Carpal Tunnel Syndrome and Repetitive Strain

Injuries

A Guide for Wellness, Recovery and Prevention

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Table of Contents
Introduction ...............................................................................................................4
The Purpose of this Guidebook................................................................................4
Overview of Carpal Tunnel Syndrome ................................................................6
Glossary of Terms .....................................................................................................6
Cumulative Trauma...................................................................................................7
Signs and Symptoms ................................................................................................7
Who is at Risk? ..........................................................................................................8
Treatment and Prevention of Repetitive Injuries.........................................10
Exercises to Help Prevent Strain............................................................................10
Dietary and Lifestyle Changes ...............................................................................11
Computing Industry ................................................................................................12
Construction Industry .............................................................................................13
Treatment of Injuries..............................................................................................13
Review......................................................................................................................14
Myths and Mysteries Surrounding RST ............................................................16
Conclusions...............................................................................................................22
References ................................................................................................................23

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Introduction
Many studies reveal repetitive strain injuries or (RSI)
including Carpel Tunnel Syndrome (CTS) are reaching new
and “epidemic” proportions, at least according to Medical
News Today and Body Aches News.

Dennis Downing of BackSafe.com reports millions of people suffer from RSI

injuries every year, mainly because of the increasing use of computers and
technology in daily activities.

Those most at risk are individuals who spend multiple hours each day in front of
a computer, working with a keyboard, or individuals on assembly lines that
perform repetitive tasks daily.

However, computer users are not the only people at risk for injury. Construction
workers, healthcare workers, musicians – and work or form of “play” requiring
repetitive motion can result in injury and chronic pain.

RTI injuries, especially CTS result in billions of dollars

of lost work time, pain and suffering every year.

Most injuries are difficult to heal, especially if you become injured but have to
continue working. With proper education and evaluation however, most people
can recover from and prevent future repetitive strain injuries. We will show you
how.

The Purpose of this Guidebook

This guidebook will help you understand CTS and RSI injuries, and help you
understand steps you can take to treat symptoms, relieve pain, and even prevent
future injuries from influencing your ability to feel your best and avoid permanent
suffering.

Most people with repetitive strain injuries experience feelings of depression,

discomfort or fatigue. This is normal, and treatable. Using the tips outlined in this
guide and medical advice provide by your GP, you can learn to lead a healthier,
more productive and better quality of life, no matter your diagnosis or condition.

Even if you have not yet been fully diagnosed with an RSI injury, this book will
teach you how to prevent injuries from hurting you and compromising your ability
to work, play and enjoy your life.

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We recommend you read this guide from beginning to end learning as much as
you can about CTS and other repetitive strain injuries. Since CTS is THE main
repetitive strain injury suffered by workers, this book will focus on describing this
injury and providing details about how to treat it and improve the quality of your
life following a diagnosis with CTS. It will however, also contain a wealth of
information about other types of injuries, so you understand CTS and RSI from a
much broader perspective.

We begin our journey with an overview of CTS and RSI injuries.

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Overview of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is one or many illnesses or injuries grouped under
what researchers refer to as “repetitive” injuries, or injuries caused when we
repeatedly use or misuse certain tendons, muscles, or ligaments in the body.
More often than not, these injuries result from occupational illness or hazards.

Keep in mind as we go along in this guide however, that anyone can suffer from
a RSI or carpal tunnel syndrome.

To understand what CTS is, you need to understand some common definitions
associated with this injury and injuries related to CTS, or those commonly
grouped as “repetitive use” or “repetitive strain” injuries.

Glossary of Terms
Here are some terms used to describe carpal tunnel syndrome and related
disorders. Understanding these terms will help you understand how to treat your
condition and prevent future injury from affecting the quality of your life.

Repetitive Motion Injury or Trauma – A repetitive motion trauma occurs

when someone injures the living tissue in the body. Usually this injury
happens when you apply movement to muscles or joints in a certain way
consistently over time. This causes fatigue and increases the muscle’s
susceptibility to injury or tearing. Repetitive strain injuries often involve
greater damage to the tendons and muscles surrounding the joints. They
result from repetitive use usually, but can happen as a single injury or
incident occurs, causing lasting pain when a person reuses the part of the
body often.

Carpal Tunnel Syndrome –Describes a specific injury or syndrome,

resulting when a nerve in the wrist becomes compressed in the exact
location it passes through the wrist to the hand. The syndrome results in
weakness, pain and sensation disturbances in the hand. Many people
mistake CTS for various other RSI injuries.

Cumulative Trauma Disorder – Often shortened to “CTD” this disorder

results from repetitive motion and overuse of muscles when someone
uses them in an incorrect position. CTD usually refers to chronic cases of
CTS and other injuries that do not resolve permanently or go into
remission with traditional treatment measures. A GP may also use this
term to describe an injury occurring in multiple locations throughout the
body.

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Cubital Tunnel Syndrome – CBTS, which is different from CTS, results
from compression or an injury to the ulnar nerve in the cubital tunnel. This
is the passage between the bony part of the within the elbow and the tip of
the elbow. So, rather than suffer wrist and hand pain alone, the individual
affected is likely to experience pain, tingling, numbness or weakness in
the elbow and surrounding area.

The idea of “cumulative trauma” or injury that builds up with time is an intriguing
one. Understanding cumulative trauma is essential for combating CTS and RSIs.

Cumulative Trauma
CTS and all other repetitive injuries qualify under the general terms “cumulative
trauma” or “repetitive motion disorders”. What exactly do these terms mean? To
understand, you must understand how the tissues and tendons in the body work
to help produce movement.

Usually, tissues and tendons in the body slide easily back and forth to support
movement of the wrists, fingers, elbows and other joints in the body.

A synovial sheath, a capsule enclosing the tendons in the body, covers these soft
tissues to protect them. Typically, movement does not result in pain, even when
someone engages in the same movement daily. Consider for example, walking.
Most people do not suffer RSI injuries by walking, and this is a repetitive task you
engage in daily.

However, when an individual engages in repetitive movements or injures to

certain parts of the body, like the hands, wrist or elbow, this sheath, the synovial
sheath, will fill with fluid and place pressure on underlying nerves. This results in
pain, which pay spread to the fingers (with CTS) and the wrist.

Signs and Symptoms

Patients with repetitive use injuries often display the same or similar symptoms.
CTS typically results in the following:

Burning in the hand, fingers or wrist and thumb.

Pain on movement of the hand, fingers, wrist and thumb.
Prickling or tingling sensations that attend movement.
Swelling and irritation of the fingers and other attachments.
Other pain, tenderness or discomfort depending on the areas affected and
the overall health of the person affected by the injury.

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Repetitive injuries like carpal tunnel are more common among people who work
in certain occupations (computer work, labor or manual labor, assembly etc.) or
engage in repetitive sports (like tennis – consider tennis elbow for example, a
repetitive use injury).

Who is at Risk?
Some people are more at risk than others for CTS injuries. These include:

People who work in assembly, as they often must perform the same tasks
repeatedly.

Individuals who work in mail services, as they too often must perform the
same tasks repeatedly, straining the back, wrists or other areas of the
body.

People in the manual labor industry, including those engaged in data entry
or word processing.

Individuals performing data entry or word processing tasks daily are most likely to
suffer from CTS specifically, with millions of the working population seeking
healthcare and advice from their GP for pain associated with CTS injuries. Any
tasks involving repetitive typing, bending and twisting can also result in injury.

Did You Know?

People who are overweight or obese are MORE likely to suffer
CTS and other repetitive strain injuries. Why?

Obesity contributes to swelling and edema in the body. This can

compress nerves and result in pain and irritation associated with
CTS and related disorders.

Excess weight also carries with it extra pressure on the body’s

muscles and stresses the body when a person engages in
repetitive tasks or tasks needing twisting and lifting motions.

Apart from obesity or overweight, other risk factors for CTS and
related disorders may include having diabetes, one’s age (the older
you are, the less limber your tendons and tissues), one’s general
health status, gender (women are more at risk than men) and
individuals with arthritis.

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 Arthritis also results in inflammation of the tendons and tissues
surrounding the joints and ligaments, which can lead to CTS or
symptoms of CTS.

As GPs diagnose more and more individuals with CTS and other repetitive strain
or overuse injuries, it is more important than ever consumers educate
themselves about the causes, treatments and prevention of these disorders.
Doing so will ensure you live a better quality of life, one without pain and
discomfort.

Now that you know a bit about CTS, it is time you learned more about other RSI
injuries, treatment and preventive measures you can adopt to improve your
health outcomes.

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Treatment and Prevention of Repetitive
Injuries
The treatment for many repetitive use injuries like CTS is often the same. Most
GPs encourage those affected to engage in an ergonomic evaluation at work.
This evaluation will assess any causes contributing to your condition, including
poor posture or an improperly set workstation.

An experienced occupational therapist can help evaluate your workstation and

adjust your chair, desktop, keyboard, or other workstation materials to help
reduce any stress placed on your wrists, tendons and other body parts.

A competent occupational therapist may also provide you with dietary

recommendation and preventive exercises and steps you can take to help
prevent injury. Even if someone sets your workstation correctly, if you work long
enough hours you are subject to injury.

Exercises to Help Prevent Strain

Many exercises can help reduce your risk for developing repetitive use injuries or
CTS. Exercises are a good idea for anyone engaged in routine activities that
involve bending, twisting or stressing of the tendons, ligaments and joints in the
body.

Construction workers who work with vibrating tools are also at risk for injuries to
their hands and their wrists, so they too will benefit from exercises. They may
work more on strengthening and flexibility exercises to keep their muscles and
ligaments in proper working order.

Regardless of your industry, a therapist will usually recommend similar exercises.

Most exercises focus on two areas:

1. First, strengthening the wrists, hands, fingers, and other muscles

supporting the tendons and surrounding ligaments.

2. Second, exercises meant to relieve pain and discomfort and provide the
ligaments and muscles a much-needed break.

An occupational therapist or physical or other bodywork therapist is the person

most qualified to help you decide what exercises are best to help strengthen
supportive muscles that influence the repetitive actions you engage in.

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As far as rest, work breaks are necessary for anyone engaged in repetitive
activities, whether they work in construction, at a computer terminal, or in the
manual labor industry. Work breaks consist of ten-minute breaks every hour on
the hour.

Here are some suggestions for good exercises and rest breaks that will help
reduce tension and pressure in your joints and ligaments:

 If you work at a computer station, take ten minutes and step away from
your desk. Raise your hands above your head. Flex your fingers open and
closed for two minutes. Repeat ten times, two times each ten-minute
break.

 Use a strong form of putty, exercise putty or clay, and roll it around the
palm of your hand. This will help massage the tendons and ligaments in
your hand and wrist, may help improve flexibility and may help strengthen
your wrists and fingers. Be sure you consult with a qualified healthcare
professional to select the putty best for you.

 Repetitive injuries may also involve the eyes. Eyestrain is a common

complaint among workers spending long hours in front of computer
terminals. Make sure you take time to look away from your computer for a
few minutes each hour. Look at a distant wall, a blank wall for a few
minutes, then close your eyes for five minutes and let them rest. This will
do wonders for reducing eyestrain and may even help remove tension
headaches.

For workers engaged in other occupations, a qualified ergonomic or occupational

therapist will work with you to help develop a sequence of activities that will help
strengthen and relax your overworked muscles. These may include bending or
stretching exercises to improve flexibility and promote circulating blood
throughout various regions of the body.

Dietary and Lifestyle Changes

It is important you uphold a proper weight and eat a healthy diet to improve your
overall health and reduce your risk for repetitive strain injuries. Your GP may
recommend you consult with a qualified dietician, nutritionist and exercise health
specialist or physiologist to develop an exercise program that will help strengthen
your body and help you lose weight safely if you need to.

Ergonomic Evaluations

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 Many employers will provide workplace ergonomic evaluations to
employees at risk for repetitive strain injuries. Ergonomics involves
studying how nature and structure affect the space you work in, and
how restructuring your workspace using scientific principles can
help reduce your risk for injury and improve your comfort.

An ergonomic specialist may come sit at or visit your worksite to

evaluate you while you work. They will make detailed notes about
the way you sit, stand, type or handle equipment or machinery.
They will notice postural changes, and recommend slight or major
changes to your workstation to reduce pressure and strain on your
wrists, hands, back and other body structures.

These adjustments may seem awkward or uncomfortable initially,

especially if you already suffer from CTS or another repetitive strain
injury. However, with time and proper practice, your body will adapt
to working in a newer, safer way.

The sooner you have an ergonomic evaluation performed, the more

likely you are to prevent future injuries from destroying your ability
to work.

Remember, ergonomic evaluations can be helpful for individuals in

any occupation, not clerical or administrative workers alone.

If you do plan to embark on a diet and exercise routine, make sure you include
plenty of whole foods, foods that are not processed and do not contain many
additives or chemicals, in your diet.

You might also consider taking a good multivitamin supplement, even if you eat
well. Many people do not understand that sometimes, eating well is not enough
to aid your body. Some people need a little extra boost. A daily multivitamin will
ensure your body gets the minerals and nutrients it needs to thrive and fuel you
throughout the day, bolstering your immune system and reducing your risk for
injury or illness.

Now let us focus on a couple of industries where RSI are more likely to happen.

Computing Industry

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Carpal Tunnel Syndrome and other injuries are most common in the computing
industry. The practice of ergonomic evaluation is now commonplace among
many employers to help prevent injuries before they happen.

New employers may spend time with an ergonomic professional, who will
evaluate their desk and workstation and adjust it according to a person’s height,
weight and the work they perform. A specialist may also recommend specific
exercises you should follow to help prevent injury.

Because injuries are much easier to prevent than treat, it is important you make
note of everything the ergonomic specialist recommends when you begin
working.

Construction Industry
The construction industry is another industry where repetitive strain injuries are
common. Many workers, including street workers, sheet metalworkers and other
construction workers continue to work even with injuries. This can result in lasting
neck, shoulder, back and hand pain that you may find difficult to treat
successfully. When this pain becomes severe, the person suffering may develop
a “cumulative trauma disorder.”

In the severest form of injury, a person may experience lifelong disability from
their occupational injury, leading to lifelong stress and the need for lifelong
medical treatment and side effects.

Manufacturing Industries or Electronics

Any industry involving workers that assemble or collect and put small parts
together may increase the risk for repetitive strain injury. If you work an assembly
line, you may do the same activity repeatedly, increasing your risk for wear and
tear on the ligaments, tendons and muscles involved.

Now you know about risk factors for injuries, so, how can you treat an injury if
you do develop one? There are many ways to treat RSI injuries.

Treatment of Injuries
If you already suffer from an injury, you must make adjustments in your
workspace and routine. You also need to receive medical care to help your body
heal. Most repetitive injuries like CTS take a longtime to recover from. Here are
some examples of common treatments recommended by GPs for treating CTS
and related injuries.

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 Anti-inflammatory medications – These medications help reduce
inflammation in the body. A repetitive strain injury usually results in
inflammation in the body. Some examples of this medication include
Paracetamol. Your doctor may prescribe some medication and
recommend you use it daily until your symptoms become less prominent.

Rest – For many people, the best treatment initially is rest. Rest will allow
the ligaments, tendons and tissues time to recover. This also helps
decrease inflammation and swelling. You will need extra treatment
however, when you start working again to prevent more strain to the
injured site.

Surgery – In severe cases, where the nerves become compressed to the

point where they cause undermining pain, or when a person experiences
nerve compression in the spine or other major part of the body, a GP may
recommend surgery to help soothe the pressure on the nerves. Usually
this involves a lengthy recovery time, and the results may be
unpredictable. It is best to try other means of treating your condition before
considering surgery. Many GPs recommend surgery as a “last resort”
when other treatments have failed.

Iontophoresis – Many repetitive strain and other disorders affecting the

musculoskeletal system respond well to “iontophoresis.” In this treatment,
a provider uses a drug or “ionized” substance and applies it to the skin
using an electric current. This does not hurt, though a patient may report
feeling some tingling sensation during treatment. Treatment typically
requires multiple sessions. The result is a decrease in inflammation, which
can in turn reduce pain and discomfort.

Corticosteroid Treatment – A GP may recommend localised treatment

where they inject corticosteroids into the affected region of the body to
help reduce inflammation and pain. This treatment is temporary and may
cause side effects but often helps severe cases.

Of course, there are many additional treatment alternatives a GP or therapist

may recommend for you. Natural remedies may also prove helpful. These may
include supplementing your diet with natural anti-inflammatory agents like flax
seed oil or primrose oil.

Review
CTS and RSI injuries are common. Fortunately, you can treat most injuries with
little intervention. The sooner you seek care for the injured or affected body part,

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the more likely you are to recover from an injury without chronic or long-term
effects.

Since we spent some time talking about injury, we should spend a few minutes
debunking some common myths and misconceptions people have about RSI
injuries. Understanding these fallacies will bring you, one-step closer to
preventing future injuries and treating the injuries you do have successfully. The
next section focuses on some of the more common myths people have about
repetitive strain injuries and disorders.

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Myths and Mysteries Surrounding RST
W hen it comes to carpal tunnel syndrome and other repetitive strain injuries,
many myths and mysteries exist. This section will help you judge fact from fiction
when reviewing your risk and treatment methods for these serious disorders.

This section looks like a question and answer session to provide you with
comprehensive information about each topic presented.

Q. Is carpal tunnel syndrome most often caused by on-the-job overuse of

the hands and wrists, like among people who work in clerical or computer-
related jobs?

A. While carpal tunnel syndrome is common among data entry workers and other
professions involving computer use, these types of jobs are not the MOST
common cause for carpal tunnel syndrome. In fact, there are many conflicting
studies about the causes for carpal tunnel and related repetitive strain injuries.
Slater (1999) suggests workers in heavy manual labor or construction
occupations are more at risk than computer workers for CTS. However, others
report industrial employers are no more at risk than construction workers.i The
truth is there is no one major cause for this disorder, there are many causes and
many risk factors.

The more easily you identify these risk factors and causes, the more likely you
are to take action to prevent injury. Your overall health, personality, the time and
length of employment, training and your ability to take breaks and engage in
ergonomic evaluation may all affect your risk for CTS and related injuries. Some
studies suggest certain “systemic” or total body illnesses, like autoimmune
disorders including diabetes and arthritis, predispose people to these types of
injuries. These are major causes for CTS, even more so than one’s employment.

How does this affect you? Use this information as a preventive tool. Consult with
your GP and evaluate your risk factor for CTS and other repetitive use injuries.
The more you know about your personal risk, the more active steps you can take
to prevent an injury from becoming serious or long lasting.

Q. What types of jobs other than construction or computer related jobs can
result in repetitive strain injuries or CTS?

A. There are many unusual jobs that can strain and injure you. Assembly
workers who perform the same tasks repeatedly are sometimes more at risk for
repetitive strain injuries than others, partly because in some industries they are
less likely to receive information and training about the risk of CTS.

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Some researchers note that unusual professions including “jewelry making” can
place one at risk for CTS. This is because individuals who make jewelry often
work with small pieces, including gems and beads, and perform tasks repeatedly
that need precision, and that may result in strain and pain.

Q. Can people not engaged in legitimate “work” activities suffer CTS?

A. Yes! There are many people suffering from repetitive strain injuries resulting
from work but also play! Tennis players for example, are more at risk than some
other sports athletes for repetitive strain injuries like tennis elbow. Other activities
that may result in injury include housekeeping. The act of cleaning floors for
example may result in what some refer to as “house worker’s knee.” Gamers, or
people who engage in video gaming for sport, may also suffer what some call
“gamers thumb,” which is a repetitive injury to the thumb that may result from
pressing a button repeatedly when playing video games.

While this may sound humorous, such activities can result in serious and
permanent injury if not addressed. Writers, who “write” manually, without using a
keyboard, can also injure their whole arm, their thumb and other parts of their
body. Sometimes GPs refer to this pain as a “writer’s cramp.” Anyone who
engages in a task repeatedly is at risk for injury, whether you sew something,
whether you make jewelry, count money or even sharpen knives for hours on
end.

Some people realise pain in their neck, shoulders, upper back and even lower
back if they sit improperly. Even “couch potato” people with poor posture may
suffer back strain from sitting in an unsupported position for long times. What
does this mean for you? No matter what you do, you should strive for balance in
your life. You should exercise regularly, take breaks from any activity you engage
in routinely, and make sure you treat any injury that appears chronic.

If you find you spend countless hours in front of a video game, and your thumb
chronically hurts, and then take a week off. You can even visit your GP for
recommendations about how to reduce your pain or improve your technique to
reduce your risk for serious injury.

Q. What is the difference between repetitive strain injuries and overuse

syndromes?

A. Many GPs classify carpal tunnel syndrome (CTS), repetitive strain injuries
(RSIs), cumulative trauma disorders (CTDs) and other injuries as one in the
same. They all result when you use or overuse parts of the body, which results in

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short, or long-term injury and pain. “Compression neuropathy” also refers to CTS,
because it results in compression of nerves in the wrists, arms and hands.

Q. I am a musician. Could I be at risk for a repetitive use or strain injury? It

seems almost anyone is at risk.

A. Yes, almost anyone who performs any task routinely is at risk. This does not
mean however, that you will develop a repetitive strain injury. It does however,
suggest you should take preventive care to prevent an injury from influencing
your ability to do what you like best, including playing music.

Musicians often engage in repeated physical movements that affect the tendons,
nerves and the muscles in many parts of their body, depending on the instrument
they play. Some are more at risk for injuries to the hands and arms, while others
may be at risk for injury to the fingers and wrists (like piano players) or the
shoulders (like violin players). If you are not sure whether you are at risk,
research your condition or consult with a GP to find out what types of exercises
an other preventive measures you can take to help reduce any damage the
tendons and soft tissues in your body may experience from repeated playing. No
one wants to give up music. The good news is with proper care, you do not have
to.

Q. What are the more common exercises used to treat RSI?

A. The types of exercises recommended may depend on the types of injury and
place of injury you are most at risk for. For example, individuals working at
computer terminals may use putty to help exercise and relax the hands, wrists
and fingers. A GP may recommend they stretch their shoulders and neck. Other
exercises may include back flexibility and core strengthening exercises, which
can be helpful for people that must lift or engage in frequent bending during the
day. A stabilisation ball is a tool many therapists use to help strengthen the core
muscles or trunk muscles in the body (as these support the back, neck and even
legs).

Q. What are some other injuries or disorders that result in pain similar to
CTS and RSI?

A. Many injuries may result in pain, tingling and inflammation in a person’s body.
This is one reason it is critical you consult with a GP if you feel pain, tingling,
numbness or discomfort when engaging in any activity. Here are some common
injuries resembling RSI injuries. Some of these injuries are injuries that attend
RSI injuries, meaning people develop them at the same time they develop RSI
injuries.

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Tendinitis – This refers to inflammation, edema or swelling occurring
within a tendon, according to the American College of Rheumatology.
Tendons attach the muscles of the body to the bones, and contract to help
move bones.

Bursitis – This refers to inflammation involving small sacs between the

bones and the muscles or skin and tendons, called collectively the “bursa.”
These small sacs are important because they allow the muscles, tendons
and skin to glide easily in the body. Inflammation in the bursa of the body
may resemble the pain people with arthritis feel. The symptoms are
similar, and may include pain, stiffness, edema or tenderness, usually that
comes with movement. People may experience more pain at night. People
usually experience this pain near the joints more often than in other
tendons or areas of the body.

Unlike tendonitis, that when treated quickly often heals, bursitis can recur
often or result in long-term or chronic pain and discomfort. It does not
however, cause deformity but it may restrict the range of motion an
individual has. Like may RSI injuries, bursitis often results from overuse or
improper use of the body’s ligaments, tendons or soft tissues. Sometimes
conditions including tendonitis and bursitis go with rheumatoid arthritis or
other autoimmune disorders.

Tenosynovitis or DeQuervain’s Syndrome – This condition causes pain

in the wrist and the forearm near the thumb. It is commonly confused with
CTS. Usually with proper diagnosis, this condition is easily treated.
Tenosynovitis affects tendons in the thumb, the “abductor pollicis longus”
and the estensor pollicis brevis” both which help move the thumb and
connect muscle to bone. Tenosynovium is a slippery substance that lines
the tunnel holding these two tendons in place; if this coating becomes
infected or inflamed, then a person has tenosynovitis. Actions that can
cause this condition include pinching or grasping and squeezing items
repeatedly.

People with autoimmune diseases including rheumatoid arthritis are also

more at risk for this condition. Usually the best treatment for this condition
is rest. Many GPs will recommend you work with a therapist to learn
proper exercises to help avoid future irritation and work with you to ensure
you use neutral alignment of the wrist when engaged in at risk activities
like grasping or pinching and squeezing. Rarely when the condition
warrants severe intervention, a GP may recommend anti-inflammatory
agents or even cortisone injections to relieve pain and inflammation.

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Tendinosis – This is another term commonly used to describe tendonitis
that is chronic in nature.

Thoracic Outlet Syndrome – This injury results in chronic neck pain,

resulting from compression of the ligaments and tendons located between
the cervical spine and bordering anatomy. Nerve roots become
compressed and irritated, which may result in conditions radiating
throughout the body. Common complaints include:

o Inflammation in the arms and hand.

o Discoloration of the hand resulting from improper flow of blood to
the hand.
o Heaviness or discomfort in arms and hands.
o Pain in the neck and shoulder not lessened by ordinary means.
o Fatigued arms or hands.
o Muscle weakness.
o Pain in the arms and hands.
o Cramping and numbness that may occur in the hand, neck,
shoulder and surrounding regions.

Poor posture and injury are common causes for the compression
resulting in this injury. Other people, including those with osteoporosis
are more at risk for this condition. Stretching, strengthening and anti-
inflammation or pain medications are commonly used to help relieve
any discomfort associated with this condition. With proper treatment,
this condition dose not become chronic.

Trigger Thumb – Occurs when the fingers in the thumb (or sometimes a
finger or multiple fingers” become painful on movement, usually because
someone uses the thumb or finger repeatedly, as in when they use a
mouse to click repeatedly. The finger or thumb may spasm repeatedly and
cause pain or discomfort. Other distinguishing features include a “clicking”
sound when the person bends the affected appendage, and pain and
tenderness in the affected area. Some patients with severe forms of this
condition may form a nodule, which “locks” the thumb, or finger into a
specific flexed position. If trigger thumb becomes this serious, a GP may
recommend surgery to repair the injury and return normal movement to
the afflicted area. You may need to use special equipment to avoid
injuring the affected area again.

Myofascial Pain Syndrome – This is a chronic condition resulting in pain

or a burning and stabbing sensation in a localised area. Many times what

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 happens is someone injures a tendon or muscle in the body that refers
pain elsewhere in the body, thus this syndrome may be difficult to
diagnose correctly. There is not much research on this specific disorder,
other than identifying it by an aching and nagging sensation. It may result
in chronic pain not easily treated, causing endless fatigue or even
depression in some.

Sometimes GPs diagnose the condition by finding “trigger points” in the

body. These are places that when pressed, result in pain and tenderness
often within a muscle. Usually patients with this condition have four
different trigger point types, including an active point, where pain is most
prominent, a latent point, a secondary point that is irritable and a satellite
point, which is an irritable spot within a muscle that may be active when
the muscle affected is found between other trigger points. Physical
therapy can help relieve this condition sometimes, as can corticosteroid
treatment.

Q. What are the more common symptoms of RSI injuries?

A. The symptoms you experience may depend on the type of injury you have or
the severity of it. Here are some common complaints reported by people with RSI
injuries:

 Warmth or redness of the affected tendons or joints.

 Tingling and numbness in the hands, fingers or arms, neck or limbs.
 Coldness in the hands or feet.
 Loss of strength in the affected area, like the shoulder, back or neck.
 Constant pain or pain on movement. This is common in the shoulder,
neck, wrists, hands and fingers.
 Tenderness in the forearms or elbows.
 Tenderness in the palm of hands or feet.
 Pain in the upper or lower back or pain that radiates to legs.

Q. How are RSI and related injuries diagnosed?

A. There are many ways GPs can diagnose conditions including CTS, RSI,
tendonitis and related disorders. The more common diagnosis instruments
include physical examination, medical history, X-rays to help identify arthritis or
other underlying conditions and MRIs or other tools that provide graphical images
of the tendons and tissues of the body.

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Conclusions
Repetitive strain injuries, disorders, and carpal tunnel syndrome are among the
more common injuries suffered today. As more and more people rely on
technology to work and as a form of communication, GPs will continue seeing
more patients with these types of injuries.

You have the ability to overcome CTS and other repetitive use injuries. The key
to your long lasting health knowledge. You must understand what to look for, and
taking proper action if you feel your body is overstressed.

This guide described many of the more common signs and symptoms of CTS
and RSIs. If you have any suspicion you might develop these injuries consult with
your GP or occupational therapist at work. They can help you develop an action
plan that will reduce the odds of chronic injury.

With prompt care, most injuries do not become chronic.

We hope you enjoyed our guide on CTS and repetitive use injuries. To your
health, and your wellness!

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References
Armstrong, TJ, Chaffin, DB. Carpal tunnel syndrome and selected personal qualities.
Journal of Occupational and Environmental Medicine, 1979; 21:481.

Bingham, RC, Rosecrance, JC, & Cook, TM. Prevalence of abnormal median nerve
conduction in applicants for industrial jobs. Am J Ind Med, 1996; 30(3):355

Cannon, LJ, Bernacki, EJ, & Walter, SD. Personal and occupational factors associated
with carpal tunnel syndrome. Journal of Occupational Medicine, 1981; 23:255.

Slater, R.R. Carpal tunnel syndrome: Current Concepts. J South Orthop Assoc. 1999;
8(3):1.
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Armonstrong, Chaffin. Carpal tunnel syndrome and selected personal attributes. 481.

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