I recently read a case coming out of Alberta where a clerical worker developed carpel tunnel syndrome from work. She was promoted in her workplace and had to do even more typing and handwriting with poor quality office furniture and pens. She was not able to take breaks due to the pressure to produce, staff shortages and hiring freezes. Ultimately, the new job aggravated her condition to the point where she required surgery.
The worker had her workers’ compensation claim for benefits denied by the Workers’ Compensation Board and the Dispute Resolution and Decision Review Body because she could not prove the symptoms were caused by her job.
It was not until the Appeals Commission for the Alberta Workers’ Compensation reviewed the matter that the worker was able to receive benefits. She had to show there was a connection between her job duties and the carpel tunnel symptoms. Although the worker could not prove her original job caused the syndrome, she could show with medical evidence that the new job she was promoted to aggravated her pre-existing carpel tunnel syndrome.
There were four other women in her office with the same problem as her.
This makes me wonder if ergonomic training for workers at computers should be mandatory. Some basic education about using workstation equipment, taking brief breaks and stretching could go a long way to prevent or at least thwart the progress of carpel tunnel syndrome or any kind of repetitive stress injuries involving tendons or nerves.
Ergonomics is the science of designing user interaction with equipment and workplaces to fit the user. Proper ergonomic design is necessary to prevent repetitive strain injuries, which can develop over time and can lead to long-term disability. (Definition derived from the International Ergonomics Association).
In Ontario, there are no legislative provisions regulating ergonomics or requiring the prevention of ergonomics-related injuries. However, the Occupational Health and Safety Act does require employers to protect employees’ health and safety and take preventive measures to protect employees from possible ergonomics-related risk, hazards and injuries. In my opinion, this means that employers should help prevent carpel tunnel syndrome.
British Columbia, Saskatchewan, Manitoba, Newfoundland and Labrador and federally regulated workplaces have specific provisions in their occupational health and safety legislation or regulations that require them to a) identify factors in the workplace that may expose workers to a risk of musculoskeletal injuries, b) assess the risks, and c) eliminate or at least minimize the risks using controls such as appropriate workstation, seating or footrests, education, training and monitoring of the situation.
Every jurisdiction needs this kind of legislation.
Let’s take a look at carpel tunnel syndrome. Carpel tunnel syndrome is a nerve disorder that causes sensations of tingling, burning, numbness, loss of feeling, loss of strength and pain in the hands (usually the thumb and second and third fingers). The symptoms are worse at night because some sleeping positions aggravate the situation. It typically causes compression of the median nerve in the carpal tunnel. Some people are more prone to the condition than others; in fact, women are three times more likely than men to develop the syndrome, likely because the carpal tunnel itself may be smaller in women than in men.
There are several causes of carpel tunnel syndrome, including trauma or injury to the wrist that causes swelling, such as sprain or fracture; overactivity of the pituitary gland; hypothyroidism; diabetes; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; the development of a cyst or tumour in the canal; and tendon inflammation resulting from repetitive work leading to repetitive stress injuries.
If carpal tunnel syndrome is caused by a medical problem like rheumatoid arthritis for instance, doctors will likely treat that problem first. Things can be done to alleviate pain such as resting the wrist, using the other hand more often, stretching, wearing a splint on the wrist—especially at night, and icing the area. At some point, painkillers, surgery or injections of anti-inflammatory corticosteroids may be required.
But what can be done to prevent this syndrome? Things that may help prevent carpal tunnel syndrome include:
- Treatment for any disease that may be causing the syndrome
- When performing the same tasks repetitively with your hands, trying not to bend, extend or twist your hands for long periods of time; the wrists should be straight and level and not tense
- Not working with your arms too close or too far from your body
- Not resting your wrists on hard surfaces for long periods of time
- Switching hands during work tasks
- Making sure the tools you use aren’t too big for your hands
- Taking regular breaks from repeated hand movements to give your hands and wrists time to rest, and rotating activities so you are not doing the same kind of task for too long
- Not sitting or standing in the same position all day
- When using a keyboard, adjusting the height of your chair so that your forearms are level with your keyboard and you don’t have to flex your wrists to type; the forearms, wrists and hands should be in a straight line parallel to the floor as you type
- Making sure that the workspace has adjustable screens, keyboards, chairs and work surfaces to eliminate extra strain to the wrists and hands
- Sitting up straight in the ergonomic chair while working, and tapping keys lightly as you type
- Using a soft wrist pad with your keyboard
- Stretching—for example, stand and extend both arms out in front of you from your chest with palms facing out and fingers pointing up; hold for a count of five; straighten your wrists and relax fingers, then make a tight fist with each hand; bend your wrists down and count to five; repeat as required
Check out these visual tips on how to prevent carpel tunnel syndrome.
I have played the piano since the age of five, and I have used a computer for school and work my entire life. In my experience, I have found the following helpful for me:
- Staying warm – do not type on keyboards with cold hands, wrists and forearms; warm them up with warm water before beginning
- Using heat packs on your neck to stay loose and weigh down your shoulders when working (I find that neck pain and tightness aggravates wrist and hand pain)
- Staying flexible – one can never stretch too often (lower and upper body stretches, with a special emphasis on neck stretches, shoulder rolls and shrugs, wrist stretches and rolls, and upper back and chest stretches)
- Checking your posture every 15 minutes – make a conscious decision to remain working in proper posture
- Using an ergonomic keyboard, mouse, chair and if required foot stool; never lean incorrectly in the chair to reach the floor
- Staying relaxed – when working, do not kink your neck in strange positions or lean into the screen, put elbows on the desk and lean in on your hands, or tensely raise your shoulders up
First Reference Human Resources and Compliance Editor