Dr. Peter Andree
703 Woodside Rd. #3
Redwood City, CA 94061
(650) 367-1534

Wrist Pain-Carpal Tunnel and Repetitive Strain Injury (RSI)

With increasing computer use, both at work and at home, wrist injuries have become very common. They generally start out mild, but can become disabling. These injuries have forced many people to change professions, and often result in permanent disability. Don’t take your wrist pain lightly!

How can keyboarding hurt my wrist? Carpal tunnel and RSI can come from many causes, but one of the most common is computer use. How can this happen? After all, it’s not like you are operating a jack hammer! Computer use seems so gentle, how could you be injured? The answer is repetition. Repetitive Strain Injury (RSI) is caused when the same muscle is used through the same motion over and over, without enough rest. Muscles fatigue, they don’t get enough blood supply, and joints become chronically inflamed. Many other activities can cause carpal tunnel and RSI, but in the Bay Area, computer use is the most common.

Carpal Tunnel: The carpal tunnel is formed by an arch of eight small bones in your wrist, and the flexor retinaculm ligament which serves as the base of this arch. The hole in the arch is about the size of your finger. The Median Nerve passes through this tunnel, along with several blood vessels and tendons, so it’s a pretty tight fit. When the arch shifts, it causes pressure on the Median Nerve and other structures. Pressure can also be caused by anything that makes the stuff inside the tunnel expand, such as tendonitis of the finger tendons. Carpal tunnel and RSI often occur together.

Treatment: The foundation of treatment is a good exam. This should include muscle tests and sensitivity tests to find what nerves are not working right, and challenges to determine where those nerves are being irritated. I believe that the nerve is often being irritated in several locations. It is common to find irritation in the wrist (from carpal tunnel syndrome) in the arm and forearm muscles (from myo-facial trigger points) in the elbow ligaments (from inflammation and adhesions), in the shoulder area (from thoracic outlet syndrome) or in the neck (from cervical subluxations). Few people have all of these problems, but most have more than one. I think this explains why problems often come back after carpal tunnel surgery. The surgery dealt with the wrist part of the problem, so it gave some relief, but the other parts of the problem cause pain to return. I work hard to find all of the problems, and deal with them all.