Welcome to Am I Dying, a column that hopes to save you from your late-night WebMD spiraling. You can email us your hypochondriac questions at amidying@nymag.com.
Am I starting to develop carpal tunnel? It doesn’t necessarily hurt me to type, but occasionally when I work out and put a lot of weight on my wrist, it hurts — and then I wonder if all that typing is contributing to the problem after all. Is a painful wrist the start of carpal tunnel, or am I just weak? What even does carpal tunnel feel like? Can you reverse it if/when you notice early signs?
In the same way that I assume my constant attachment to my phone is leading me down the road to early blindness and unceasing anxiety, I, too, assume that I am only days or weeks away from carpal tunnel at any given time. What we are doing is not natural. I can tell I’m hurting my hands (not to mention my brain) when I read my phone with one eye closed in the dark every night before bed. The way I hunch over my stupid 11-inch laptop is reminiscent of a gargoyle, and my palms often hang listless off the edge. It is only a matter of time.
Dr. Ismail Nabeel, an ergonomics expert and deputy medical director of the Mount Sinai Selikoff Centers for Occupational Health, pretty much agrees that we are doomed. While there are certain conditions that make a person more likely to develop carpal tunnel — particularly diabetes and pregnancy, he says — people who type frequently in non-ergonomic positions also face an increased risk. So that’s pretty much all of us. But before you panic, let’s talk about what carpal tunnel really means.
Carpal tunnel occurs when the median nerve — one of the five main nerves that run from the brachial plexus (a cluster of nerves that span from the spinal cord to the armpit) down the arm — is compressed by pressure placed on the wrist, says Nabeel. As the nerve gets increasingly compressed, we may start to experience numbness and tingling in the hand(s) and wrist(s), and if left untreated, this may progress to aching and pain, Nabeel explains. This can also lead to weakness, and even atrophy of the hand muscles, making it difficult to pick up and hold onto items, or make certain movements.
Usually, says Nabeel, the point at which most people go to the doctor is when carpal tunnel symptoms are well underway, and the patient is experiencing some numbness and/or pain in the hands. While carpal tunnel can still be treated at this stage (more on how in a minute), early intervention is crucial to managing the symptoms, says Nabeel. Much of this comes down to education, he says — patients are taught how to position their workstations/laptops/devices in order to reduce the pressure placed on one’s wrists, and given simple wrist exercises to perform after a long day at the computer.
Texting — or phone use in general — doesn’t seem to present as much of a problem, because when you’re on your phone, your wrists are often in what Nabeel describes as “neutral” position — or extended straight outward. It’s on one’s computer where the worst offenses typically occur — and where taking wrist exercise breaks is extra-important. “Simple extension of the wrist, or flexing of the wrist, twisting back and forth the palm of the hand, extending your elbow — these are all really good exercises,” says Nabeel.
But let’s say you definitely have carpal tunnel, and are already at the numbness/pain stage. Nabeel says carpal tunnel is usually diagnosed by physical exam, sometimes in conjunction with an EMG test (which measures muscle response) or MRI, which can show doctors the degree to which a nerve is compressed. If these tests reveal significant compression, doctors may prescribe a wrist brace to wear at night (which is, incidentally, when most people experience the most acute symptoms of carpal tunnel — which can make it hard to connect them to daytime activities!). Again, though, Nabeel says it comes back to correcting the positioning of your workstation and your body when you’re at work, and making sure to take breaks after long periods of typing.
As for the exercise factor: I’m reminded of the fable/dad joke about the patient who goes to the doctor complaining of pain in his eye whenever he touches it. (The doctor’s advice? “Then don’t touch it.”) If what you’re doing is causing consistent wrist pain, it’s probably not the best thing for you to do. Or maybe you’re doing it wrong. (No judgment.) Still, Nabeel thinks it’s likely the pain you’re experiencing is related to carpal tunnel, and can be treated elsewhere. “I would encourage this individual to continue exercising, and try to address and fix any issues at the workstation, as well as to use a wrist brace at night to minimize the symptoms,” he says. “Over time, the nerve that has been inflamed and compressed starts to get better, and the inflammation around the nerve lessens, and the person won’t have significant symptoms anymore.” I know a wrist brace doesn’t sound very cool, but at least you only have to wear it when you sleep. It’s the least you can do for your poor, worn-out daytime hands.
