PAINFUL WRISTS NEED TREATMENT

Using a modified pizza cutter, in front, can help avoid stress on a person's wrist instead of holding a cutter in the usual way.

Different items can be used to exercise and strengthen the wrist.

A wrist rest can help support a computer user's arms to help avoid carpal tunnel syndrome.

From 19th-century milkmaids to 20th-century computer operators, workers have frequently complained of pain after repeating the same movements over and over. No one really knows how many workers suffer from repetitive motion ailments, although some estimates in the United Sates say they could account for as much as half of all workplace illnesses.

Carpal tunnel syndrome, the most serious of the repetitive stress injuries, costs U.S. industries billions of dollars each year.

Dr. Rickey Lents of Orthopedic Associates said the condition is basically a pinched nerve caused when too much pressure is put on a nerve that runs through the carpal tunnel, which runs from the wrist into the hand and carries tendons to the fingers and a major nerve.

The pain, numbness and tingling of the disease can happen anywhere and anytime, at home or at work, Lents said. Most often symptoms begin by awakening one at night. Shaking or massaging the hand may work temporarily, but if ignored, the pain gets progressively worse. The pain increases, the grip weakens, and the person may begin dropping things. Fortunately appropriate treatment is available.

Early diagnosis of carpal tunnel syndrome minimizes the possibility of permanent nerve damage, discomfort and disability.

Sharon Naughton, occupational therapist at Southeast Missouri Hospital, said she is involved primarily in prevention of the disease.

"We are interested in reducing the hazard in the workplace before it becomes a problem," she said. "If you can alert a person to the positions and activities that should be modified, the potential for injury is reduced."

Naughton said activities that involve repetitive gripping or pinching, moving the wrist repetitively or handling tools that either are jarring or cause vibrations can put one at a higher risk for developing a variety of wrist problems, such as carpal tunnel syndrome.

She offered several wrist safety policies. Avoid extreme wrist positions, maintaining a neutral wrist position. Try not to bend your wrist extremely up, down or to either side.

Avoid sustained postures by not staying in one position for a long period of time,

Take frequent short resting and stretch breaks. It has been found that a brief five-minute stretch break every two hours can reduce potential for problems. These mini-breaks actually increase production, and one does not have to move from his work station to perform the stretches.

Donna Goodson, occupational therapist and certified hand therapist at The Hand Center, said education is a priority for her.

Understanding what carpal tunnel syndrome is enables one to be a better advocate for himself in changing his habits. she said, adding: that she uses splints to teach people that if they aren't able to do an activity with a splint on, the wrist must be in the wrong position. They need to change that activity by raising or lowering themselves or by changing tools.

Goodson also uses modalities of heat and cold as pain control, and she teaches stretch-rest exercises for on the job.

If nonsurgical treatments aren't effective, surgery may be recommended for the carpal tunnel syndrome. Two surgical techniques commonly used are open carpal tunnel release or an endoscopic carpal tunnel release. Either procedure takes 45 minutes to an hour and can usually be done as same-day surgery. The transverse ligament is divided to open up the carpal tunnel and relieve the pressure on the nerve.

The physician will suggest a rehabilitation program that may progress from exercises that maintain circulation to those that improve range of motion and strength.

Authorities agree that prevention is the best "treatment." Once symptoms occur, see your doctor for diagnosis and appropriate treatment. By taking action early, you can help prevent and minimize symptoms while reducing the risk of permanent damage to the wrist.

"My advice is to seek medical treatment early," said occupational therapist Goodson. "If the condition has progressed too far, surgery is the only way out."