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Desk Related Wrist Pain

Dr. Drew Schwartz Dr. Drew Schwartz May 4, 2020
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen
Additions/comments provided by Kyle Bickel, MD – Hand Surgeon

If you’re reading this, we can assume you’ve experienced wrist/hand pain at some point in your life. Or maybe you’re just an anatomy buff who wants to up their game. If the latter is the case, congratulations; if it’s the former, then we have you covered here. 

 

Numbness and tingling are all too common in the desk-worker world and frustrating to deal with on a day-to-day basis. However, if you make your living at a desk, these pain-inducing behaviors are almost impossible to avoid.

 

The first step to combating this pain is properly setting up your workstation to work for you and not against you.

 

Proper ergonomics are crucial at your workstation as they provide passive guidance to proper form. You can do all of the exercises in the world, but if you continue to have poor ergonomics for 8+ hours/day, it will be all for naught.

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Carpal Tunnel Syndrome: Seeing A Specialist

Carpal Tunnel Syndrome: Seeing A Specialist

The Major Players 

 

The number of structures that pass through or surround an area as small as the wrist is truly incredible. However, this feat of engineering comes at a cost to the vulnerability of fragile nerves, vessels, and tendons.

 

The two structures that are the most common areas of concern are the median and ulnar nerves.

Median Nerve

Median NerveThe median nerve originates at the brachial plexus (a large branching nerve bundle near the neck), then travels under the pecs of the chest and through the armpit. After leaving the armpit, the median nerve travels over the top side of the elbow, through the forearm, and finally passes through the carpal tunnel. As you can see, this important nerve passes through numerous muscle groups that are known for being problematic for desk workers.

Ulnar Nerve

Ulnar Nerve This nerve originates at the brachial plexus in the neck, travels under the pecs of the chest and through the armpit. The ulnar nerve then takes a turn and goes under the elbow. This area is commonly bumped and often called the “funny bone” region. So, the next time someone says they hit their funny bone, you can be that guy (or gal) that says, “According to my research, it’s actually the ulnar nerve.” 

 

The nerve then proceeds through the forearm and finally passes through Guyon’s canal on the pinky side of the wrist. Below is a chart to show where each nerve provides feeling to the hand. This chart will allow you to correlate the area of numbness you may be feeling to which nerve is problematic.

Nerve Chart

Common Causes of Wrist/Forearm Pain

 

The workplace has continually evolved into a sedentary style environment, which has led to an increase in computer-related wrist injuries. The rise of remote working, digital advancement, and video games have also contributed to this growing trend. Below are some of the motions/positions to be mindful of while typing or gaming:

Typing and Gaming Movements

Hand/wrist positioning Deviations in any direction can cause symptoms, but by far the most harmful are ulnar deviation and extension of the wrist. Both of these positions cause profound strain on the structures of the wrist and, most importantly, the nerves of the wrist. Extension of the wrist is also notorious for putting a significant amount of stress on the flexor tendons.

 

Forearm Position Forearm positioning and angles are often overlooked since most of the pain occurs around the wrist. The forearms should be at the same level as the wrists or slightly above. The forearms need to be supported by either the armrest (it’s in the name, go figure!) or by your desk. 

 

The elbows should never be below the wrist while typing or gaming. If the forearms are below the wrist, they tend to put the wrist in a harmful position. The common practice of using a laptop stand will put significant strain on the wrist. My recommendation is to use a peripheral keyboard to preserve the screen height, while also keeping wrist neutrality.

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Carpal Tunnel Syndrome: Median Nerve

Carpal Tunnel Syndrome: Median Nerve

Repetitive movements from the mouse to the keyboard This motion is often impossible to avoid so if you must perform it, make sure your forearm is moving with you. Stationary forearms with only wrist deviation can cause a strain on the structures within the wrist over time.

 

It is recommended that you adjust your DPI or “mouse sensitivity” to a higher setting, which will increase the distance moved on the screen in relation to your movement of the mouse. In doing so, you can limit the accumulated distance traveled by your hands in performing repetitive tasks.

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Carpal Tunnel Syndrome: Testing

Carpal Tunnel Syndrome: Testing

Symptoms of Wrist/Forearm Pain

 

Typically the symptoms involved in nerve compression are felt as tingling, numbness, and pins/needles. Muscle pain or fatigue usually presents as an ache, burning, searing, or sore sensation. The almost constant effects of compression throughout the day can manifest into severe problems in the form of motor weakness and loss of control.

 

In many cases, the pain will present in a pattern suggestive of carpal tunnel syndrome; however, it is wise to take a step back to assess the situation. It is easy to jump to the conclusion that once the symptoms start, they are likely to be permanent. In many instances, this is not the case and the problem can be fixed with ergonomic considerations along with proactive rehabilitation

 

In a related post, we’ll cover the simple steps you can implement to turn the ship around and experience relief.

Doctor Profile

Dr. Drew Schwartz

Dr. Schwartz is a chiropractic physician located in Cleveland, OH, who specializes in the ergonomic and wellness sector. In addition to his chiropractic practice, Dr. Schwartz also runs For The Wellness - a blog dedicated to health for deskers and gamers. He’s had the privilege of working with professional Esports teams, collegiate teams, and companies around the globe, to better the lives of those who work at a desk.

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