Wrist pain from overuse affects over 50% of people whose job requires frequent typing on a computer keyboard. However, any job or activity that requires repetitious finger movement is capable of causing this type of wrist pain.
The leading culprit is tedonitis, or tendinitis — inflammation of the wrist tendons; more precisely the flexor digitorum tendons which pass through the wrist. As you move your fingers alternating between flexion and extension, which is essentially what typing is, the wrist tendons rub against one another. The tendons are protected by a slippery sheath to allow smooth gliding during movement, but if this sheath loses its protective qualities, it can cause the tendons to inflame and swell. Certain drug side effects and illnesses can cause this; check with your doctor.
The problem with tendonitis is that, by nature it affects tendons of muscles that are needed for work or play; for example the wrist for typing, the elbow for golf and tennis, and the achilles tendon for running. The individual therefore continues in the offending activity until she can no longer tolerate the pain, and by that time a lot of microtrauma has occurred. The microtrauma (tiny tears and fissures in the tendon and sheath) releases inflammatory products and attracts scar tissue formation, which makes them stick together even more. The tendons undergo trophic changes (changes on the cellular level) and don’t function as well as before leading to chronic pain.
Prevention is the key for all cumulative trauma/ repetitive strain injuries– these painful conditions are totally preventable and don’t need to happen in the first place. You don’t want to ignore prevention because tendonitis takes a long time to resolve once it is entrenched. In some cases, tendonitis can lead to carpal tunnel syndrome, where the median nerve in the wrist gets squeezed and injured leading to numbness and weakness of the hand.
For wrist tendonitis from typing, make sure your workstation is ergonomically set up:
- Use an adjustable keyboard tray to lower and angle down your keyboard at a level where you don’t need to contract your shoulder muscles to raise your arms above the keyboard.
- Keep your upper arms in the same plane as your torso, and close to your sides (don’t type chicken winged).
- Keep your elbows angled at about 95-100 degrees, wrists straight in line with the forearm or slightly bent downwards
- Use a good chair with lumbar support and if necessary a foot stool to rest your feet on
- Head up, ears directly over shoulders, eyes in line with center top 3rd of computer monitor; shoulders relaxed.
Take 30 second to a minute mini-breaks if you are going to be typing more than an hour straight.
Stretch wrists periodically in flexion and extension; hold for 10 seconds; do wrist circles ten times in both directions.
Do shoulder circles ten times in both directions.
Do chest and neck stretches every other hour during the day.
Stand up and do wall angel exercises (50) at least twice during the day to counteract the tendency for neck and shoulder flexion during sitting.
1. Buy a thin gel ice pack at your local drugstore; freeze.
2. Place a folded kitchen towlette around your wrist, make it the same size of the gel back.
3. Get help from your housemate; have him or her wrap the ice firmly around your wrist and hold in place with a sock (tie it around the ice and knot it). You can also order wrist icebands with velcro bands, but this contraption will get the job done. Make sure it is placing light compression around the wrist. Leave on for 20 minutes; repeat every two hours.
4. Rubbing castor oil on your wrist tendons may help reduce the inflammation. You can usually buy some at a health food store. Do a light massage over the tendons in long strokes, in an away from your body direction. Don’t press too hard.
5. Expose your wrist to the sunlight at least 3 hours a day.
6. Eat an anti-inflammation diet for 2-3 weeks: go heavy on fish oils; reduce grain intake; eat plenty of alkaline foods (green leafy plants).
7. Don’t do stretches when your tendons still hurt; introduce light flexion and extension stretches when the pain drops by at least 75%.
8. Do your best to reduce the activity that precipitated the tendonitis for 2-3 weeks. When you aren’t treating, use ace wrap and wrap your wrist several times, about three wraps. This will provide some support while allowing wrist movement but not enough to risk further aggravating your tendons.
When you have cured yourself of the pain, implement the preventive strategies mentioned above so it never happens again.