Ergoblog

Update on My RSI Issues (AKA things are looking up)

If you've visited before (or clicked the link on the sidebar that describes my issues), you know I started this blog because of hand pain from typing/mousing.  I haven't been posting too much lately, but it's not because things have gotten worse.  My hands are actually about 95% better (this is after more than 4 years of not being able to work at the computer for more than an hour or two a day without pain).  I won't say I'm completely cured yet (they still feel a little stiff at times), but I think I'm heading that direction.  I'm even playing World of Warcraft (yes, I'm a geek) in addition to my regular computer work.

So, what miraculous thing helped me?  Was it the hand braces, the drugs, the various contraptions for exercising my wrists?

Nope.  (None of that stuff helped me.)

Then last summer, I was diagnosed with hidden food allergies, specifically gluten and dairy.  Of course, I was eating these things every day (gluten is found in wheat which is found in... just about everything) and my body had built up a tolerance, but there were symptoms.  Everything from my RSI to headaches to asthma to acne to heartburn.  I had no idea these things were all related (I just remember feeling annoyed that I was already having all these troubles in my 20s--what kind of mess would I be by 50??). 

So I must thank the doctor (it was an alternative medicine clinic... my regular doctor just wanted to prescribe drugs for everything) who thought to ask: have you ever been tested for food allergies. 

It's a pain to have to avoid these foods (eating out is very cumbersome), but it's worth it to feel so much better.  If you are struggling with hard to diagnose issues, I encourage you to do some research on symptoms of hidden food allergies (there are a lot of them and they can manifest differently in different people) and get tested if it sounds like a match.  I read that 1 in 8 people are actually allergic to wheat and many don't know it (and for the rest of the popular, it's apparently not something anybody digests really well).

Check it out, and good luck with your issues!

Link Between Carpal Tunnel Syndrome and Diabetes?

Well, here's something you really don't want to hear: "Carpal tunnel syndrome may be an early warning sign that diabetes is just around the corner."

That's according to an article called "Carpal Tunnel May Predict Diabetes" over at WebMD.

In a study of 2,655 people with diabetes (compared against 5,300 without it), researchers looked back through nine years of medical records and found out that "people who had been diagnosed with carpal tunnel syndrome were 36% more likely to later be diagnosed with diabetes, regardless of other diabetes risk factors."

They go on to say that they can't prove anything yet, but it apparently is known that nerve injuries are common with diabetes, so maybe CTS could be a warning sign of what's down the road for some...

I guess we better stop eating those Big Macs and chocolate shakes before the twinges in our joints turn into something even more serious.

So, I Have All These Food Allergies...

After three-plus years of trouble with repetitive stress injuries, and trying everything short of surgery, I may have actually figured out my problem.  As I mentioned a couple months ago (chronic muscle and joint pain caused by vitamin deficiencies?), I went to a doctor for digestion issues, and she had me tested for food hidden allergies (something no other doctor had thought to do previously).  I had positive responses for.. a lot.  Here are the biggest offenders (which are in things most of us eat on a daily basis):

• gluten (found in wheat, rye, and barley)
• dairy
• eggs

Based on these results and my symptoms, we (doctor and I) think it's likely that I have Celiac Disease (though I'd have to have a biopsy of the small intestine done to know for sure), which means eating gluten harms these little things in the small intestine called villi--they're what help you absorb nutrients from the food you eat.  So, even though I have a good diet, my body hasn't been getting all the vitamins/minerals it needs for years.  This leads to all sorts of problems (a lot of things like acid reflux, irritable bowel syndrome, bone and joint paint, and chronic fatigue syndrome may actually be caused by Celiac Disease). 

Because the symptoms can be different in different people and many aren't even obviously related to digestion, this is something that gets misdiagnosed a lot.  The stats I've read estimate that as many as 1 in 133 people in the U.S. have Celiac Disease and many of them just don't know it.  (Apparently it's especially common in those of Northern European descent.)

So, long story short, I'm now avoiding gluten (and my other allergens), which is inconvenient, but at least it's all you need to do to protect yourself and get better.  From what I've read, it takes 3-6 months for the gut to heal.  I'm already sleeping much better (digestion issues kept me up before), and I'm hoping this will turn out to finally fix my hands too. 

Chronic Muscle & Joint Pain Caused by Vitamin/Mineral Deficiencies?

One of the first things doctors do when you go in complaining about Carpal Tunnel Syndrome or some Repetitive Stress Injury is tell you to take it easy for a while (sometimes offering a wrist brace) and give you a prescription for anti-inflammatory drugs.  This helps some people, but a lot of us just have trouble again once we get back to work.  Since visiting a new doctor (one who specializes in natural medicine, which involves getting to the root of the problem instead of just throwing drugs at you) for something else (see my heartburn blog), I'm starting to wonder about the role vitamin/mineral deficiencies might play in repetitive stress injuries. 

The main reason I'm wondering is that I found out I'm not digesting things properly, so my body is short on vitamins, and minerals.  I'm currently being tested for food allergies (which can be the basis for all of this).  After finding out that joint pain is one of the side effects of this malnutrition, I'm wondering if that may be at the root of my RSI (as well as my other issues).  It's something you don't necessarily think about (at least I didn't, because I eat a healthy diet), but now it's got me looking up these things on the Internet (and I'm definitely going to ask my doctor about it when I get the results for my food allergy tests). 

Here are some interesting articles I found, in case you're curious about this sort of thing:

"Orthomolecular" medicine may help with muscle and joint pain, depression, and chronic fatigue.  (In this system--which is practiced by MDs, despite being considered an "alternative medicine"--non-toxic, natural substances are used, primarily herbs, vitamins, and minerals).

Vitamins and Your Health -- This is a big long article on what all the vitamins and minerals do for you exactly.

Natural Pain Relief for Carpal Tunnel Syndrome -- Both B6 and B12 are mentioned in this one: "A Japanese study of 174 university students found that students with lower levels of vitamin B6 showed symptoms of carpal tunnel syndrome." -- "Vitamin B12 - a study looked at the effectiveness of vitamin B12 for people with carpal tunnel syndrome due to overuse of the nonparalyzed arm after stroke. For two years, 67 people in the study received 1500 mcg of vitamin B12 a day, and the remaining 68 did not. After two years, there was significant improvement in the group taking vitamin B12 compared to the untreated group."

Oh, and for those of you wondering if you might be having these vitamin/mineral deficiencies, take a look at your fingernails.  My doctor knew right away when she looked at mine, because they have vertical ridges down them.  I'd never thought anything of it, but I guess nails can tell a lot about your overall health.  More on that here: Fingernails and Nutrition.

This is not to say I think everyone who has RSI trouble has mineral/vitamin deficiencies, but I'll be interested if it's part of the problem in my case, since I've tried just about everything else for my hand troubles. 

RSI Update: My Hands Have Been Better

Is RSI something that one is ever completely cured of?  I'm not sure.  The lucky ones maybe.  I will say that my hands have been noticably better over the last few months.  (You can read about my original whinings, er reasons for starting this blog, here)  Although I still have trouble with my hands, I've been able to get back to a close-to-normal work load.  Since I work from home, I do spread my tasks out over the entire day (an hour here, do something away from the computer, an hour working--that kind of thing), so that helps.  I have a feeling I couldn't handle eight hours a day hammering at a keyboard in some office for very long.  However, this is quite an improvement, since my hands used to hurt so much I could barely drive.  I still have hope that they'll improve further if I try not to push things.

So, what have I done?  It's hard to say that it's been any one thing, because when you've had RSI for a while, it takes a long time to get better.  I tried Flextend for about a year (and I still use the gloves from time to time), but it wasn't the cure-all I'd hoped for (check them out if you haven't though--it seems to work well for some people).

About a year ago, I replaced my TouchStream keyboard (which I never quite got the hang of) with a Kinesis ergonomic keyboard, which I like and plan to keep.  I also replaced my regular mouse with an iGesture (unfortunately FingerWorks, the company that makes this and the TouchStream, have gone out of business), which I also like a lot.  For a while I relied heavily on Dragon NaturallySpeaking, but I've been using it less lately as my hands have been bothering me less (so I've been able to type more).  I still think it's an excellent tool, though. 

Another thing that has changed is that I've lost about 25 pounds.  I wasn't exactly a fatty before, but now I'm pretty lean.  Although I don't remember discussing it in this blog before, I seem to remember reading about ties between obesity and RSI.  Like I said, I wasn't obese, but I figure any little bit might help with these kind of things.  That much less stress on the body, ya know?

Lastly, the break reminder program.  I have it set to go off every 20 minutes I sit at the computer.  I'm not always good about obeying it, but I do try to at least get up and stretch a bit a couple times an hour.  Our bodies just weren't built to sit in a chair hacking at a keyboard for hours in a row. 

Anyway, I'll post further updates if anything changes.  Good luck to everybody out there who is having trouble.

Carpal Solution?

I caught a recent news article that mentioned something called the Carpal Solution as a device designed to help Carpal Tunnel Syndrome sufferers.  "It's called the "carpal solution," FDA registered therapy which is worn at night and gently tugs at the three key points surrounding the carpal tunnel. This decompresses the soft tissue around the carpal tunnel and relieves pain and other symptoms of CTS."

Anyone heard of it?  Anyone tried it?  If it focuses on the carpal tunnel, then it probably wouldn't do much for those of us who experience pain in the hands (from RSI), but it sounds interesting.

Original article: Treatment Helps Carpal Tunnel Without Surgery

Hm, I checked out the web site for the company, and it points out the spots where the device works--it looks like one might target the hand after all.  Unfortunately, it's not a once-you-buy-you-can-use-it-forever device.  You buy the number of nights of treatment you want.  For one hand and one week's worth (7 nights), the price is $28.95.  For a sex-week course (right and left hands for 28 nights--I guess you don't use it every night), it's $159.90. 

Since most of the products that promise to relieve RSI/CTS don't, I'm reluctant to spend money on something like this.  (Browsing the web for reviews didn't assuage my reluctance).  After Christmas, I may order a week's supply, if only so I can write a review of the product for you folks.

Here's a link to the company's site: http://www.mycarpaltunnel.com

Cases of Carpal Tunnel Syndrome on the Rise

Carpal Tunnel Syndrome isn't a problem that's going anywhere, but with the number of reported cases rising each year, it looks like it's getting more attention in the medical community.  According to a brief article from the Las Vegas news: "The number of carpal tunnel syndrome diagnoses continues to increase. Many factors are contributing to this injury trend, including the fact that Americans are working longer hours on their computers, and workforce technology such as laptops and handheld electronics empowers us to work just about anywhere."

What's being done?  Well, the article mentions that at a meeting between the American Society for Surgery of the Hand and the American Society of Hand Therapists (ASHT), new scales were discussed for assessing the severity of CTS sufferers.  I'm not sure how exactly that will help in the long run, but at least people out there are paying attention to the growing problem and working on ways to help people with pain.

New Approaches to Carpal Tunnel Syndrome Unveiled

Combating Horrible Advice for Carpal Tunnel Syndrome Sufferers

I have a lot of respect for medical professionals, but it's hard not to cringe when I see a doctor's advice for Carpal Tunnel Syndrome published in a major paper like this: "Simply resting the wrist can lessen tunnel inflammation and let the nerve recover. That can be accomplished by wearing a wrist splint, obtainable in most drugstores. Some people get relief by wearing it only at night. Anti-inflammatory medicines -- ibuprofen being an example -- can also alleviate inflammation and nerve compression. If these measures fail, the doctor can inject cortisone, which almost always calms inflammation. In only a few instances is surgery necessary to free the nerve from whatever is pressing on it." -- from the Sun Herald

First off, most people who think they have CTS have some other kind of repetitive stress injury that has nothing to do with the carpal tunnel (It's Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals)

Second, drugs and rest are only a short-term solution.  Same with cortisone and even surgery (most people's problems come back a few months or a year after the surgery--my source is again the excellent RSI book mentioned above).  Yeah, the symptoms might get better for a while (how not?), but as soon as you resume your regular activities (if you work 40 hours or more a week at a computer, it's hard to escape them...), your problem is going to come back.  You need to change your work environment.  Make sure your chair is at the right height, use a quality ergonomic keyboard, ditch the clicky-clicky mouse for something like the iGesture, install a break reminder program and get up and walk around a couple times an hour (or at least do exercises at your desk), etc. etc. etc.  It's really about changing the way you work, not just taking drugs or wearing a splint.  The office ergonomics section at Healthy Computing has lots of information on setting up your workstation.

Third, sometimes the solution is more about correcting a muscle imbalance than simply resting the joints.  Something as simple as putting a thick rubber band around the tips of your fingers and thumb and doing exercises where you flex your fingers outward can help build the strength in the muscles opposite those that get used every day from everything to opening a jar to typing.  Flextend is a more comprehensive way to exercise those muscles.

Lastly, for a lot of people, pain that manifests itself in the hands or wrist may not even be because of a problem in that area.  You might have a trigger point (kind of like a pinched nerve) in your back or shoulder.  If you've tried exercises and changing your habits and aren't having much luck  (raises hand), check out a book like The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief (this book goes behind hand problem... they cover aches and pains in every part of the body). 

Now that I've ranted for a page, I'll end with a reminder that I'm not a medical professional and everything above just comes with the experience of having read about RSI and ergonomics and having dealt with pain issues for the last couple years.  Do see a doctor if you're having trouble, but my advice is to go straight to someone who specializes in repetitive stress injuries.  I wasted a lot of money going from a general practitioner to her referral, a doctor who specialized in hand surgeries, to another referral, a physical therapist who got to bill me for multiple weeks without ever solving my problem... I wish I'd started out just spending the $40 on the afore mentioned It's Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals and The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 

Good luck!

Text Messaging Leading to RSI for Kids?

As if it isn't bad enough that our computer keyboards and mice are contributing to an increasing number of instances of RSI in the adult population... now, the warning is out on cell phones.  More specifically, text messaging and how popular it's becoming for kids.  A brief article called, "Kids Texting Messages in Danger of RSI," takes a look at the how and why of phone-induced repetitive stress injuries...

"According to the Chartered Society of Physiotherapists, regular texting using just a thumb to type could cause pain and swelling in the tendons and possibly long-term injury...As more children acquire mobile phones, and phones get smaller, they are at risk of a condition more commonly linked to desk-bound adults."

http://www.news-medical.net/?id=12714

Avoiding RSI

An article posted online at Forbes today addresses RSI: "Avoiding Repetitive Strain Injury"  It's interesting that the article shows up in a business magazine.  Previously, carpal tunnel syndrome and RSI have been afflictions mainly associated with computer professionals. It just goes to show you anyone who spends a lot of time at the keyboard is at risk.  Some of the highlights of the article...

"Adjust Your Chair. Your forearms should be horizontal to the keyboard. Adjust your chair to the proper height as needed. Many "ergonomic" chairs are adjustable every which way to meet individual needs. Add or remove extra cushions and padding as you see fit. Arm rests or no arm rests? It's up to you.

Pick Your Keyboard Wisely. Ergonomic keyboards may help head off any pain. If you don't go ergonomic, make sure you get a keyboard that isn't stiff and causes you to pound the keys. You could also consider a trackball instead of a mouse. Use an adjustable keyboard tray for both.

Know When To Stop. There's often pressure to finish the job, but if you feel pain, stop. It's also wise to take regular breaks, wiggle your fingers and shake your wrists. Get up and walk around."

Read the original article for the complete list.

Avoiding Repetitive Strain Injury