arms give strong muscle tension.
- Forearm brush angle = 180 degrees. That is, the hand and forearm should be in the same line as horizontally vertically . There are lots of devices with a special bulge for the wrist - a roller near the mouse mat, gel pads or a computer table with similar bulges. Alternatively, you can put something soft under the forearm by raising your hand, or use a “computer bracelet” .
- Elbow Support, “computer arm support”. The fact is that the average weight of a person’s hand is 5-7 kg. If the elbow hangs without support, the weight of the hand is distributed on the deep muscles of the neck. Hence, excessive tension and pain in the neck, head, upper back (trapezius muscles are overloaded). To fix the elbow, it is not necessary to buy a new chair or a special table. Google “computer arm support” - there are many cheaper solutions that can be screwed to a chair or table.
Plus it’s very useful to learn how to work with your left hand. The development of the skill takes about a month, gives +50 to creativity and allows you to get less tired. Do not forget to change the position of the hand, if you do not use either the keyboard or the mouse, do not let the hand lie idle all the time, if you do not use it. Lift it, hold it up, twist the ball.
The right gadgets
Choosing the right gadgets can greatly alleviate pain and stop the development of tunnel syndrome.
Mouse, or boot rule
You don’t buy shoes that are big or tight? Exactly the same rule is true for the hand. A large computer mouse is suitable for people whose palm is larger than average. The main thing in choosing a mouse is your own feelings. And to order mice online, you can use a simple rule. If you take a ruler and measure the distance from the tip of your ring finger to the base of your palm, you will get the sizes small (up to 17 cm), medium (17-19 cm), large (19-21 cm) + photo. As an option, there are mice with an adjustable size.
The height of the mouse is important: it must support the palm so that it does not hang on the weight. If the mouse is small for you, then the brush will sag above it, and if large, you will have to squeeze it harder. Ideally, your brush should literally merge with the mouse into one. Yes, do not forget to correctly configure the mouse programmatically.
When moving the mouse, try to move the forearm more, use the brush movement only for small operations.
Try ergonomic computer mice. The disadvantage of such mice is that it takes time to get used to them.
- Vertical mice(fig. 7, see above). Everything is designed well in their device, but the angle “brush-surface of the table” is too high, you need to squeeze your hand when working, it strives to slip.
- Orthopedic mice. Meet less often, are more expensive. Support the entire arm, reducing the load and tension of the interosseous membrane. Handshoe Mouse, Contour Mouse, etc.
- Alternative devices (graphic tablets, virtual pencils, touch screens). Hand when working with such a device is located in a neutral position (45 degrees to the surface of the table), the fingers of the hand get less load. Very effective discharge for the brush.
Keyboard, or take care of the thumb
The same rules and angles apply to keyboards. Ergonomic keyboards are especially good - they allow you to maintain the brush-table angles and the brush-forearm angle (the keys are deployed for the right and left hands).
The keys should be pressed gently and lightly so that there is no unnecessary load on the fingers. Type correctly: pain in tunnel syndrome is aggravated by the overload of the thumb, which occurs if you often press the space bar with the thumb of only one hand.
Exercises: Wrist exercise
In the early stages of tunnel syndrome, exercises help a lot.
- force your fingers into a fist and unclench,
- shake with relaxed brushes, gradually raising them to the sides and up,
- interlock your fingers and make squeezing movements,
- press your elbows to your sides, squeeze your fingers into a fist and rotate with your hands in different directions,
- press your elbows to your sides, palms forward, squeeze-unclench your fingers in the phalanges,
- connect the palms together in front of the chest, pressing the tips of the fingers with tension, tilt the hands to the right, then to the left,
- make rotational movements with the brushes to the sides and inward,
- in turn, pull one finger forward and twist your finger either clockwise or counterclockwise,
- take turns making a ring, pressing each finger with force to the thumb.
For exercises, you can use simple rubber soft balls, with and without spikes: twist them, squeeze tightly with the whole brush, squeeze in turn with one finger, toss and catch. If you keep such a ball on the table, it will be easier to remember about the warm-up.
Make simple self-massage brushes. To do this, gradually knead your fingers in turn, first with your right hand - on your left, then vice versa. From the tips of the fingers to the base. Self-massage and baths are effective at the onset of the disease, and in the later stages, the effectiveness decreases.
What to do if it hurts, but you need to work
It happens that wrist pain and work in progress torment you at the same time.
The first step in this situation is to relieve pressure on the nerve! To do this, use special locks that hold the hand in the correct position. In pharmacies and medical equipment stores you can buy special devices - orthoses, bandages, braces for the brush. They are very convenient, they can be easily put on and taken off, you can work in them, they do not limit their owner. Such dressings are no less effective than medical and surgical treatments. Do not want to wear a bandage during the day - wear it at least for the night. Please note that the dressing must contain a rigid or springy element. Alternative dressing pads and styluses, touch screens can be added to the dressing.
Try to put your sore arm on your elbow up with your fist. And do not abuse painkillers. Follow the general rules and mode of operation, take mini-breaks. Sports activities - pull-ups, push-ups on the uneven bars, push-ups on the palms, exercises with weights - also strengthen the hands and prevent the narrowing of the channel.
The main thing is not to give up!
Andrey Beloveshkin - Doctor, Candidate of Medical Sciences, former teacher of the Belarusian State Medical University, speaker of TEDx. Currently advising, conducting trainings to strengthen health resources. Research area - scientific measurement of health resources, individual prognosis and risk assessment of diseases, their proactive correction. Author of the beloveshkin.com health resources blog.
The first symptoms of tunnel syndrome are pain, tingling and numbness in the hands, unpleasant sensation when the hand, thumb and index finger are bent.
Treatment for acute pain, severe inflammation and severe course of the tunnel syndrome is prescribed medication, but if it does not help, this is an indication for surgical treatment (open way or endoscopically).
The basis for the prevention of tunnel syndrome are exercises that, especially in the presence of the first symptoms of "carpal syndrome," should be done daily and regularly. The more often you take breaks to perform exercises, the more benefits they will bring, as they improve blood circulation in the muscles of the wrist and contribute to their stretching.
It is also important to properly equip your workplace at the computer, observing certain rules:
- When you sit at a table and work with the keyboard, the angle of bend of the arm at the elbow should be straight (90 °).
- When working with the mouse:
- the brush should lie on the table as far as possible from the edge,
- the brush should be straight,
- the elbow should be on the table.
- It is desirable to have a special support for the wrist - it can be a mouse pad, a special-shaped keyboard or a computer table with special silicone pads.
- The chair or chair should have armrests.
2 unpleasant syndromes
What is it?
Tunnel syndrome, or carpal tunnel syndrome - the general name for a painful situation where the nerve of the wrist is pinched between the bones and tendons. The wrists and fingers are numb, sore, movements become stiff. Among the reasons, doctors call various types of hard physical work, injuries and. long incorrect position of the hands, unnatural bends when working with the tablet and computer.
Prevention: control of the correct position of the hands during work, regular rest and gymnastics for the hands.
Smartphone finger syndrome - This is pain, numbness, inflammation and in severe cases, the curvature of the thumb, and usually on the right hand, since when using a smartphone it is most often involved.
Prevention: regular change of the “working finger”, control of the correct position of the hands.
Research is being conducted on this subject and debates are underway, because we are all inextricably linked with electronic devices, but not all of them have such unpleasant consequences. Doctors say that the tendency to diseases of the nerves and joints is not always obvious and it is not worth provoking it with an incorrect load.
What is carpal tunnel syndrome?
It seems like I called some obscure medical term, but what is it is incomprehensible. Let’s clarify. Carpal tunnel syndrome or tunnel syndrome or chronic trauma of repeated stress is a neuralgic disease caused by pain in the right hand.
It is especially common in people who often work at a computer. As a rule, it develops in people who monotonously do extensor - flexion movements. Most often, this ailment occurs on the right hand, however, if you are left-handed, the development of the disease is possible on the left as well.
This disease occurs not only among bloggers, but also among all people who somehow make money with their hands, that is, artists, sign language interpreters, machinists, etc.
By the way, it is interesting that for the first time they learned about this disease not when the first plants were launched, or the first artist wrote his work, but when the typewriters were invented. Now they are upgraded to keyboards. But although there has been a change in the type of object, the disease still manifests itself.
Let's talk more about why this disease occurs.
The causes of the disease
As you know, our hand consists not only of skin and bone. It also contains tendons that allow it to perform a variety of rotational and flexion actions, and nerve cells through which the brain sends a signal.
So, the tunnel channel syndrome develops just in the place highlighted in red in the picture, in the middle of the brush.
- Long stay of the brush in one position. Because of this, the tendon begins to grow and enter the nerve, which is located inside it. And you yourself know when a nerve hurts, for example, in a tooth - you want to climb the wall. Here is the same thing.
- Constant tension in the hand, which leads to inflammation of the nerve of the tendon, which also causes severe pain.
- Lack of rest. In our school in primary school, the teacher always carried out warm-ups after long writing. I even remember this poem: “We wrote - we wrote, our fingers are tired. We will rest a bit and start writing again. ” Meanwhile, we squeezed and unclenched our fingers.
I shared a good exercise with you 🙂
This ailment can occur in people of different professions:
- sign language interpreters suffer because their hands are constantly in motion, namely the hands.
- artists, as their limbs are constantly tense during work.
- bloggers, hands that are constantly typed on the keyboard, and accordingly do not know any rest.
Also, the reasons may be completely unrelated to work, for example: arthritis, trauma, sports, diabetes, pregnancy. But we will not consider them.
Symptoms of the disease
What are the symptoms of this tunnel canal syndrome?
1. Numbness of the fingers
2. Weakness in the fingers
3. Weakening brush movement
4. Poor coordination
5. Acute pain piercing the arm from the beginning of the palm to the elbow joint
6. Cold or hot hands (a symptom should occur constantly)
As a rule, this ailment worsens at night, which prevents a person from sleeping soundly. In this case, massage or exercise can help him.
If your work is connected with the Internet or you are a blogger, I advise you to spend home disease test:
Для этого необходимо соединить тыльные стороны ладоней, а локти развести в стороны, так чтобы запястья были под углом равным 90 градусов. Если в течение минуты у вас не появятся болевые ощущения, либо покалывания в кончиках пальцев или ладонях, у вас все в порядке. В противном случае следует обратиться к специалисту.
Профилактика и лечение
Сейчас давайте поговорим о том, как можно предотвратить синдром туннельного канала:
- If you are working on a PC, watch the angle of the degree in the elbow, it should be equal to 90 degrees.
- In order to relieve tension in the wrist area when interacting with the mouse, use special hand pads, they are sold in many stores.
- Also, your workplace should be equipped with a special chair with armrests so that the hand rests in the same plane.
- If your hands are constantly in motion while working, buy a special bandage to help keep your hands in the correct position.
If “mouse hands” cannot be avoided, let's talk about how to treat them:
1. There are a variety of ointments that help reduce swelling and inflammation of the joints. You can use them, but only with the appointment of a doctor.
2. There are drugs that reduce the inflammatory process in tablets and also in suppositories, but they can also be prescribed only by a doctor, taking into account individual tolerance.
3. Another good way is to wear a bandage at night to keep your arm straight and relaxed.
If speak about folk remedies, here you can help a leaf of plantain or cabbage, which has the ability to relieve inflammation.
However, you should remember that you should not self-medicate and you need to contact a neurologist to establish an accurate diagnosis and prescribe appropriate treatment.
You can also perform certain exercises:
- Squeeze your hand into a fist and begin to rotate it clockwise, then against it for a minute.
- Just squeeze and unclench the cam.
- Rotate with your thumb while the rest are squeezed.
- Bring your fingers apart and push them hard.
- Shake hands.
All these exercises should be done at least 1 time per day for 1 minute and then you can not only avoid pain, but also prevent the onset of this disease.
Now you know what tunnel syndrome is and how to treat it, and most importantly, how to prevent it. If your work is directly related to hand strain, try to take a break as often as possible and give them rest.
Do exercises, drink vitamins to strengthen joints, and most importantly, follow the rules of working at the computer. After all, they were not just invented. The main thing is not to be lazy!
By the way, as a prevention of tunnel canal syndrome, I can share with you another super-way. This is work in the country 🙂 My husband and I often go to our country house and tell you honestly summer chores - this is a great exercise not only for the hands, but for the whole organism. Here I will show you a collage of autumn photos of our cottage.