To: bovik@K.GP.CS.CMU.EDU
Subject: carpal tunnel syndrome
Date: Wed, 26 Jun 91 11:25:06 EDT
Message-ID: <5275.677949906@AMALIE.TIP.CS.CMU.EDU>
From: Penny.Anderson@AMALIE.TIP.CS.CMU.EDU

Here's the information I've collected from the bboards on carpal tunnel
syndrome.  Unfortunately, there are no specific recommendations for where to
have it treated.

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From: Christopher.Colby@F.GP.CS.CMU.EDU

A friend from M.I.T. just sent me a copy of a memo that has been going
around there.  Those of you who know nothing of Carpal Tunnel Syndrome should
definitely read this.  Those of you who have heard of it might want to read
it anyway, as it includes some helpful hints for prevention.  (Background
information: 6.170 is an undergraduate software engineering lab at M.I.T.)

-chris

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This message has very little to do with 6.170, but since you will all be doing
intense ammounts of typing this term and probably in the future, you should 
know about Carpal Tunnel Syndrome.  I apologize to all those who already 
know about this.

Carpal Tunnel Syndrome is an advanced form of Forearm Overuse Syndrome and
tendonitis in the wrists.  Basically, the bones in your wrist form a 3-sided
tunnel (called the Carpal Tunnel).  Your tendons, blood vessels and nerves 
pass through this tunnel.  If your tendons swell up too much, it can pinch 
your blood vessels and nerves, causing numbness in the fingers.  If it is 
ignored, permanent damage can occur.  Even if it doesn't advance to the 
numbness stage, it is extremely painful and can render your hands pretty
useless.

In the past, mostly factory workers were the victims of this type of injury,
which is caused by repetitive motion (aka Reptitive Motion Syndrome.)  However,
most cases now are related to computer use. I developed this infliction last 
year when i was taking 6.170.  I developed pain in my wrists, that sometimes 
ran from my fingers all the way to my elbow.  I was stupid and ignored it,
thinking it would go away as soon as the  class was over and i got to take a
rest from typing.  I rested it 3 weeks and it seemed fine until i started 
typing again at my job.  The pain got worse and worse until i could barely 
write, or even tie my shoes.  Then one day i woke up and i couldn't feel the
tips of my fingers.  I ran to the med center.

I had both my hands in casts, and then splints for the remainder of the summer.
Even though I've taken almost 6 mos. of rest from typing, i still experience
severe pain whenever i type. (Not good news for a 6-3).  Almost a year later, 
I am taking strong anti-inflamatory medication and pain killers (equal to 
7 Advil) everyday.  I am in physical therapy 3 times a week getting ultrasound
treatment, and i ice my wrists all the time.  My orthropedic doctor has 
diagnosed it as chronic, although we are trying everything to correct it, 
possibly even surgery.  Basically, I'm trying to say that this is VERY SERIOUS.
It can really interfere with your career...  And it CAN HAPPEN TO YOU!!!
My doctor says he currently has 15 cases of students with chronic variations 
of Forearm Overuse Syndrome.

I probably got this because I typed wrong.  Do the following to avoid 
developing CTS/Tendonitis:

1) Keep your wrists UP while typing.  DO NOT PUT YOUR WRISTS ON THE TABLE!!! 
   It might seem uncomfortable at first, but you'll get used to it.
   KEEP YOUR WRISTS UP!  KEEP YOUR WRISTS UP!  This is VERY important.

2) If you feel your wrists might need support in the "up" position, put a 
        pillow under them or something.

3) Make sure you are using the Shift Keys properly.  Do not hit the shift 
key with the same hand you hit the other key.  

4) Try switching your mouse to the left side now and then if you are a righty,
and viceversa for lefties.  There are lefty configured workstations in  38-344.

5) Make sure that the key board is low enough.  It should not be too high, 
so that you would have the temptation to rest your forearm on the table.
If the keyboard is too high (as it often is in Athena clusters) put the key
board in your lap.  Good posture while typing can make an amazing difference.

6) If you experience any pain, ice it and Go to the Med Center.

7) If it hurts too much to type, for God's sake, give your hands a rest.  
I worked through it last year, and I got a good grade in 6.170, but i'm not 
sure if that good grade was worth screwing up my hands for possibly the rest 
of my life (not very optimistic, i know.)  I'm currently looking into Law 
School since I don't know what else I'd be able to do if I can't get rid of 
this... :)


Party On and Keep your Wrists Up, 

[name withheld]
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04-Mar-91 11:01    Gene.Rollins      Carpal Tunnel Syndrome and Piano
From: Gene.Rollins@VISTA.VENARI.CS.CMU.EDU
Carpal Tunnel Syndrome (CTS) can also afflict people who play piano.  Many
piano teachers unwittingly teach piano techniques that can cause this
problem.  Research indicates that the only factor in determining the loudness
of a note is the SPEED with which the piano key is struck.  Piano technique
that uses FORCE, especially short, hard strokes can cause CTS.  My wife,
Beverly, had CTS about 16 years ago, and after medical care, she went to a
piano teacher who specialized in physically-sound piano technique.  She
corrected some problems with her piano technique and finished her music
degrees.  As was posted on the market bboard, Beverly gives private piano
lessons and teaches safe piano technique.

Keeping your wrists up is also recommended for piano players.  Perhaps it is
also a good idea for typists to avoid pounding their keys hard..........gene
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05-Mar-91 12:25    Charles.Myers@SEI.CMU.EDU    re: Carpal Tunnel
If anyone should start experiencing the symptoms of CTS, I'd recommend that
you see a chiropractor.  Most of them are taught at least one technique
for treating it in school.  I've had CTS several times, and been treated
effectively each time.  "Effectively" means that the condition was cleared
up after 2-3 visits spread out over 1-2 weeks.
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22-Mar-91 17:57    Gene.Rollins            Wrist Support/Carpel Tunnel Syndrome
From: Gene.Rollins@VISTA.VENARI.CS.CMU.EDU
We must be careful in changing our typing habits.  We could make changes for
the worse!  I noticed that with my keyboard high, I rested my palms on the
bottom of the keyboard when typing.  I lowered my keyboard and started
resting my wrists on my crossed-leg or chair-arms.  This started causing me
some pain.  I had better typing habits with the keyboard at an intermediate
height.

Any habits that restrict blood flow to the hands or interferes with the
tendons going through the wrists into the hands will cause problems.

So, I am concerned about the use of wrist resting devices.  I haven't seen
them or the documentation.  But, I suggest that if you make changes to your
typing habits be sure to listen to your body's feedback.  The symptoms of
Carpal Tunnel Syndrome include pain shooting up the forearm, numbness in the
hands, swelling of the fingers, and others.  If you don't experience any
symptoms, perhaps you shouldn't change your habits.

Try this experiement.  Hold your forearm and hand straight up in front of you
with your fingers pointed to the ceiling and your thumb pointed toward you.
Keep your wrist straight and hand relaxed.  If you bend your fingers up and
down you can see movement in your wrist and feel it with the fingers on your
opposite hand.  You really don't want anything pressing against that soft
part of your wrist while you are typing to allow that movement to be
unrestricted.

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22-Mar-91 20:36    David.Lampenfield            More on Tunnel Carpal ...
From: David.Lampenfield@GLOBE.EDRC.CMU.EDU

As it turns out the nerves in the tunnel are for the 
thumb, index and middle finger.  The nerves for the
ring and little finger are elsewhere along the
forearm . Upper arm and shoulder pain can be related
to the non TCS pain. (1)  

Of course, anti inflammatory drugs will help with both. (2)

I hesitate to post what i have learned recently as
its not clear what is general info or a diagnosis.
The most important thing is to get profession help soon.  
TCS is  progressive and degenerative.
Early treatment is the best and cheapest solution.

(1) Chiropractor, very useful and covered by major medical.
(2) Regular pill pusher, aka AMA certified M.D. , also useful. 

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