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Computers don't cause carpal tunnel syndrome
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Posted By Eddie Newall
Computer use does not lead to carpal tunnel syndrome, according to a study published today (11/06/03). The finding has broad implications for treatment, workers’ compensation lawsuits and the ergonomics
products industry. See: http://tinyurl.com/e15w
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Posted By Nick House
Eddie
I'd like to see the report on their findings, to see how the researchers reached this decision.
Call me a cynic, but I'll stick to the general consensus for the time being.
That said, should someone develop arthritis or similar condition, then carpal tunnel syndrome (cts) may well follow as a by-product, and arthritis sufferers should keep a careful eye out for symptoms of the onset of cts.
Regards
Nick
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Posted By Michael Miller
The results of a recent study on passive smoking was annonced on radio 4 live within the last few weeks. It claims that passive smoking is not as harmful as first predicted according to leadind scientist who just happened to be funded by the tobacco companies. It was suggested that this may have a major impact future civil claims. Now call me an 'old sceptic' but I for one do not believe anything unless it is backed up by hard evidence and studied by those who are independant, transparent and only have the public interests at heart.
We would do well to take all of these claims with a pinch of salt!
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Posted By Adrian Watson
Dear Michael,
Science is not neutral, and there is no such thing as an impartial observer. The only person who is impartial is one who doesn't care, so why would he be observing?
With regard to the comments on carpal tunnel syndrome, without having read the paper, I cannot make further comment.
With regard to passive smoking, the evidence is lacking and does not indicate anything clearly. Studies generally find that passive smoking has a relative risk of around 1.2 with a 95% confidence interval of around 0.9 to 1.4. Anything with a relative risk of less than 2 is unproven to have any effect. The relative risk also needs to be understood in context of all the evidence, which is equivocal to say the least. I would suggest that you have regard to the Bradford-hill criteria in considering the evidence.
Regards
Adrian Watson
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Posted By Ken Taylor
The few people that I have come across with this condition during my lengthy health and safety career have all been key-board operators. I have always suspected that the nature of key-board operation has been an influential factor rather than duration (as stated to be have been considered in the research). Hopefully the actual report will enlighten us further than the sketchy reference provided.
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Posted By Hilary Charlton
I agree that this study is clearly in the interests of the person carrying it out. Although with keyboard work I have never suffered from this particular complaint, it should be noted that I was properly trained as a secretary prior to taking over health and safety. When mice first came in I did suffer some problems with my right wrist and found that a mouse mat with wrist rest was a necessary item. I see untrained personnel every day whom I know are going to suffer from problems related to their arms, wrists and shoulders purely from their posture. I train where I can but people seem to feel the need to suffer from pain before they take this advice on board.
I do feel that keyboard work can lead to carpel tunnel syndrome but do not feel that it must or that this is unavoidable. It would be of considerably more use if, instead of disproving a theory, the organisation undertaking this study could come up with a means of preventing all strains of this sort through improved ergonomics. But then, as I say to myself a hundred times a day "what do I know!"
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Posted By Jim Walker
First point I would like to make is its nothing to do with computers and all to do with repetitive actions. In other areas these are widely documented and classified as industrial injuries.
The other thing is, these injuries are going to pale to insignificance when the generation of phone texters start suffering.
We will all need to be on our guard against computer "RSI" claims from the young person who has spent the last 3-4 years texting her (or his) mates on the mobile phone mini keyboard.
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Posted By Dave Wilson
having suffered from wrist and hand pain I changed to a 'Trackball' Mouse and almost instantly did not suffer.
We have given these to others with the same problem in the company and it would appear to alleviate thier symptoms as well.
Took a couple of weeks to get used to the mouse though!
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Posted By Jack
With a few exceptions (eg Adrians erudite posting) the responses seem to have been of the knee jerk variety without as far as I can see anyone seeing the paper.
I, too, have not seen it but assuming it is properly peer reviewed it at least deserves consideration. It should be seen as providing some evidence on the basis of a particular study. It won't 'prove' anything and will need to be considered together with the myriad of other research.
From the snippets I've seen it does not say WRULDs are not connected with DSE use; it just looked at CTS. That has always been the subject of some debate in OH circles with some suggesting DSE use might exacerbate CTS symptoms rather than cause the condition. It is after all not only confined to DSE users with evidence of links to hormonal changes in pregnancy and, I believe, excessive alcohol consumption.
I don't know what the paper says but I feel we should try and approach it with an open mind.
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Posted By Dave Wilson
Where do you people get the time and energy to look at never mind read all this stuff!
must be doing a Phd or something or is CTS & WRULD the only thing which your people are exposed to.
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Posted By Hilary Charlton
Actually yes, pregnancy can lead to symptons similar to those of CTS, but when I experienced this it had nothing to do with hormone levels and everything to do with the baby lying on the nerves and sending them to sleep - I had to get up and wait to lunchtime to get any shopping as I could not hold a pen to sign my name until the effects had worn off. I was not working at this time, obviously on maternity leave so I know this was totally unrelated to the working environment!
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Posted By Jack
Interesting anecdote Hilary but I'm not quite sure what point you are making. Are you saying that your experience indicates pregnancy hormone levels can be discounted? Your point that 'pregnancy can lead to symptons (sic) SIMILAR to those of CTS' would seem to suggest this.
According to the National Institute of Neurological Disorders and Stroke, Diseases or conditions that predispose to the development of carpal tunnel syndrome include pregnancy, diabetes, and obesity.
It is also says There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed in the course of normal work or other daily activities can result in repetitive motion disorders such as bursitis and tendonitis. Writer's cramp - a condition in which a lack of fine motor skill coordination and ache and pressure in the fingers, wrist, or forearm is brought on by repetitive activity - is not a symptom of carpal tunnel syndrome.
ON THE PAPER ITSELF it is in the Journal of the American Medical Association, and was carried out by Dr. Johan Hviid Andersen of the Department of Occupational Medicine at Herning Hospital in Denmark paid for by the Danish Medical Research Council and the Danish Ministry of Employment.
They carried out a survey of some 7,000 workers and over 5000 of the group were assessed a year later.
They concluded that computer use does not pose a severe occupational hazard for developing the symptoms of CTS and that while there was evidence that forceful industrial work contributes to CTS their data indicated that keyboard use was an unlikely occupational risk for developing carpal tunnel syndrome. BUT they also said that based on other studies they could not exclude the possibility that very intensive and repetitive keyboard use could be a risk factor although in their opinion it was not an important one.
They did find an association between use of a mouse for more than 20 hours a week and a slightly elevated risk of possible carpal tunnel syndrome, but no statistically significant association with keyboard use.
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Posted By Hilary Charlton
Yes, I did say "similar" to CTS, I saw the Doctor and he confirmed that he thought it was CTS but if it didn't pass after the baby was born he would send me for tests to see if definitely was and what action should be taken. Obviously, when you are expecting there is a limit to the amount of prodding around they want to do with you.
The study you refer to actually cites water retention during pregnancy as being the cause of CTS and not hormones, this is more understandable because oedema will cause pressure on nerves and vessels and various cramps in the extremities, the same water retention can be found in diabetes and of course obesity.
I am not trying to disprove any theories and indeed I agree with the study as it is written.
Hilary
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Posted By Jack
Sorry Hilary, I hadn’t realised that your comment 'pregnancy can lead to symptons similar to those of CTS' was made in relation to your own circumstances, I had assumed it was a comment on the literature. I thought (obviously incorrectly) that you were making the point that pregnancy can lead to SYMPTOMS SIMILAR to CTS but that there is no association with CTS itself. My mistake.
My original point was not really about the association between pregnancy and CTS but about there being other factors outside those which are work related. I should probably have simply said pregnancy without referring to hormones but I did base that on other references in the literature, such as:
'People who suffer with Thyroid Diseases, Amyloidosis, Rheumatoid Arthritis, and Diabetes are more prone to others to develop Carpal Tunnel Syndrome. People who experience Hormonal changes relating to Pregnancy, Menopause and the use of Birth Control Pills also are more prone to Carpal Tunnel Syndrome. Job stress also has been linked to an increased likelihood of Carpal Tunnel Syndrome. As well as, there is more frequency of Carpal Tunnel Syndrome in Alcoholics'.
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Posted By Miriam
I've used a keyboard for over 30 years without any problem. I've not read this report but from my own experience a lot of problems are due to incorrect typing technique on the part of the operator. This is made worse by people sitting at awkward angles in relation to the keyboard & screen or haunched over the keyboard due to having their chair too high. The use of gimmicks such as wrist-rests when typing and the so-called 'ergonomic' keyboard I think can also give rise to WRULD. The 'ergonomic' keyboard may be suited to the person who designed it, but for others it can cause discomfort in the hands and wrists since it forces the fingers to be spread out unnaturally and awkwardly over the keyboard.
Miriam
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Posted By Geoff Burt
Miriam
Out of interest why do you call ergonomic keyboards and wristrests 'gimmicks'?
Geoff
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Posted By Hilary Charlton
Geoff,
I know why she calls keyboard rests "gimmicks" - Miriam has obviously had proper training in how to type, this includes posture and style at the keyboard which ensures that one could continue to type day after day at high speed without suffering from any wrist pain. Consequently, to Miriam, these items will be gimmicks meant to compensate for a lack of proper training. To a certain extent I agree on this. I disagree that a mouse wrist rest is a gimmick as although I was properly trained, this was back the dark ages, pre-computer and certainly pre-mouse and I have experienced wrist problems as a result of this. Consequently, I value my mouse wrist rest very highly and do not think of it as a gimmick, more a necessity.
Hilary
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Posted By Ken Taylor
Where I have failed to get individuals to adopt a good hand position for keyboard use, the wrist rest has proved a 'second best' option to improved behaviour. However, I remain sceptical regarding the strangely laid out 'ergonomic' keyboards.
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Posted By Ron Young
From my experience in office based environments, the use of ergonomic keyboards is very much an individual decision. Some heavy users of keyboards think they are the bees knees, whilst others prefer the traditional keyboard. There appears to be a resistance from experienced typists who reported aches & pains in hands & wrists to try the ergonomic keyboard but after a trial period of about two weeks, uptake of these keyboards is about 75%, with most of those adopting them, reporting less ULD symptoms and a general recovery from the aches & pains previously suffered. Whether there is some psychological effect in this open to debate, however, I am happy to spend the £30 odd quid if it makes a difference.
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Posted By Nigel Hammond
Regarding wrist-rests, I am not convinced they are a good idea.
Systems concept, the ergonomics trainers, say wrist rests are a bad idea because they restrict blood supply in the thin tissues of the wrist. However they say that wrist-rests for keyboards - used to rest the palm are OK.
I have tried out wrist rests for mouse work but can't seem to use them as a palm rest - instead I found myself having to use them as a wrist rest with the result that I experienced tingling in my fingers - because of restricted blood supply.
I have used a mouse quite intently for years and have always used them in the correct ergonomic position - close to keyboard - with upper arm hanging level with body and fore-arm at right angles. I have had no problems without a wrist rest.
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Computers don't cause carpal tunnel syndrome
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