It is a common misconception that using a computer causes carpal tunnel syndrome. In fact, there is a near universal belief that technology gadgets can cause all sorts of hand problems. Both the lay public and most healthcare providers believe that entities such as “blackberry thumb” and “Nintendonitis” truly exist and that common hand problems such as flexor tendonitis and basal joint arthritis of the thumb are caused by repetitive typing or using a mouse. The most common myth remains that carpal tunnel syndrome is “that computer disease” and that using your hands for what is now an everyday function for many people can cause physical harm. Nothing is further from the truth.
Not only are common conditions like carpal tunnel syndrome, trigger finger and tennis elbow NOT caused by so called “overuse” or “repetitive stress” but they are actually metabolic and hormonal related issues that are actually quite easy to treat; given the right diagnosis is made and the sufferer is seeing the right type of specialist. Furthermore, the rarely discussed economic ramifications of this are staggering. CTS is now responsible for 1/3 of all money spent on workers compensation, rivaling low back pain, and more than 2 billion dollars is spent a year on a condition commonly seen in the general population, but particularly common in perimenopausal woman, diabetics and hypothyroid patients. It is also common in third trimester pregnancies but usually resolves after delivery once fluid retention diminishes. Unfortunately, money in work comp better spent on compensating injured workers in true work related accidents such as falls, crush injuries or lacerations, instead goes to a pool of patients suffering from a common and easily treatable nerve compression disorder.
Education regarding carpal tunnel syndrome and other such “repetitive stress injuries” is severely lacking and the information available to the public, employers and insurance industry is based upon myths not supported in the scientific literature amongst hand specialists. The misconception may have come about due to former association between women and keyboard use since secretarial work had certain demographic trends and these are same patients that tend to suffer from CTS. Any hand surgeon will tell you they never see an adolescent sufferer, yet they are typing away all day on Facebook or using a smart phone.
Other misconceptions abound such as the belief that surgery will make the condition worse or that it is painful and has high recurrence. While patients with a mild nerve compression can improve with splinting, vitamin B6 and anti-inflammatory medication, most with significant nerve compression diagnosed in a nerve study will need a surgical release of the nerve. This can now be done endoscopically, via a small incision under local anesthesia in an outpatient center. The hand can be immediately used for simple, daily tasks.
Dispelling the myth will not only have great economic impact, crucial in this age of healthcare cost containment, but also enable the sufferer to have the appropriate and speedy treatment.
Alejandro Badia, MD, FACS
Badia Hand to Shoulder Center
Founder, OrthoNOW® orthopedic walk-in centers