First Defense: Prevention

Numbness, tingling, and burning sensations typically don’t show up overnight. They’re the result of numerous microtraumas over months, if not years. In most cases, with a condition such as this, there isn’t a magic bullet. It took a lot of work to get you and your wrist to this point, and it is going to take a lot to get yourself out of this.

Here we will outline some steps for a proactive preventative approach to handling your symptoms, how to treat the issues that caused them, and what you need to know before going to a hand/wrist specialist.

Preemptive Approach

Workday Warm-up – Warming up before the workday may seem like a ridiculous notion, but the amount of stress your hands experience throughout the workday is startling. Before your workout, you always warm-up, right? So, why would putting in a 2-3 hour session of working be any different? 

Dynamic stretching before your workday will allow the tissues to become more pliable and “warm-up” before you become a keyboard warrior. Warm up with lotion with your stretches or self-massage to assist this process.

• Held flexion – 20s
• Held extension – 20s
• Hand fans to closed fist – 20s
• Finger stretching in flexion and extension – 5s per movement per finger
• Circumduction clockwise and counterclockwise – 10s

Taking breaks – Increase the number of actual breaks you take throughout the day. They don’t have to be excessively long breaks but enough to get you out of a prolonged position. Two- to three-minute breaks every 30 minutes is enough. 

What you are trying to accomplish here is resetting your posture and ergonomics. So get up, walk around your desk, self-assess to see what needs to be stretched, and don’t just mindlessly pick up your phone (trading a screen for a screen isn’t a break).

Proper workstation setup – Proper chair setup, monitor placement, and peripheral guidance all play an important role in the prevention of wrist/forearm injuries. Appropriate ergonomic set up is one of the most overlooked portions of hand and wrist care.

The place and position you sit in for 8+ hours a day should be as kind to your body as it can be. Here is a quick ergonomic walkthrough for your desk.

Treatment For Hand and Wrist Numbness

Treating symptoms is the reason you seek out a physician in the first place, but the most significant part of healing starts and ends with you. If you are suffering from numbness, tingling, pain, or weakness due to your repetitive work activities, you should seek outside consultation and treatment. Treatment approaches will vary from one specialist to another, but in general a treatment algorithm of conservative management/self care, followed by other more active measures such as splinting, physical therapy, medications, or surgery is standard for these injuries. The proper treatment for your condition will depend on a number of factors. In most cases, less severe and less long-lived symptoms are amenable to conservative measures, while severe or longstanding symptoms are more likely to require active or invasive treatment.

Below you’ll find some common conservative treatment measures:

Tissue work – Transverse Friction Massage, Myofascial Release Technique, and Fascial Distortion Model are just a few of the techniques that may work well for tissue relief. The primary goal of myofascial work is to improve flexibility and bloodflow, and relieve spasm within the muscles and fascia of the forearms. The fascia can become tight and painful when muscles fatigue and become swollen from overuse. This can also lead to nerve compression, as the nerves travel through muscle groups within the fascia.

Ice massage – This can be helpful in decreasing inflammation in muscles and soft tissues, especially after a long day of typing. The basic premise is allowing the ice to cool the inflamed structures after a day of overuse. Applying an ice pack or soaking the forearm/wrist and hand in an ice bath while performing simple flexion/extension motions with the wrist can provide significant symptom relief. This slight movement not only helps keep the wrist from feeling stiff but also exposes different portions of the inflamed tissue to the beneficial effects of the cold source.

Kinesiotaping – This form of bracing adds stability but also allows the wrist to move freely. The muscles can move freely, which prevents atrophy and further destabilization in the wrist. The Kinesiotape helps with inflammation and edema control as well.

Therapeutic exercises – You’ll first want to start with some simple range-of-motion (ROM) exercises then progress to weights, bands, etc. Establishing a base of the proper form before loading the tissues is vital. 

You know your body best and should always stop if you start to experience pain. It is important to know the difference between “good” pain and “bad” pain. Anything greater than 5 on a scale of 0-10 is “bad” pain. With these exercises, you always want to go to fatigue and not push the tissue to excessive work. In this case, forcing the tissues more is not always the best approach – your goal is to care for your tissues, not hurt them further!

Why Strengthening Helps Wrist Pain

It may seem counterintuitive to perform strengthening exercises or pushing their your wrists when they already seem overworked. However, you should consider counterpoints to that argument.

-Pain reduces the overall strength of muscles due to our natural pain avoidance mechanisms.

–Longstanding inflammation from overuse and injury can produce fluid buildup, tightness, and even scar tissue in the muscles, along tendons, and surrounding nerves traveling through the forearm and wrist into the hand.  This can produce restriction of normal flexibility and tissue gliding, which can cause the wrist and forearm to feel “restricted or tight” when trying to perform normal functions.

Strengthening Exercises

• Rubberband work in abduction – 10-15x 
• Stress ball in adduction and finger flexion – 10-15x
• Resisted Flexion/Extension with theraband or self resisted – 10-15x
• Wrist curls with weights Flexion/Extension – 10x 
• Thumb ROM abduction and opposition with a rubber band – 10-15x

The information you’ve gotten from this article will hopefully allow you to approach your activities with the tools necessary to minimize the potential for physical harm that can occur with repetitive work stress, such as keyboarding, mousing, and deskwork. The best way to combat the short-term and long-term effects of overuse and strain on your upper extremities is to educate yourself and be proactive with your self-care. Put the same amount of work into this education as you would when you research your next big-screen TV. After all, it’s your health on the line here, which is the biggest asset you have.