The average person working at a keyboard can perform 50,000
to 200,000 keystrokes a day. Small repetitive movements can disturb the
delicate balance of muscles, tendons, and ligaments in the hand and cause
cumulative trauma disorders (CTDs), also known as repetitive strain injuries
(RSI’s) or musculoskeletal disorder (MSD's). These conditions occur over time
and are also referred to as overuse articles. The use of proper keyboard and
pointing device techniques, rest breaks, and a properly set up workstation, can
significantly reduce the risk of developing an overuse injury.
What causes upper extremity nerve injuries?
The nerves that
supply the arm leave the spinal cord in a complicated network of nerve fibers,
roots and bundles called the brachial plexus. These nerves course down the side
of the neck to form the median, radial and ulnar nerves that travel down the
arm and innervate the muscles and provide sensation. Motor nerves send signals
to muscles telling them to contract; sensory nerves allow you to feel sensation
where they supply the skin. If these nerves are compromised in any way, loss of
strength and sensory changes can result.
Nerves can be compromised through repetitive movements.
Repeated motions can result in compression or "entrapment "of nerves.
Compression can be caused by tight muscles, inflammation of surrounding
tissues, or misalignment of the nerve.
When a nerve is compressed, you feel the sensations
somewhere between the point of compression and your fingertips. Ulnar, radial
or median nerve compression can occur anywhere along the path they travel
through, from the neck to the hand. Shoulder pain can be referred from a nerve
pinched in the neck. Pain in the forearm, wrist, or fingers can originate from
compression at the neck, elbow or wrist level. That is why when you have pain
in your elbow, wrist or hand, you should start looking for the cause at the
neck and move down the arm.
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