Carpal Tunnel Redux
June 18, 2007 6:56 AM   Subscribe

Carpal tunnel relief question and a request for an Atlanta-area specialist.

I have carpal tunnel syndrome in the left, for sure. The right side mimics the symptoms pretty regularly, so it's possible that I have it in the right as well. I will be having my second nerve conduction study in a few weeks to determine if this is the case. I've had symptoms for a few years now, and my doctor feels that surgery is the next step. I would prefer not to have anyone cutting into my hands unless it becomes absolutely necessary. Additionally, I am somewhat suspect about my doctor's abilities, for no logical reason that I can come up with except that he went to med school in Guadalajara (I can't find much helpful info about the school after a quick google search).

So, here I am, working in IT consulting (which seems to mean "sit in front of a computer all week"), and I used to enjoy playing computer games in my spare time. I haven't played very much at all for quite some time, in an effort to decrease stress and inflammation. I have some degree of pain almost constantly, and quite a bit more when I'm typing or mousing (in both hands, so the common suggestion of giving up mousing probably wouldn't help).

I use a powerball on occasion to strengthen my arms, wrists, and fingers. I have discovered that I can use Ace elastic wrist bands to manage the pain when not typing (they're not helping at all while I type this post), and Ace padded wrist splints at night. I cannot use Handeze as the glove portion cuts off the circulation in my hands. I play with Thinking Putty often. I have a MS natural keyboard at work, and, while I type, my arms are angled slightly downward, and the keyboard is angled slightly backward. I also take Celebrex on occasion.

Besides leaving IT and switching my career to who knows what... What else can I do to try and make this go away without surgery? Will continued use of Celebrex as an anti-imflammatory protect me from future nerve damave?

And, finally, can anyone recommend Atlanta's best CTS specialist? Ideally, someone on the north side hospital district, or in/around Sandy Springs, Marietta, Alpharetta, Roswell areas... Email is in profile if you wish to converse outside AskMeFi.
posted by to Health & Fitness (15 answers total) 1 user marked this as a favorite
I cannot recommend this highly enough: The Kinesis Ergo Classic Keyboard

About 7 or 8 years back I was having pretty consistent wrist strains from typing/mousing on the job and at home, and the MS Natural keyboard did nothing for me. Out of desperation, I purchased the Kinesis Ergo Classic Keyboard, and within a week my wrist pain went away.

I have one at work, and one at home. While they cost $300 each, they also have been the best thing to happen to my wrists in my entire life. On top of this, 7+ years later, the first one I purchased still works fine, including the on-board macro and reprogramming features, despite things like drink spills and constant abuse. These things are built like tanks.

If you can already touch-type, you can get up and running on one in a week or less, at full speed (potentially faster than before). There are newer models that are basically the same shape but with more features, but I can only speak for the Classic version.

Caveat: I was never diagnosed with Carpal Tunnel, so it is possible that my experiences were simple muscle strains. All I know is that I had reached a point where I was seriously considering changing careers up until I tried this keyboard, and 7+ years later I'm still going strong.
posted by tocts at 7:23 AM on June 18, 2007

Another stupid-expensive keyboard, which is supposed to reduce stress, is the no impact TouchStream LP. A guy I used to game with who had similar problems (required lots of typing for work, extreme hand pain) wrote a review of it here. 1) The keyboard is very spiffy. 2) The company that made it has, like all small hardware manufacturers, gone under and stopped producing drivers, new hardware, etc.
posted by anaelith at 7:41 AM on June 18, 2007

Have you tried massage therapy? I had a (probably less advanced) case of RSI building in my right arm, and an RMT virtually cleared it up in three (somewhat painful) visits. If you're down the road of nerve tests, it probably won't be enough for you, but it may well help.
posted by jacquilynne at 7:46 AM on June 18, 2007

Following on from what Jacquilynne said - my wife had very bad RSI which was cured by osteopathy. She has lax joints and the problems in her lower arms were referred from her shoulders. Fixing it involved various exercises to build up strength in her back and shoulders.

I'm not saying that's what you have, but I would consider that avenue before going down the route of surgery.
posted by crocomancer at 8:13 AM on June 18, 2007

You should have your thyroid checked.

What about if you used a program like Dragon Naturally Speaking to limit your need for typing? I have no idea how this program would work in the IT world, but maybe someone else does. Or what about using your hand in a different position (like using a tablet interface with your computer so mouse/typing movements become pen movements)?
posted by Eringatang at 8:52 AM on June 18, 2007

I stopped using a mouse & switched to a wacom tablet. MAJOR improvement for me. When I use a mouse now I notice my hand goes numb pretty quickly but I don't have that problem with the wacom at all.
posted by miss lynnster at 8:53 AM on June 18, 2007

The short version:

Sharon Butler's book Conquering Carpal Tunnel Syndrome, Active Isolated Stretching, and some sort of relaxation/yoga.

The long version: My RSI Saga

Doctors: FindADoc: Health Care Providers for RSI Patients
posted by callmejay at 10:38 AM on June 18, 2007

Response by poster: I'll look into getting regular massages. I'm not sure a tablet would help a lot since the issue is with both hands, but i'll try a trackball (that I already have) for a week or two, and if that doesn't help, i'll look into tablets.

Any other tips would still be greatly appreciated.

Also, callmejay's saga mentions going to a rheumatologist. Does anyone else have experience with either a rheumatologist or chiropractor for RSI/CTS?
posted by at 11:55 AM on June 18, 2007

I had RSI for a couple years in graduate school (in the late 90s). I couldn't type at all for a year, and I wrote most of dissertation using dictation software. You may wish to look into this - it's frustrating and has a steep learning curve, but it can be better than being unemployed.

I would strongly encourage you not to get surgery, since in many cases the inflammation from carpal tunnel syndrome is really caused by impingements in the chest and shoulders.

The best things for me were deep tissue massage and yoga. I found this book helpful.

Seconding the kinesis keyboard - I use one now, and it works well.
posted by betterton at 12:50 PM on June 18, 2007

I had the surgery on both hands about 15 years ago as my hands keep me hanging on the sides of boxcars.

I have not regrtted it yet.

I did have a very good surgeon and you can barely see the scars. I have seen some picts from a not good surgeon, so buyer beware.
posted by raildr at 9:35 PM on June 18, 2007

I understand that the Kinesis keyboard helps some people and I bought it on the recommendation from a friend who also had one. However, it's not enough to help everyone. It didn't help me. But no keyboard I have found has, so you may want to try anyways, as well as other more conventional ergonomic keyboards.
posted by tomo at 2:52 PM on June 20, 2007 [1 favorite]

I'm curious about finding reputable massage therapists that have specific experience with this kind of thing...
posted by tomo at 2:54 PM on June 20, 2007

I picked mine off the internet, basically. I used the googled for the Ontario Association of Massage Therapists or something similar until I found the governing association for them in my province, then used their online listings to find one that was near me. I chose a therapist associated with a larger health clinic under the assumption that they'd be more likely to be good. Ultimately, I'm sure I was at least partially lucky in finding someone great.

For reference of anyone in Toronto, Wendy Yano, at Yorkdale Mall, was awesomely helpful, amusingly geeky and accepts Greenshield health insurance.
posted by jacquilynne at 6:37 PM on June 20, 2007

Best answer: Followup post:

I found a doctor, Dr. David F. Fowler at Capital City Orthopaedics and Sports Medicine. He's just the right level of old school that he actually spends time with patients, knows what he's talking about via experience, recommends homeopathic solutions first, doesn't immediately suggest the latest expensive drugs, and doesn't overbook himself. His scheduling system is in a notebook. With pencil and pen! I love it.

Anyway, he recommended taking B-complex vitamins and fish oil supplements and prescribed piroxicam, an older (and $4) anti-inflammatory. These things helped immensely! I also still sleep in the splints and wear my Ace wrist wraps when I am in pain, but for the most part, I'm in significantly less pain than I used to be.

He did clarify something that I've been wondering: As long as I'm not hurting, I'm not doing any damage to my nerves.

Hope this helps other folks who are suffering...
posted by at 2:23 PM on October 30, 2007

Response by poster: Err... Holistic, not homeopathic. Sorry.
posted by at 2:27 PM on October 30, 2007

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