Approximately two-thirds of employees from industrialized nations use a computer on a daily basis and one in five spend at least 75% of their total work time behind a computer. It’s no wonder so many people suffer from carpal tunnel syndrome (CTS) in addition to neck, shoulder, and arm pain. There are many reasons for the presence of CTS in office workers who utilize a computer. The following is a partial list of causes:
- The computer screen is not positioned correctly in front of the worker forcing the neck to be rotated to the side or the head has to look up or down too far.
- The mouse and/or keyboard is placed on top of a counter, too high to operate without significant bending of the wrist, often against the sharp edge of the counter.
- The shape of the keyboard is flat, forcing the hands and wrists to pronate (roll inwards) too far. This places more pressure on the nerves in the forearms.
- The use of a mouse usually requires the entire arm to move, frequently running off the mouse pad requiring repositioning.
- Paperwork data that needs to be entered in the computer is placed too far off to the side and sustained neck rotation is required during the data entering process.
- The chair and computer desk do not fit the person’s height (either too high or too low) and/or the feet don’t touch the floor.
- There is too much glare from windows or overhead lighting making it difficult to see the screen.
- In the aging worker, poor eye sight requires the use of magnifiers which can be quite distorting when the head is moved, even a small amount.
- There are often other medical conditions that the computer operator may have that increase the likelihood of developing CTS such as obesity, hormone replacement therapy, diabetes mellitus, hypothyroid, the use of birth control pills, and others.
Therefore, the treatment of CTS must be multi-factorial and sometimes address one or more additional health issues that may co-exist. Frequently, there may be similar overuse types of conditions present in addition to CTS such as neck strain, thoracic outlet syndrome, nerve compression at one or more locations such as the neck, shoulder, elbow, and forearm. Each patient’s case is unique and a careful history is usually needed to uncover these potential contributing conditions so they can all be properly managed in addition to CTS. Because we spend a lot of our daytime hours at work, a careful work-related history is important to identify potential "ergonomic" (design) culprits that can be fixed with simple workstation adjustments. These may include mouse/keyboard placement to an under the desk pull out tray to eliminate the need to overly bend the wrists and eliminate the pressure from the counter top edge. Raising a chair and placing a box under the feet while sitting (for shorter workers), switching to a track ball mouse so only thumb movement is needed to move the pointer (or a touchpad as found on most laptops), an ergonomic keyboard (curved, not flat), moving the screen in front and slightly down from eye level, prop paperwork on a stand-up tray close to the screen so only eye movement is needed, and wearing appropriate quality eye glasses possibly with bi- or trifocals are some potential work station remedies. Chiropractic care is especially well-suited to address these issues because of the whole body treatment approach utilized.
