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Typing, texting and carpal tunnel

When it comes to preventing carpal tunnel syndrome, the key may be found in one simple saying, according to Dr. John Fatti: “Let your brain listen to your hand.”

This week on “Take Care,” Dr. Fatti explains how carpal tunnel syndrome happens and how to avoid it. Dr. Fatti is founder of the Syracuse Orthopedic Specialists Hand and Wrist Center. His work in the field of upper extremity care has been featured in several of the nation’s top medical journals.

Historically, repetitive motion injuries often occurred in factory workers or manual laborers who used the same motion over and over. But with the information technology dominating work and personal life, the amount of time Americans spend on keyboards and smart phones has caused a rise in the instances of carpal tunnel syndrome.

“We have names for it now -- video thumb, smart phone carpal tunnel -- people that use their hands in a repetitive, quick way are using the tendons in their hands much more rapidly and much more in an overuse-type situation.”

So Dr. Fatti wants people to realize that common activities, such as typing or texting, can have serious repercussions if pain is ignored. “If your hand is talking to your brain, please have your brain listen and make adjustments in your activities,” he says.

Carpal tunnel syndrome is essentially when a nerve that is located in an anatomical tunnel in the wrist gets “squashed” by tendons surrounding it that get inflamed due to irritation. While the pain that comes as a result is usually restricted to the hand and wrist, it has potential to spread to the upper arm and neck.

More and more products, like keyboards, are now labeled “ergonomically friendly.” But Dr. Fatti says that while these products help, what really affects the odds of getting carpal tunnel syndrome is how long your hands are performing the same repetitive motion.

According to Dr. Fatti, prevention can come down to two simple factors.

The first, “take a break. Nobody’s tendons are meant to work more than an hour or an hour-and-a-half in a row. So, just a small bathroom break, or just to sit at the computer terminal and take your hands off the keyboard for even a minute-and-a-half or two minutes, just gives those tendons a break so that you don’t have the continued use.”

The second, “a variation of activities is the key-not doing the same thing over a long period of time,”  says Fatti.

Carpal tunnel syndrome can still occur even if you are using these prevention methods.  Dr. Fatti recommends that the best time to see a doctor is when the frequency of numbness or pain starts increasing.

Symptoms can first be treated using conservative methods. “There are some pretty good anti-inflammatory medicines you can take by mouth. Physical therapy, electrical stimulation and ultrasound treatment is successful in some patients,” he says.

If these kinds of treatments don’t work, and surgery is required, Dr. Fatti says a new operation called an “endoscopic carpal tunnel release” is minimally invasive. It involves an incision in the wrist that’s less than a quarter of an inch, and uses a scope to perform the surgery. This operation has a quick recovery time, and a recurrence rate of less than one percent, meaning it’s considered by Dr. Fatti to be a “one time fix.”