Wrist Update

[elfs]

I went to receive a second opinion yesterday regarding my wrists. I think he was a little surprised when I described to him the amount of time in front of the keyboard and how this was a quality of life issue. I wouldn't be surrendering my keyboard anytime soon.

He ran me through a collection of flexion and extension maneuvers to determine if there was anything else underlying the pain in my wrists, and he determined that there wasn't anything out of whack with my neck or back, things that would lead to an improper hang of the right arm and shoulder, because I sometimes have stabbing pains under the scapula and a burning sensation in the upper right bicep. He said I have "the neck of a girl." Apparently, men can't turn or flex their necks as much as women can, but mine is an exception, even more flexible than most womens'.

He was able to show me where in the right arm the initial signs of carpal tunnel syndrome could be found. There is a distinctive feel to the carpal tunnel when it's tapped, and it should feel solid. Mine didn't. They felt hollow. They echoed a little bit. My family physician hadn't known about that, and had missed it in her diagnosis.

Still, he was able to tell me that, recovery-wise, my first physician had been more or less correct: knock off the video games, ergo the desktop, get a smaller keyboard for my home (I have one of those early MS Natural keyboards, the ultra-wide monster that takes up the entire keyboard tray) so I have room for the mouse nearer to my hand.

He also told me to find a swimming pool. I had been on the varsity swim team in high school, fastest guy in the school-- third fastest in the state of Pennsylvania, 1983... man, were my schoolmates pissed when I decided for my senior year to quit getting up at 5am and eat a ton of protein just to swallow a gallon of chlorine before "breakfast" proper, and chose to play Ultimate Frisbee instead. All of the muscles in my upper torso were well-massed, but atrophied. My body has had no reason to remove all that muscle fiber, but it's now undeveloped. It's trying to support itself and my regular activities as a typist, and that's why I get upper shoulder pains after a long day. So, a half-hour of laps, three times a week, if I can manage it.

Comments

[rapier.livejournal.com]

Dude, those old-school MS Naturals are king. Your doc told you to get rid of it? Man. The ergo guy here recommended it specifically. Sure, it's a mile and a half from the right hand side of the board to my trackball, but my shoulders are broad enough that a standard keyboard makes my shoulders all hunchy-inwards and uncomfortable.

[jenk]

Me too...between the broad shoulders and the DDDs, the old-style ergo is great. That said, yes, having the mouse close by is nice too, and if Elf doesn't need the wiiide keyboard then a change might help.

(I got an adjustable-height table from Ikea for a bit over $100, and it makes a great worktable. The mouse is right next to the keyboard, and I plopped the monitor on an old Yellow Pages to raise it up.)

tapping on the carpal tunnel

[happy-hacker.livejournal.com]

Where did the doctor tap to feel that? I'm just curious (and tapping on my wrists). :)

-HH

Re: tapping on the carpal tunnel

[elfs.livejournal.com]

He tapped on the underside of the wrist, with two fingers, pretty solidly but not painfully, right where the wrist meets the palm. On my right, I can feel it, like a real brief echo; it's not there in the left.

Re: tapping on the carpal tunnel

[sarabande7.livejournal.com]

If you're talking about that little bump right below the heel of the thumb, sounds like the business end of the trapezium (http://eatonhand.com/iha/bon010r.gif) bone; also a front view (http://eatonhand.com/iha/bon010p.gif) of same.

This diagram (http://eatonhand.com/hw/ctr3.gif) is probably a very clear illustration of where the doc was banging on you -- right over the transverse ligament. (It comes from the "patient information" section of eatonhand.com (http://eatonhand.com) -- a wonderful resource for the most of us who aren't sitting on a copy of something like Functional Anatomy of the Limbs and Back) Here's the page on CTS where that graphic can be found along with its accompanying information: link to frame (http://eatonhand.com/hw/hw006.htm?).

That percussion test is, I think, a test for Tinel's sign (http://www.smaservicesinc.com/soa/jsoafl97/6text.htm), which, as indicated in this and other articles, is a valid but apparently pretty lo-fi way to look for CTS. The flexion tests your doctor had you do are identified in other articles and abstracts as being more generally reliable. This as a caveat to all those who might go around tapping on their wrists as a primary means of self-diagnosis. Since CTS is a condition associated with edema in the carpal tunnel, I'm guessing the echoing the doctor was looking for would result from that retained fluid.

Ok. End info-dump.

Swimming. How interesting.

Re: tapping on the carpal tunnel

[elfs.livejournal.com]

I think the recommendation to take up swimming was specific to my case. I am heavily overmuscled in the upper torso because of my varsity school days; those muscles either work, or they're a drag. These days, they're a drag. That's part of the problem. He wants me to make them part of the solution.