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Carpal Tunnel Syndrome

Wrist brace for Carpal Tunnel Syndrome

Diagnosis

A few weeks ago I was referred to a specialist for the treatment of Carpal Tunnel Syndrome. I first noticed the symptoms in early January, it started happening at night with a partial numbness in the fingers of my left hand. I didn’t think much of it at first as it’s the expected symptom of sleeping in a position that reduces the blood flow. But when it kept happening with my left hand and never happening with my right and then started getting worse (including happening during the day) I sought medical advice.

The doctor asked me to bend my hand down (as if trying to touch my left elbow with the fingers of my left hand). Within about 10 seconds this caused numbness – this result from bending one’s wrist is a major symptom of CTS.

Treatment

On Thursday I saw a specialist about this, she agreed with the GP’s diagnosis and made a wrist brace for me. She started by cutting off a length of a tube of elastic woven material (similar to a sock) and then cutting a thumb hole, that became the lining. Then to make the hard part she put a sheet of plastic in an electric saucepan (which had water simmering) until it started to melt and then used a spatula to fish it out. The melting temperature of the plastic wasn’t that high (it was soft at about 50C when she put it on my arm), it wasn’t at all sticky when it was partially melted, and it didn’t seem to conduct heat well.

After wearing the wrist brace non-stop for a few days I have noticed an improvement already. Hopefully I will make a full recovery in a matter of a month or so, I will probably have to wear a wrist brace when sleeping for the rest of my life, but that’s no big deal – it’s more comfortable to sleep with a wrist brace than a partially numb hand. I’ve also been prescribed a set of exercises to help remove scar tissue from the nerves. I haven’t done them much yet.

In terms of being annoying, the wrist-brace has 3mm diameter holes in a square grid pattern with a 25mm spacing. This doesn’t let much air through and in warm weather my arm gets sweaty and starts to itch. I’m thinking of drilling some extra holes to alleviate this – the part which makes my arm itch doesn’t need much mechanical strength. The only task which has been really impeded has been making peanut butter sandwiches, maybe it was making sandwiches not typing that caused CTS? ;) In any case I’m not giving up typing but I would consider giving up peanut butter sandwiches.

I really hope to avoid the surgical option, it doesn’t seem pleasant at all.

Other

One final thing to note is that Repetitive Strain Injury (RSI) is entirely different. RSI is a non-specific pain associated with repetitive tasks while CTS is a specific problem in one or two nerves where they go through the wrist. RSI apparently tends to reduce the effective strength of the afflicted limb, while milder cases of CTS (such as mine) cause no decrease in strength – of course a severe case of CTS results in muscle atrophy due to reduced nerve signals, but I shouldn’t ever get that. Many people think that RSI and CTS are essentially the same thing – I used to think that until a few weeks ago when I read the Wikipedia pages in preparation to seeing a doctor about it.

I want to obtain some of the plastic that was used to make my wrist brace, it could be really handy to have something that convenient for making boxes, containers, and supports for various things – among other things it doesn’t appear to generate static. The low melting temperature will prevent certain computer uses (the hot air that comes out of a cooling system for a high-end CPU would probably melt it), but it could probably be used to make the case for an Opteron system with careful design. I’m guessing that the cost of the plastic is a very small portion of the $150 I paid to the specialist so it shouldn’t be that expensive – and I’m sure it would be even cheaper if it wasn’t bought from a medical supply store. If I ever get time to do some work on an Arduino system or something similar then I will definitely try to get some of this plastic for the case.

Also the Wikipedia page has a picture of what appears to be a mass-produced wrist brace. I think that it might be improved by having the picture of the custom one that I wear added to the page. I unconditionally license the picture for free use by Wikipedia and others under the CC by attribution license. So if anyone thinks that a picture of my hand would improve Wikipedia then they can make the change.

8 comments to Carpal Tunnel Syndrome

  • sylware

    Typematrix with dvorak (or programer dvorak) layout may help.

  • Wow, that’s pretty crazy. Glad you’re getting it taken care of, though. The prognosis sounds good!

  • Ian

    If you ruin your wrists you’ll need a permanent vacation and a change of vocation :-)

    Seriously though: I know artists who cry when they draw. If you really want to avoid surgery, for Pete’s sake give your wrists a holiday and take a break from the computer…

  • -dsr-

    There’s a whole class of thermoplastics, but the one your probably have on your arm is called Kydex. It’s widely available, and not too expensive.

  • etbe

    sylware: Regardless of medical issues, Dvorak is generally a good thing – if you don’t have to use qwerty keyboards. For sysadmin work you end up using lots of keyboards at lots of places. I guess I could carry a USB keyboard with an adapter for PS/2 ports with me everywhere, but it would get annoying.

    Ian: Don’t worry, I’m taking this seriously. While my wrist is getting better (I can feel the difference) I’m not too worried.

    dsr: Thanks for that, I’ll check it out. Also I received the following by email from someone who possibly didn’t want their name published:

    I noticed that you made mention of wanting to get hold of some plastic similar to that used to make the wrist brace you have. The nearest that I have found which is easily obtainable here in Australia is sold by Jaycar in bead form….. its not the cheapest as you only get 100 grams for $14.95. Jaycar claim it melts at 60 to 65 deg, its white when solid, and goes clear if you get it up to about 65 deg.

    check out http://www.jaycar.com.au/productView.asp?ID=NP4260

    Quote from the Jaycar descripton:

    Polymorph Pellets

    Polymorph will change the way you make parts. It’s a commercial grade thermoplastic that softens enough to be formed into any shape at around 62 – 65° C. You simply heat the pellets in hot water or with a hair dryer. It hardens at room temperature to form a tough plastic material similar in consistency and colour to Nylon. It can be drilled, sanded, ground, machined or heated and reformed again and again. Endless uses in model making, craft, single part manufacture, prototyping, engineering, science, lab, clinical applications and more.
    Supplied in a 100g bag of 3mm pellets

  • Capn

    If you’d like to get into the Arduino (or just want to come hack on anything that takes your fancy), then you’re welcome to come along to our Hackerspace:

    http://hackmelbourne.org/

    We meet one night a week and one weekend a month, and lots of mad hacking fun is had by all!

  • Ben

    Hi Russell, I sympathise with your ailment and I’m glad you’re already seeing progress in your recovery.

    This entry seems quite timely, as my own right wrist tingles as I write this and has been doing so for the last week or two, but unfortunately I’m in a foreign country so medical attention is out of the question. Instead, I’ve temporarily resorted instead to becoming a left handed mouse user in an attempt to refrain from destroying one of my more important work tools..

    I’m still not sold on Dvorak for solving the ailments the plague me when using qwerty. Is there a programmer’s layout that distributes braces, brackets, semicolons, and common symbols amongst the stronger index/second fingers rather than burdening the right third/pinkie with the whole lot? This seems common to both dvorak and qwerty, is ignored even in the TypeMatrix, and is the main source of stress on the right wrist (besides the mouse, for right handers).

  • etbe

    Capn: Thanks for the information, I’ll visit that some time.

    Ben: If you have done the test of trying to touch your elbow and found it to cause more numbness then you should start taking serious measures to alleviate it. I suggest buying a 30cm ruler and a good supply of masking tape. In the evening tape the ruler to your arm with one end over your knuckles and attach it at your knuckles, wrist, and further down your arm. If you do that every night and avoid bending your wrist during the day then it hopefully won’t get any worse before you get professional medical attention.

    As for layouts, you could always create your own layout. It’s not that difficult to remap keys in Linux.