Computers can get on your nerves literally

New Delhi, Apr 3: Old rusty typewriters may have been replaced by sleek and gleaming computers, allowing your fingers to fly across the keyboard at a phenomenal speed of 240 strokes a minute. But you may be courting a serious neurological disorder in the process, besides impairing your vision, warn doctors.

As advanced technologies breed sophisticated maladies, more and more white-collar professionals, assembly line workers and students are not only disappearing behind thick glasses but also experiencing numbness in fingers and shooting pain in shoulder blades. Doctors have given it the name of Carpal Tunnel Syndrome (CTS).
While the ultra-violet rays that bounce off the screen have the potential to damage sensitive retina as much as the sun's rays, the furious pounding at tiny keyboards can permanently immobilise your hands, in extreme cases, says Dr Vijay Sheel Kumar, the former head of the Neurosurgery Department at the Mercy Hospital, New York.

CTS, one of the most commonly known Repetitive Stress Injuries (RSIs), is so called because the pain begins in the wrist (or the muscular capsule) and then spreads until it reaches the shoulder and neck. The pain is severe and can even lead to formation of a ganglion, explains Dr Kumar, who was a neurosurgery professor at the State University of New York and also worked at the Apollo hospital in Delhi.

Computers are not the only culprits. Addiction with playing games on mobile phones or sending SMSes, whether as a habit or part of professional requirement, can also lead to CTS, says Dr Kumar, who is the director of the Gurgaon-based Pain Clinic.

The most important symptoms of CTS are numbness, tingling and pain in fingers (except the little finger) and hands upon waking in the morning, weak hands and a tendency to drop objects. Once CTS has progressed beyond a certain point, it may require surgery to correct the problem.

CTS is considered an inflammatory disorder caused by repetitive stress or physical injuries that cause the soft tissues across the median nerve to become swollen. In the early stages, this compression on the swollen nerve causes pins and needles sensation. In severe cases, muscle at the base of thumb may atrophy and hand functions permanently impaired.

"Much like stepping on a garden hose will slow the flow of water, compression on the nerve fibres by the swollen soft tissue in and round the carpal tunnel results in a slower transmission of nerve signals through the tunnel,'' explains Dr Kumar.

The CTS victims till recently were meat packers who had to slice scores of carcasses everyday, or auto workers who had to drive the same screws hour after hour, or food processors.

Today, the victims are white-collar professionals and clerical workers --- scribes racing against time to meet deadlines, airline personnel spending endless hours checking reservations, secretaries typing out notes in plush cabins of corporate offices, telephone reservationists, cashiers and word processors. The more human beings interact with machines, the more pervasive the CTS becomes.

While schools may encourage their pupils to grow up computer-savvy, the big culprits are software games that become a kind of chewing gum for eyes, says the doctor. Once hooked, kids can play for hours with an addictive compulsion. The psychological high is confined not only to the kids; even sane adults are turning into computer junkies spending hours playing sedentary golf, tennis, chess or simply shooting down enemies on screen.

Besides working on computer keyboard or typewriter, common activities that have been identified as contributing to repetitive stress induced CTS syndrome include construction work such as handling many bricks, stone or lumber and excessive play of percussion instruments. Those engaged in beedi-making or embroidery works are also susceptible to it.

A group of hobbyists known as speed-cubists who solve Rubik's Cube as fast as possible for competitions are known to have been prone to CTS from turning the sides of their cubes in such a fast matter, which causes the problems cubist's thumb and Rubik's Wrist.
Working with screens is more demanding than simply banging on a typewriter, because the variety of activities involved exhaust the body organism faster. Computer users may position their hands over the keyboard with the sensitive wrist cocked upward or downward, compressing the tendons, ligaments and nerves that run through its narrow confines whereas on a typewriter the workers are forced to pause many a time to move the carriage or change the paper. Also, typewriter keys have a certain amount of spring while computer keys often strike against a hard base.

While working on computers, we use all our fingers, which gives respite to them in turn, but while playing games on mobile phones or sending SMSes, normally thumbs are used. The repeated pressure on nerves in thumbs can lead to CTS. In extreme cases, the affected fingers or thumb can be amputated.

According to the latest estimates (January 2008), there were 23 crore 70 lakh mobile users in India. Every month there is an increase of 70 lakh mobile users in the country. Mobile phones are not only an instrument for information dissemination but also a tool for gaming.

By the end of this year, mobile gaming market in India is estimated to reach three crore dollars and 33 crore 60 lakh dollars by 2009. On an average, every week 1.5 trillion SMSes are sent in the country, and jokes and participation in queries from TV channels form a major portion of them.

Dr Kumar says working for long hours at computer can be a potential cause for CTS, but playing games on mobiles or sending SMSes can be more dangerous. Though no specific study has so far been done in India on the correlation between mobile games and CTS, but a recent survey in the IT industry has revealed that every third worker in this industry becomes victims of CTS and other RSI ailments within a year in their jobs.

The survey, conducted on 30,000 employees, is being touted as the largest of its kind in the world at a workplace. Dr Deepak Sharan, of the Bangalore-based neuromusculoskeletan centre who headed the survey team, says 50 per cent of the employees working on computers contracted this disease within a year. In the western countries, middle aged women workers in the IT industry were found to be contracting CTS while in India, the average age of workers contracting this disease was 27 years.

Nearly one-third of the workforce in developed countries and one-fifth in the developing countries are pounding their fingers on the computer keyboard daily. With modernisation taking place at a phenomenal speed, the movement of people in the offices has deteriorated. If a file or some data are required, all that the person has to do is to go on punching on the keyboard.

Since the early '90s, the incidence of repetitive stress injuries (RSIs) has become the largest category of reported worker illness and injury, forcing both the professionals and workers to sue computer manufacturers like IBM, Apple Computers and AT&T.

According to the US Bureau of Labour Statistics, repetitive injuries resulted in the longest median absences from work (17 days) of any frequent type of work-related injury and cost the country billions of dollars in health care and lost productivity.

One of the first treatments suggested consists resting and splinting the wrists at night for one to two weeks. In some cases, this treatment is satisfactory; however in most cases, this only provides temporary relief, or no relief. Medication includes diuretics (water pills which can get rid of some of the fluid) or injections or corticosteroids.

Dr Kumar says carpal tunnel release can be done by endoscopy, cutting into the ligament to relieve pressure on the median nerve.

In most cases, relief is almost immediate. The procedure is surgery and does not require overnight stay. It has high success rate.

The most effective way to prevent carpal tunnel syndrome is to take frequent breaks from repetitive movement such as computer keyboard usage. Free software programmes such as Workrave and Xwrits are available to remind users to take breaks and stretch their wrists.

The monster chip is here to stay and proprietors on both sides of the Atlantic are hastening to comply with new labour laws covering everything from lighting and user-friendly office furnishings to repeated breaks for stressed-out employees and "ergonomically correct" computer accessories to ward off the technology-induced ailment.

UNI