Forearm Issues

November 6, 2004 12:29 PM

There's something long and hard inside my forearm, and it's not my radius or ulna! Tendonitis? Carpal tunnels? Repetitive Stress Injury? Keyboard allergy? Whatever you call it, I'm experiencing some pain and even a little numbness. I'm working on ergonomics, using ice and advil. A little massage. Rest. Any other suggestions? I will see a doctor but I welcome advice and anecdotes on computery injury / strain. Thanks!
posted by scarabic to health (13 comments total)

Heh-heh...nice one, quonsar.

On a more serious note, though, scarabic, you are almost certainly feeling the effect of carpal tunnel/RSI. If you're feeling what it sounds like you're feeling, it's the sheath that surrounds a column of muscles/nerves/tendons that's getting swollen and stiff. It feels like there's a rod running down the underside of your forearm, into the outer edge of your inside wrist, right?

That's a pretty common effect of spending too much time at the keyboard, in the wrong position. (As I recall, you've got a keyboard-focused job, which would totally make sense.) I've had much the same thing myself--in my case, I never ended up even going to the doctor, and it ended up healing fine.

I'm not suggesting you shouldn't see a doctor yourself, but I decided to try a lot of stretching, more frequent breaks, and sitting in a different posture first, and over a couple of months, that started to really help. On a hopeful note, the condition is now totally gone, for me, and I did have the same sensation you did.

A doctor who knows what they're doing could probably help you recuperate even more quickly, but it is definitely reversible (in many cases, at least), and it does definitely require paying a lot more attention to how you spend your time at the keyboard. There are a lot of online resources around this topic...you should check them out, and try to re-arrange your workspace accordingly.
posted by LairBob at 12:43 PM on November 6, 2004

Whoops...missed your comment that you were already working on the ergonomic aspect. Beyond that, I found that frequently stretching my hand and fingers backward to stretch that area, and regularly exercising my hands, wrist and forearm with those little hand exercisers helped the most.

(I got one of those little "GripMaster" finger trainers that a lot of guitarists use, with a separate little push-thingie for each finger--that seemed to help more than "two handles around a circular spring" kind.)
posted by LairBob at 12:46 PM on November 6, 2004

I also have a keyboard-related job, and on some days feel some heat/pain in my backhand and foreharm.
To force myself to have a break from time to time on those day when I getting a lot of work, I use the Windows tool RSI-Guard. Pretty nice.
posted by XiBe at 1:18 PM on November 6, 2004

Numbness is which fingers? Carpal tunnel will produce numbness in your thumb, index, middle, and sometimes half the ring finger, whereas ulnar nerve compression will be ring and pinky.

Ergonomics, stretching, and frequent breaks are the key. Make sure your desk and chair are the right height, and that your palms aren't resting on the keyboard. There's another carpal tunnel thread in AskMe, too, from a couple months ago.
posted by gramcracker at 1:31 PM on November 6, 2004

Hm. Hard to say which fingers felt numb. I started making more mistakes typing, and just didn't feel very articulate in that hand. I guess definitely the ring finger.

It feels like there's a rod running down the underside of your forearm, into the outer edge of your inside wrist, right?

Yes, except it's actually in the overside (dorsal?) part of my forearm, running from my outer elbow to the top side of my wrist. Most of the pain is near the elbow.

How do exercises help? Right now, exercising seems like it would be just more pain. I feel like I should just put my arm in a sling for a few days.
posted by scarabic at 2:46 PM on November 6, 2004

I suffer slightly with carpal tunnel and is hereditary as both my mum and grandmother suffered with it. I don't have the hardness described but I do suffer with the numbness in my fingertips, particularly in the winter months and when my hands have been raised for a reasonable period of time (when there is a restriction in blood flow). I find that lowering my hands and shaking them will increase the blood flow and the sensation disappears.

It's quite possible that the condition will get worse as I get older and it is relatively common in the UK to have the situation reversed by having a simple operation on the nerves to increase the blood flow. My mum had this operation on her hands about 7 years ago and she took the unusual step of having both hands done at the same time (which meant that I had to lend my hands for all the awkward personal jobs) and hasn't suffered with it since. It's an operation that is more common than you would think and I know about 4 people that have had this done already.

Some advice about relieving the symptoms for carpal tunnel syndrome can be found on the NHS website for starters, but I'm sure that there's a lot more with a bit of goggeling.

After all this typing and how cold my hands are at this moment, it means that I'm going to have to now start looking silly and start shaking those hands again :D
posted by floanna at 3:08 PM on November 6, 2004

How do exercises help? Right now, exercising seems like it would be just more pain. I feel like I should just put my arm in a sling for a few days.

Actually, it does sound more like tendonitis if you are in that much pain. I used to suffer with that in the tendons on the front of my lower legs when I used to walk miles to school - and it is excruciatingly painful, like a burning sensation. The doc gave me some anti inflammatory drugs and it would take lots of rest before the pain subsided.

I'd advise keep away from the keyboard for a while although I know it will be hard to keep away from MeFi etc Scarabic ;)
posted by floanna at 3:22 PM on November 6, 2004

Well, the sheath on the underside is actually the "carpal tunnel", from my understanding--if you're feeling the sensation on the top of your forearm, you've probably got some kind of RSI-type condition, but maybe not precisely carpal tunnel.

(I've felt tension and stiffness myself along the same path you've described, but for me, it was much more prominent along the path on the bottom of my forearm. It's probably more a factor of the specific ergonomic strain you're imposing, more than anything else...how specifically, is one holding one's arm wrong?)

As far as exercise goes, it's not going to be the first thing that helps--the first things that make a difference are going to be adjusting your workspace, and stretching the areas that are stiff. (If you're having trouble figuring out how to stretch them, that's exactly where a good doctor or a PT can help...to figure out the exercises that are going to make a difference.)

Exercise won't begin to make a meaningful difference until you're on the road to recovery, but once you are, exercises are going to make sure that the muscles and tendons, fascia, etc., are getting challenged in a variety of different ways, and not just by being held in one position for a very long time. Exercise increases blood flow to the area, which definitely helps, but more importantly, it makes all the muscles and tendons in that area stronger.

Over the long run, having a well-conditioned set of muscles are mean that they're all going to share the burden of staying in a given position better. One of the prime contributing factors to RSI is that when the muscles don't share the effort equally, the ones that do end up saddled with the task of keeping your arm in place are over-burdened, and taking up all the slack for the weaker ones. Basically, an RSI condition means that your muscles are just not strong enough to hold your arms in a certain position for the amount of time you're demanding, and end up locking themselves in place to compensate. Your basic options are to (1) decrease the amount of time you demand of them, and (2) increase your strength.

Good luck, though...this is definitely beatable.
posted by LairBob at 5:42 PM on November 6, 2004

FWIW, when I had a bout of RSI (tendinitis, in my case) I found this author's book very helpful. (It looks like the earlier book has been superseded by this one.) It's really good to know the difference between the various kinds of RSI (carpal tunnel, tendinitis, etc.), and how to deal with them.
posted by hattifattener at 6:27 PM on November 6, 2004

Point of correction: There is no evidence to suggest that carpal tunnel syndrome is caused by too much typing, or bad ergonomics. It may be that it is, but there isn't any proof of it yet. This according to the surgeon who did endoscopic surgery on me over the summer. It can of course be aggravated by overuse, but it is not caused by it, as far as anybody has shown conclusively.

Some things I did to relieve the symptoms were stretching (using one hand to bend the palm of the other back, hold, then forward, hold) and using a software break timer designed to halt your computer if you type too long. I think this is the one I used, but they all tend to have similar names.

Definitely see a doctor. For me the diagnosis involved being stabbed with needles and jolted with electricity, but your doctor might not be such a dick about it.

If it's CTS, the first thing they'll do is give you wrist braces for sleeping. If they do, be sure NOT to use them while typing, even though it's tempting to think it might help. Believe me, it does the opposite.

Second option is usually a shot of corticosteroids into the carpal tunnel. Squirm-inducing process, but it only lasts about 5 minutes, while the results can be drastically reduced symptoms for a year or so.

Third option, the one I ended up going with after three years of stubborn suffering, was surgery. About the wussiest surgery you can get. Was easy, and seems to be working, pretty much. If this ends up being the only option, and you want to know more about what to expect (from the patient perspective) feel free to e-mail me.
posted by Hildago at 9:09 PM on November 6, 2004

I did some research on carpal tunnel syndrome a few years back and found a good brochure with lots of pictures. Here's what I remember: There is actually a band of cartilage that encircles the wrist - this is the carpal tunnel, it holds the muscles and tendons together loosely like wrapping your hand around a bouquet of flowers. Carpal tunnel syndrome is when the muscles are stressed and swollen and press against that circle of cartilage. I don't know if they still do surgery, but what they used to do is cut that bracelet to relieve the pressure on the swollen tendons and muscles. They were no longer held together.

That sounded horrible to me, so what I finally found to cure the pain was swimming. I was able to build up the muscles in my shoulders and upper arms enough that they took a big part of the burden off my wrists and forearms. I imagine any upper body exercise would work, but I think the key is developing and using other muscles to compensate for the stresses of full-time keyboard work on your (smaller) wrist and forearm muscles.

I also used to wear a wrist brace while I slept, which was good, but I haven't had the need to wear it in several years.

I'm not a doctor, but my theory makes sense to me anyway.

Also, a doctor told me at one point to press the backs of my hands together, bending my hands at the wrist. If you feel pain in that position, then that is supposedly a carpal tunnel issue.

I second the Deborah Quilter book recommendation - I read that one too.

Good luck!
posted by bendy at 11:32 PM on November 6, 2004

Thanks for all the info, folks. I think I must have an inflamed tendon, from the sound of it. I appreciate the resources!
posted by scarabic at 12:41 AM on November 7, 2004

Massage/physical therapy can help. Heat or ice might be appropriate as well.
posted by callmejay at 10:22 AM on November 8, 2004