All Posts tagged Wrist Pain

Mouse Hand and Wrist Pain…Yes, it exists! How to avoid mouse hand and wrist pain…

Mouse Hand and Wrist Pain…Yes, it exists! How to avoid mouse hand and wrist pain…

Okay…so what the heck is mouse hand?  Yes, I know it sounds ridiculous! Mouse Hand. My wife was mentioning that she heard this term ‘mouse hand’ from some colleagues.  These colleagues were complaining that their wrists and hands were hurting from typing reports all weekend.   They said that they had mouse hand. I did some background research on this topic and did not find much written on the slang term “mouse hand” solely.

What is MOUSE HAND in medical terms? 

Well, simply put, mouse hand is a repetitive strain injury to the wrist/hand area.  In the case of mouse hand, the wrist and hand becomes strained/sprained when using a mouse for lengthy periods of time.  They also complained of tightness, stiffness, decreased wrist range of motion as well as swelling at times.  I would imagine that individuals who are constantly using a computer with a mouse (bloggers, computer technicians, web designers, etc.), would experience this type of condition.     It is amazing that as our world changes and as it becomes more technologically advanced (2oth and 21st century changes), new musculoskeletal medical conditions come about.  As our job tasks change, so do our injuries and how these injuries may come about.   For instance, let us talk about the chauffeur fracture.  The name originates from early chauffeurs who sustained these injuries when the car back-fired while the chauffeur was hand-cranking to start the car. The back-fire forced the crank backward into the chauffeur’s palm and produced the characteristic styloid fracture (forearm fracture).  It is also known as a backfire fracture (for the same reason) or a Hutchinson fracture. Today, this fracture occurs, however not due to cranking cars.  Instead, it can occur if someone falls on an outstretched hand. Let us get back to Mouse Hand.

I have found a couple of threads on the topic of mouse hand and noticed that some individuals have found ways to prevent and overcome these symptoms of mouse hand (pain, tightness, decreased range of motion and discomfort in the wrist/hand) by simply switching over to using an IPAD or device that does not require the use of a mouse or constant use of their wrist.  Others mentioned doing hand/wrist exercises or taking frequent breaks during long periods of computer/mouse usage.  These techniques both make a lot of sense to me. Mouse Hand is in medical terms a repetitive strain/sprain injury, overuse syndrome, or carpal dysfunction. What is this, you ask?  Well, our wrists consist of 8 carpal bones.  Sometimes these little 8 bones move out of position slightly, spraining the ligaments that attach one carpal to the other.  If this occurs, this causes pain, stiffness and decreased motion in the wrist – dysfunction.   Many patients present with these symptoms – they may not call it mouse hand but they realize that they have injured their wrist.

What happens to the soft tissues in the forearm?

In order to function properly, muscles (and other tissues of the body) require oxygen, which is carried by blood. When muscles are overused or overworked, which may be the result of over-training or performing repetitive motions, blood supply to muscles is reduced (tight muscles squeeze blood vessels thus decreasing flow). This places the muscle in what is called a hypoxic state. Simply stated, the oxygen supply required by the muscle to function is not being met due to decrease in available blood. This leads to the muscle not having the ability to form energy, remove metabolic wastes, etc. Your body, in an attempt to help itself then begins to replace muscle, a very oxygen-needy tissue, with scar tissue, which does not require oxygen to function. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis/tendonosis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.

I find that patients who present with these wrist symptoms (as long as there is no fracture) do well with wrist adjustments, mobilizations and soft tissue therapy to the forearm and wrist.  What do you mean by adjustments and mobilizations?  An adjustment and mobilization is essentially performed to move the carpals back into place or to get them properly moving again – to eliminate dysfunction.   Soft tissue therapy is great to relieve the tight muscles in the surrounding area.   Furthermore, wrist exercises work well to get those carpal bones moving again.  Squeezing a squishy ball or putting an elastic around your fingers and opening your hand works both the flexors/extensors of the forearm.

I hope you enjoyed this blog today.  Please provide feedback and comments.  Thank you.


MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.




Part 1 of 2: Is it Carpal Tunnel or Is it Something Else?

Part 1 of 2: Is it Carpal Tunnel or Is it Something Else?

I have a number of patients that mention that they have carpal tunnel syndrome. When I ask them how they know, they can’t explain.  After a history and physical assessment, I often recognize that their symptoms are in fact not related to carpal tunnel. Why the confusion? One thing that I have learned, while practicing, is that tingling in the forearm does not always equate to carpal tunnel syndrome.

In part 1 of this blog, I will provide specific information pertaining only to carpal tunnel syndrome. This will create a firm base for part 2 of the blog – when I explore and explain other nerve conditions which create symptoms similar to carpal tunnel. Let us begin…

What is Carpal Tunnel Syndrome?

Ok, so what is it?  Carpal tunnel syndrome, simply stated, is when a nerve in the forearm is squeezed at the wrist. More specifically, carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes compressed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (half of the fourth finger and not the little finger). The median nerve also provides motion to small muscles in the hand. The carpal tunnel is a narrow, tight, passageway of ligament and bones at the base of the hand. This tight box is home to the median nerve as well as tendons that attach to muscle and allow our hands to move. Sometimes, the carpal tunnel soft tissues thicken and/or swell. As a result, the tunnel narrows and causes the median nerve to be compressed. This creates pain, weakness, and/or numbness in the hand, wrist and may radiate up the arm.

Let us provide you with an analogy.  Think of when a four lane road merges to become a two lane road.  This creates a bottleneck in the road, which usually leads to heavier traffic due to the less room to manoeuvre.  The more the road reduces, the less the passageway for cars to pass.  Numerous reasons can cause the passageway to shrink (accidents like trauma/injury in a wrist, floods like swelling/inflammation in a wrist and construction like scar tissue/tissue rebuild/healing in a wrist) – the bottom line is that the same amount of cars still need to get through to the other side, but with obstacles or a bottleneck, it becomes harder and thus more issues (symptoms) can arise. This is what occurs when someone has carpal tunnel issues – that is – their passageway for the median nerve is being blocked or squeezed.

Symptoms usually start slow but gradual. Usually, it starts with frequent burning, tingling, and/or numbness in the palm of the hand and the fingers. Some sufferers say their fingers feel swollen and weak, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night. The person may wake up feeling the need to shake out the hand or wrist. As symptoms progress, patients complain that they feel tingling during the day. Continued carpal tunnel may result in decreased grip strength and muscles wasting at the base of the thumb. Furthermore, some people are unable to tell between hot and cold by touch.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome is often the result of a combination of factors. These factors are responsible for increasing pressure on the median nerve and tendons in the carpal tunnel. Most likely the disorder is due to genetics. Some individuals are born with a smaller carpal tunnel. Moreover, trauma or injury to the wrist that causes swelling, sprains or fractures, rheumatoid arthritis, mechanical joint issues at the wrist, stress, vibrating hand tools, fluid retention during pregnancy or menopause or the development of a cyst or tumor in the canal. Sometimes no cause(s) are identified.

Who Develops Carpal Tunnel Syndrome

Women are more likely than men to develop carpal tunnel syndrome. Carpal tunnel syndrome usually occurs only in adults and not in children.

How is Carpal Tunnel Syndrome Diagnosed?

There are a variety of tests that are used to produce symptoms of carpal tunnel syndrome.  In the Tinel test, the practitioner taps on or presses the median nerve in the patient’s wrist. The test is positive when tingling in the fingers occurs. The Phalen test, or wrist-flexion, involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together (like a reverse prayer sign). The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute.

Diagnosis is confirmed by electrodiagnostic tests such as nerve conduction studies. Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist.  Furthermore, ultrasound imaging can show impaired movement of the median nerve and Magnetic resonance imaging (MRI) can show the anatomy of the wrist.

How is Carpal Tunnel Syndrome Conservatively Treated?

Treatments for carpal tunnel syndrome should begin as early as possible. Underlying causes such as diabetes or arthritis should be treated first.

I treat carpal tunnel syndrome by using a variety of chiropractic techniques electrotherapy, ultrasound, laser, cyrotherapy and exercises.  Furthermore, soft tissue therapy techniques over the forearm, wrist and palm of the hand as well as acupuncture are beneficial.  Patients usually feel relief with two to three treatments over the course of 4 to 6 weeks.

Now that you know more about carpal tunnel syndrome…let me explain why people get it confused with other nerve issues located in the forearm.  In part 2 of this blog, I will explore and explain other nerve conditions which create symptoms similar to carpal tunnel.