It has become a forgone conclusion that if you use a computer frequently, you are at risk of developing carpal tunnel syndrome. Alternatively, it is assumed that if you already have carpal tunnel syndrome, the cause is overuse of your hands, with the most common culprit being the regular use of a keyboard and computer. Although there is some relationship between the two, we now know that developing carpal tunnel syndrome is a multi-factorial problem and using a keyboard can worsen it but does not typically cause it.
Carpal tunnel syndrome is a very specific condition where there is increased pressure on the median nerve as it crosses the wrist resulting in numbness and tingling of the thumb, index, middle, and part of the ring finger. Advanced cases may also identify atrophy and weakness of the thumb.
The assumed relationship between keyboarding and carpal tunnel syndrome is a product of the computer boom of the 1980s and ‘90s, when the use of computers in the workplace grew exponentially. During that time there was also an increase in workers compensation claims
for carpal tunnel syndrome. This was exacerbated by a number of early studies that substantiated the perceived relationship. However, since then a number of more organized studies have found this to not be entirely true. Although heavy keyboard use may aggravate carpal tunnel syndrome, the actual cause is more strongly correlated to age, gender, weight, medical conditions such as diabetes and hypothyroidism, and injuries to the wrist. Occupational exposures that can cause carpal tunnel syndrome involve excessive and/or sustained exposure to vibration or prolonged flexed or extended posturing of the wrist.
The diagnosis of carpal tunnel syndrome can be readily made by hand surgeons and orthopaedic surgeons through a careful look at patient history and physical examination. Additional diagnostic studies in the form of a nerve conduction study and electromyogram (EMG) can confirm and grade the extent of carpal tunnel syndrome. Its management is subsequently based upon that grade and can include splints, injections, and surgery (either open or endoscopic).
Asif M. Ilyas, MD