Computers and Carpal Tunnel Go Hand-in-Hand -- Or Do They?
Richard Olney, MD, a professor of clinical neurology at the University of California, San Francisco agrees, wrote an editorial to accompany the Neurology study. He suggests that high-force repetitive activity, like working in a factory or lumber mill, is a bigger culprit in carpal tunnel syndrome than the repetitive motion of using a computer keyboard.
"I think the study highlights that we don't have as good data for less-forceful repetitive activity," Olney tells WebMD.
So why has the incidence of carpal tunnel syndrome gone up at the same time as widespread computer usage?
"Perhaps the reason ... is not because of computer keyboard use, but because people are more aware of the symptoms and medical science has advanced with new diagnostic techniques to the point where more and more people are being identified who were missed previously," says Stevens.
That is not to say that using a computer can't and doesn't lead to aches and pains. This study suggests instead that it doesn't necessarily lead to carpal tunnel syndrome.
"In our study, we found that about 60% of those people at one time or another in the previous year had had aches and pains involving the neck, shoulder, arm, wrist, or hand that they associated with their use of the keyboard," says Stevens. "It does mean that using the computer keyboard is not without some health risk, but it is not carpal tunnel syndrome ... ."
"In some people with hand pain, it is more of a tendonitis," says Olney, referring to another very common diagnosis. "And it might well be that tendonitis does have more to do with the hand discomfort that develops with keyboard usage."
Tendonitis, Olney says, is caused by inflammation of the tendons or the tissue, as opposed to pain from compression on the median nerve. And for that reason, patients shouldn't rush to have surgery when, in the case of tendonitis, rest and readily available NSAIDs, or nonsteroidal anti-inflammatory drugs like aspirin, can relieve the condition.
The findings have other implications as well.
"No one has yet demonstrated that ergonomic measures are really effective in preventing [carpal tunnel syndrome]," says Olney. "You would think that if improper computer use causes carpal tunnel, then if companies are made to spend hundreds of thousands of dollars to institute ergonomic measures to help prevent it, that they ought to see some economic benefit of that, but it is not clear that is the case."
Both Stevens and Olney agree that more research in larger groups of heavy computer keyboard users is needed. "This surprising, ground-breaking data suggest that perhaps other centers with larger numbers of computer users may shed further light on this important issue in the work place," says Stevens.