carpal.txt

I'll tell you my story, maybe it will help. I can't guarantee the experience would be the same for you, or that you have Carpal Tunnel Syndrome, but hopefully at least some bits and pieces will help.

I first noticed trouble in Santa Fe 5 years ago or so. My right wrist would hurt. Pain. Weakness. Tingling. Numbness. Lack of endurance and strength. It was frustrating. I began to research things and figured I had the onset of CTS.

After plugging along for a while, things got bad. I couldn't hold a cup of coffee or open a door with my right hand. It was completely powerless and useless and was in constant throbbing pain. The worst symptoms lasted for months as I tried to figure out how to best 'get rid of it.'

I walked around wearing a forearm splint on my right forearm and hand to prevent movement. I had to keep working (as I was one out of 2 people running this small business) - so I learned how to mouse with my left hand so that I could still get some stuff done. Eventually, the problem started showing up in my left hand too (no joke!) though not quite as bad as in my right.

I tried *many* different things. I went to acupuncture (great for the short term relief) and physical therapy and chinese medicine folks. I bought a wax bath thingy (heat and cold therapy helps and feels just great) and would dip my hand in wax 7 times and then wrap in plastic and then a towel. That felt great, and gave me short term relief.

My physical therapist was wonderful. She yelled at me in the nicest way possible saying I was the youngest patient she had or had ever seen with the issue, and that I was killing my body and had to wake up and deal with the situation. She taught me a lot of stretches, mental attitudes, and most importantly she reminded me that I needed to STOP.

She explained that though the majority of the pain was localized (so, the tissue around the carpal tunnel is inflamed) it's actually a full body issue - the nerves that go through that carpal tunnel go all the way up your arm, through your shoulders and into your neck and head. She worked on my shoulders, taught me how to sit, and basically made me focus on my entire body as much as possible. Your posture, your movement of the body throughout the day, how you hold yourself - these all affect the issue.

Long story short, the absolute worst of the issue passed after a few months, but it did not go away. My main concern was being able to play the guitar/piano. I couldn't relax and play guitar anymore. It was pretty painful. On stressful days, I would come home and not be able to sit on the couch and play. I was pretty grumpy and stressed out.

The issue didn't go away. I moved out to hawaii, found a computer gig, and though I was only working half-time, the issue came right back, threatening me regularly. I learned how to type in the 'Dvorak' layout which is scientifically designed for quick and efficient typing and lets you type with 1/3 of the movement as typing in the normal layout. It helped, but not the magic cure. I was mousing with my left hand. It helped, but not enough.

After researching some more, I happened to land on some work by a doctor who was researching the possibility of RSD (repetitive strain disorder) having psychosomatic sources. What does that mean? It means that though the injury is 100% real, the main cause of the injury is actually 'all in your head' - or at least, fueled and partially caused by your mental processes and attitudes.

I chewed on that for a bit. Though my physical therapist had emphasized my #1 job was to relax my hand as much as possible, sometimes i would work for as little as an hour or 2 and my hand would be in pain and unusable. Other days I could work 6-8 hours, no problem. So, quantity of usage didn't seem (in my case) to be the main issue.

I decided take a look at what was going on with my emotions / mental state. And I found something that ended up saving my ability to work on a computer (for better or worse ;))

CTS is a repetitive strain(stress) disorder. So, the answer for me was actually in the definition of the injury:

1) Repeat less
2) Strain/Stress less

Translated in to practical reality, this meant:

1) When things begin to hurt, STOP.
2) Pay attention to your attitude while working. Are you straining? Are you stressing out? Are you tensed up? Is the body tight? Are you typing away at a  desperate clip? Are the forearm muscles tensing and are you hunched over the keyboard like a raving lunatic?

Through paying attention, I gained control. This was more than a year later after the onset, and though all the other stuff helped, this was my ticket to sanity.

I noticed that when I was stressed out, in a hurry, or just feeling shitty, I would type with fervor, really hammering away at the keyboard. My arms were tense. I was hunched over. I was in a foul mood. After 30 min-1 hour of this attitude I was screwed for the rest of the day. The pain would be back, I was a goner and would HAVE to stop else the pain would worsen.

If instead I relaxed then I would be fine. This meant frequent breaks. It meant stretching my arm (as it's not an on-or-off situation, more like a gradient of numbness/trouble). It meant slowing down. It meant stopping and thinking every 10 min to see how I was doing. It meant taking the day off to force myself away from what I was doing. It meant going outside, hitting the beach, moving my body, etc. But mainly it meant *not* working while frustrated, at any costs.

Yeah, so fast forward to today. I have the most stressful job I've ever had. I work 50 hours a week constantly on the computer (I literally can't step away from the machine, as something could break any minute). I maintain and run http://alonetone.com after work.  It's too much at the moment. My arm will 'remind me' when I become tempted to be stressed, or simple cannot handle.

Just 2 days ago, my arm hurt more than it had since I was in hawaii. This wasn't the same crippling I had before, just a feeling of swelling and a bit of pain. I had a very stressful week. My girlfriend was gone for the week and all week I was trying to get some stuff for alonetone.com done after work. I was on the computer for 12-14 hours in the day. Overdoing it, stressing out, etc. I had to remind myself to pay attention, to stop being an idiot and killing my body in this way. To relax while working. Nothing going on at work was worth me degrading my body (or mind!) in the way I was doing it. I started stretching more again, taking more frequent breaks and looking at my hands while I type. And when tempted to get stressed out (it's addicting and contagious, I'm convinced) I would stop and take a break.

In general though, I'm fine. Like I say, I'm working more than I ever have, and I rarely have issue, much less the real throbbing crippling pain from before. Sometimes I just get a 'hint' of a feeling that pain could be coming, and then I back off. All is well. I play as much piano and guitar as I can.

As far as exercises, there are some very good ones to help convince your hand to loosen and even strengthen. Again, the full body is involved, it's not only a localized issue. I can make a little video of the ones I do if you like, or you can check out this:

http://boingboing.net/2009/03/31/carpal-tunnel-syndro.html

There's one in there where he plants his hand against a tree - and then moves his thumb up. That one is *great*.

So chill out, relax, take breaks, and pay attention - that's my recipe. If you are smarter than I was maybe you can kiss the issue goodbye forever. Otherwise, there's still a thin sliver lining - you have gained a physical indicator telling you when too much is too much. Pay attention to it, or suffer.

:)

Take what you want from all that!