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Typing Away

In this modern age computers are everything to us.  Computers are our friends, foes, facsimile machines, copiers, printers, safe boxes and everything else and in between.  It is little wonder that i guard my passwords more than my life these days.

Anyway's a computer is of little use to a common user without its most evident input device and that is a key board.  Without a keyboard we would not be able to communicate with our beloved machine.  we would be left stranded in a one way communication that is not very enjoyable.  Is it?

But extended use or over use of this valuable device has its own health consequences.  I am here to talk about just a possible few.

Carpal Tunnel Syndrome or CTS is advertised to be caused by excessive typing on the keyboards.  In fact to date I do not know of a study that establishes a causal relationship between excessive typing and development of carpal tunnel syndrome.  CTS is associated with repetitive and forceful movements of hand and the wrist such as associated with work in food processing, manufacturing, logging and construction work.

The carpal tunnel is a an anatomic tunnel which is bounded by wrist bones and connective tissue and contains one of the two important nerves of the hand - the median nerve.

Symptoms of CTS develop when the median nerve is impinged or compressed either intermittently or continuously by the structures that make the tunnel wall.  The symptoms of CTS include pain, burning, numbness, or some combination of these symptoms on the inside of the thumb, index finger and half of the ring finger.  Some times these symptoms occur at night and wake up the patient.  Another very sensitive test for CTS is the "flick sign".  When someone with CTS gets the symptoms they shake the hand to relieve the symptoms.  This sign is reported to have a sensitivity and specificity of more than 90%.

The treatment for this condition begins from simple splinting of the hand.  This relieves the symptoms in 8 out of every 10 people.  Splinting is especially useful in relieving the night time symptoms of the disease.  A commercial splint is acceptable if it keeps the hand in the neutral position.

Modification of the daily activities involving the use of hand is also important.  A study demonstrated a short course of steroids used orally was beneficial in alleviating the symptoms of CTS.  if symptoms persist then the other option is local injection of steroid in the wrist area.

Surgery is patient dependent.  But becomes essential if there are symptoms of nerve damage.  The surgery can now a days be performed by endoscopic vision.  The success rates for both approaches to surgery are similar and non is superior to other in symptom resolution.

The single most important therapy for CTS is to treat the underlying disease that leads to CTS.

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