Several years ago I was working full time as a freelance writer and administrative assistant at a small nonprofit organization. I was on the computer from 9-5 every day, and often got back on it in the evenings. I wasn't typing all the time. Sometimes I was just surfing the internet, using a mouse, or editing things I'd already written. But over time these activities started to take their toll.
It started in my right hand. I'd notice a slight tingling sensation in the back of my wrist, which gradually spread to my hand and fingers. Foolishly, I ignored it.
Several months later, I was firmly convinced that I had carpal tunnel syndrome. My wrists hurt all the time, sometimes when I wasn't even typing. When I did have to type or use a mouse, the pain was unbearable. I tried to push through it, but this only led to my fingers going numb. My grip strength decreased. My elbows and shoulders started to hurt. I started to feel pain just thinking about typing. I was afraid I'd have to quit my job.
Dorsal wrist syndrome and the nebulous RSI
Going to the doctor was not at all helpful. The first person I saw said I'd have to get expensive nerve imaging tests before she could recommend me for physical therapy. On top of that, she said there was no treatment for carpal tunnel syndrome except ibuprofen and surgery (this is not true). A second doctor decided that I did not have carpal tunnel syndrome but rather something he called "dorsal wrist syndrome." When I asked him what this meant, he said "dorsal means back. It means you have pain on the back of your wrists." A lot of people think it's comforting to name the problem, and they're probably right. But as names go, this one left me pretty hopeless. All I knew was that I had a repetitive strain injury, or RSI, which is caused by performing the same small muscle movements day after day. RSI is a broad category that covers a variety of problems, including tendinitis and carpal tunnel syndrome.
Wrist RSI's and cortisone shots
Clearly, this doctor had no real ideas about what was wrong with me, and my insurance wouldn't cover any of the tests he recommended. Still, despite his lack of knowledge about my condition, he went ahead and suggested cortisone shots. Cortisone is a steroid that reduces inflammation and, if applied correctly, can diminish the pain associated with RSIs. Frustrated and in pain, I agreed to try it. After several weeks and several hundred dollars, there was no improvement in my wrists.
Doctors and the over-medication of America
Looking back on the situation, I'm shocked that this doctor even offered me the cortisone injections. He had no idea what exactly was wrong with me, and didn't know where the pain was originating. Cortisone only works if it's injected into the exact area that is inflamed. Since all he knew was that the dorsal side of my wrists hurt, there was very little chance of success.
Unfortunately, doctors get paid and not by the hour, but by the treatment. This is a huge problem in our health care system. Basically, if a doctor recommends you for surgery or some other expensive treatment, he or she makes more money. With this kind of dollar incentive, it's not surprising that doctors recommend surgery for conditions that often heal on their own.
If you have carpal tunnel syndrome or another wrist RSI, I would not put too much faith in doctors or specialists, at least not unless you have a long-standing relationship with them or some seriously good health insurance. The fact is, there's very little they can do for you. Cortisone injections have mild success, but only if the problem is inflammation. With most RSIs, there's a lot more going on than that. Physical therapy can be helpful, but most of the techniques, stretches and exercises you learn there can easily be learned on your own.
Surgery for carpal tunnel syndrome
Don't do it! Full recovery from this procedure takes months, and the surgery itself can result in nerve or muscle damage. also, there is some debate as to whether it is more effective than just waiting it out. Our bodies to have the capacity to heal themselves It, and slicing through ligaments to give your nerves more room (that's what most surgery entails) is a lot like trading one problem for another.
Carpal Tunnel vs. RSI
I do not have carpal tunnel syndrome, but whenever I have is a lot alike it. I still can't type for long periods of time. When I do I have to use a special keyboard, an ergonomic mouse, and sit in the best possible position at all times. Mostly I just use voice recognition software. I'll tell you more about these methods in subsequent posts, but for now, I simply want to point out that even if you don't have carpal tunnel syndrome, your symptoms can be very real. Carpal tunnel has become the buzzword of the condition, but the majority of wrist RSIs are not actually carpel syndrome. this is very important to remember. A doctor may tell you, after a series of tests, that you do not have carpal tunnel syndrome, and send you on your way. I know from experience that this can be very frustrating. However, whether or not you have it is not the issue. The issue is what it does to you and how you can treat it, and with the exception of surgery, the same treatments apply.
Best treatments for wrist RSI and carpal tunnel syndrome
This is essentially the subject of this blog, so at the moment I'm going to be as general as possible. Details will follow.
3. Heat and Ice
5. Good attitude
10. Vitamins and supplements