The Covid-19 pandemic has changed many things about daily life across the country and around the world. It has also changed our health in many ways not directly caused by the virus.
In the past, it was not uncommon for doctors to see students developing back and neck issues from heavy book bags. With remote learning now commonplace, that has been reduced. However, in its place has been a new issue – carpal tunnel syndrome.
In a December 2020 MSN report, Dr. Rahul Shah, a spine and neck surgeon at Premier Orthopedics in New Jersey, stated that while historically he saw carpal tunnel symptoms in young patients rarely, now, he’s seeing it once or twice every couple of weeks.
Median Nerve Compression, commonly known as Carpal Tunnel Syndrome (CTS), is a condition involving pressure on the median nerve that leads to pain, numbness, tingling, or weakness in the hand. This nerve controls movement and feeling of the thumb as well as movement of the first 3 fingers of the hand.
Dr. Shah describes it in this way:
“What happens is that the nerves travel from the neck through tunnels to the shoulder, near the elbow and into the wrist, before they get to the fingertips; so, if those nerves are getting irritated anywhere along that course, that’s the catalyst for the nerves to become irritated.”
While there are a number of potential causes of CTS, the most common is repetitive motions, such as typing, sewing or playing a musical instrument. Movements occurring with the hands lower than the wrists are especially high risk.
The flexibility of remote learning means that students can continue their education in spite of the pandemic. However, homes are not generally set up with ergonomic study areas appropriate for the length of time students are having to use them. This may lead to students spending time looking down at a laptop or tablet in their lap – exactly the type of scenario that is most risky for CTS, as well as other neck and shoulder issues.
Alan Hedge, ergonomics expert and professor emeritus at Cornell University, noted that even before the pandemic, the average age of conditions such as CTS has gone from the early 40s in the mid-1990s, to now showing up in people in their early 20s!
Because these conditions are cumulative, he fears that children are beginning down the path to CTS at even younger ages. Additionally, he points out that the hunched over posture, often assumed by students whose bones are still developing, could potentially lead to spinal deformities. While these postures are common with video games, and other device usage, the increased time spent on devices for remote learning, serves to increase those risks.
While minor discomfort may occur in a relatively short time, the more serious tendonitis and CTS typically develop over a span of 6-12 months. Across the country, many students have now been on remote learning for a year.
In an interview with NBC News, Dr. Theodore Ganley, an orthopedic surgeon at Children’s Hospital of Philadelphia and chair of the American Academy of Pediatrics section on orthopedics stated, “We don’t think of kids getting repetitive stress injuries or fatigue injuries or musculoskeletal aches and pains like the parents and grandparents get…[But children] “are not immune from these things,” especially if they work at computers day after day in awkward postures.
Early symptoms include feeling that the fingers are “falling asleep” or becoming numb at night. Subjects may wake with numbness and tingling in the hands that could extend up the arm, to the shoulder. Symptoms may be brought on during the day by certain positions, involving the wrist being bent, such as driving or reading a book. Shaking the hands may alleviate the symptoms. However, as the condition progresses, this may not help as much, or even at all. Sufferers may begin to lose grip strength, experience more pain and muscle cramping.
As the pandemic, and with-it remote learning, continue, this is an issue that appears to be with us for a while. So, in leu of overhauling your home, what else can be done? Thankfully, there are a number of things that can be done without going to great expense to make your student’s work area more ergonomic.
First, realize that it may not be perfect, but encourage them to maintain a neutral posture, most of the time. If they have been experiencing discomfort caused by poor posture, they may realize that sitting up makes them feel better.
What does neutral posture look like?
- Spine not twisted or bent
- Lower back supported
- Neck straight
- Forearms and thighs should be roughly parallel to the floor
- Feet should be flat and supported, not dangling.
- Arms should rest comfortably at the sides, with wrists straight and relaxed
- Monitor should be positioned at approximately arm’s-length and the top part of the screen comfortably at eye level.
For a desk top computer, where hard drive, keyboard and monitor are all separate pieces, adjusting the workstation may not be too difficult. However, small portable laptops and tablets like those often used by students can make this a bit more challenging. A little creativity can go a long way towards making your child’s workstation a safer learning environment.
- An inexpensive external keyboard and mouse create the ability for more adjustment. The screen can then be propped up on books or boxes to achieve the correct height. Meanwhile, the keyboard and mouse can be kept at a height that allows the wrist to remain straight.
- If you do not have an ergonomic chair, use pillows to increase the height or rolled up towels to create better low back support.
- To keep the legs relaxed, a box, small footstool or footrest can do the same job as a professional office grade foot rest.
There are numerous breaks in a typical school day. Times when the students stop work, and move around. This happens for bathroom breaks, going to/from cafeteria, library, PE, etc. Those breaks are good for the body and mind.
In remote learning, it’s important to avoid the tendency to sit still until it’s done, and instead, continue to provide those breaks. Take a walk around the house. Have distance learners do a few jumping jacks. Play a quick game of charades or try some of the “minute to win it” types games you can find online. Or, just take a screen break and do some drawing or coloring the old-fashioned way – pencil and paper.
Our children’s health and safety are always at the forefront of our minds. As they use technology more and more, both leisure time and learning time, it’s important to help them establish good habits from the beginning.
If you or your child is experiencing symptoms of CTS or other musculoskeletal discomfort, schedule a visit with your local chiropractor for an evaluation. Your doctor can help detect the origin of the pain or discomfort and make recommendations for how to treat the current discomfort as well as changes to make in order to help prevent progression or reoccurrence. If the condition requires additional care, your doctor will refer you to other health care providers and work with them to provide you the best possible care.
Remote learning time is a great time for us to observe our children’s habits and work with them one-on-one to improve their posture and spinal health. Taking these steps now will provide important strategies that can help children avoid CTS now and later in life!
Keleshian, Kristie. NJ doctor sees increase in students with carpal tunnel symptoms amid remote learning” 12/12/2020 https://www.msn.com/en-us/health/wellness/nj-doctor-sees-increase-in-students-with-carpal-tunnel-symptoms-amid-remote-learning/ar-BB1bS73w
Stenson, Jacqueline “Remote learning can be a pain for kids in more ways than one” Oct. 17, 2020 https://www.nbcnews.com/health/kids-health/remote-learning-can-be-pain-kids-more-ways-one-n1243175
Wheeler, Tyler MD, et all “Carpal Tunnel Syndrome” WebMD