Tunnel Syndrome

Most people have heard of carpal tunnel syndrome, and likely even know someone who suffers from it. Cubital tunnel syndrome is less common but also can cause debilitating symptoms, such as numbness in the ring and little fingers and wasting of muscle in the hand. More men than women suffer from the disorder, which can be caused by repeatedly leaning on your elbow or bending your arm for long periods of time. Dr. Ryan Katz, attending hand surgeon at the Curtis National Hand Center at Union Memorial Hospital, answers questions about its cause and treatment.

Most people have heard of carpal tunnel syndrome, and likely even know someone who suffers from it. Cubital tunnel syndrome is less common but also can cause debilitating symptoms, such as numbness in the ring and little fingers and wasting of muscle in the hand. More men than women suffer from the disorder, which can be caused by repeatedly leaning on your elbow or bending your arm for long periods of time. Dr. Ryan Katz, attending hand surgeon at the Curtis National Hand Center at Union Memorial Hospital, answers questions about its cause and treatment.

Of the myriad occupational diseases and ailments found in the modern workplace, perhaps none has received as much attention in the last decade as carpal tunnel syndrome, a painful swelling of the tendons and nerves in the hand and wrist.The media has depicted the ailment as an unfortunate product of the Information Age, where computer keyboards and other repetitive workplace tasks force workers' wrists and hands into the same awkward motions hundreds or thousands of times a day.But Dr. Louis B. Halikman, a Baltimore orthopedist with an interest in industrial orthopedic problems, remembers one baffling case of the syndrome in which he could find nothing in one patient's average workday routine that would explain the ache in his hands and wrists.

Late last spring, cellist Lynn Harrell began to fear that his career as one of the greatest cellists of the last half-century might be over.The cellist, who performs Tchaikovsky's "Rococo Variations" starting tomorrow with the Baltimore Symphony, decided he needed surgery to remove cartilage in both knees that was, he says, "the consequence of more than 30 years of tennis, jogging and golf."In a post-operative conference, however, Harrell asked his surgeon to take a look at his hands."For a few years I had been feeling a slight numbness in my left hand," Harrell says.

William Ison used to come home from his electrician's job with aching wrists and hands, then wake up in the middle of the night with no feeling in his fingers. When the pain spread to his neck and his once-agile hands turned clumsy, he suspected poor circulation and went to the doctor.By the time Ison was referred to Annapolis hand surgeon Dr. Neill S. Cooper Jr., he'd learned he had carpal tunnel syndrome. The occupational disorder is caused by pressure on a nerve that runs through the wrist and controls sensation in all but the little finger.

Late last spring, cellist Lynn Harrell began to fear that his career as one of the greatest cellists of the last half-century might be over.The cellist, who performs Tchaikovsky's "Rococo Variations" starting tomorrow with the Baltimore Symphony, decided he needed surgery to remove cartilage in both knees that was, he says, "the consequence of more than 30 years of tennis, jogging and golf."In a post-operative conference, however, Harrell asked his surgeon to take a look at his hands."For a few years I had been feeling a slight numbness in my left hand," Harrell says.

IT HAD TO HAPPEN. AN 11-YEAR-OLD GIRL IS SU-ing the Nintendo company because playing Teenage Mutant Ninja Turtles gave her carpal tunnel syndrome.That's the kind of page 10 story that most newspaper readers file under "whimsy: insignificant." But it's a symptom of a growing national problem.It's no longer news that carpal tunnel syndrome (CTS), a potentially crippling disorder of the wrists and hands, affects millions of office and factory workers across the country and leaves product manufacturers, employers and insurers vulnerable to billions of dollars in liability and compensation claims.

WASHINGTON -- Rain, snow and gloom of night may not faze postal workers, but repetitive motion injuries are stopping them in their tracks, say postal union representatives.Letter-sorting machines and other devices that require repetitive motions to operate have resulted in record numbers of employees contracting carpal tunnel syndrome, witnesses told a hearing conducted last week by the House subcommittee on postal personnel and modernization.Carpal tunnel syndrome is a painful condition that results from overuse of certain tendons and muscles in the arm and hand.

CHICAGO -- Carpal tunnel syndrome, a wrist-and-hand disorder once associated only with factory workers, today is known as "the malady of the information age."The Bureau of Labor Statistics reports that "cumulative trauma disorders," including carpal tunnel syndrome, are the fastest-growing occupational illnesses. In 1990 they made up 52 percent of work-related illnesses in private industry, up from 18 percent in 1980.Some 200,000 Americans each year develop carpal tunnel syndrome from repetitive motion, according to Northwestern Memorial Hospital.

Q: A close friend of mine who seemed perfectly healthy just had a positive exercise stress test. That makes me wonder if I should have one, too. When is it a good idea to have an exercise stress test?A: During an exercise stress test you have a continuous electrocardiogram (EKG) done while walking on a treadmill. The exercise is made progressively more strenuous by gradually increasing the speed and incline of the treadmill. An abnormality in the stress EKG can detect a significant narrowing in your coronary arteries that might not be evident on an EKG taken while at rest.

A 53-year-old county police officer filed a $300,000 suit yesterday in Anne Arundel Circuit Court claiming injuries suffered in a 1992 car wreck left him with carpal tunnel syndrome in both arms.Officer John Intelkofer, of the 500 block of Cyprus Lane, Severna Park, alleges that on April 18, 1992, he had stopped his county police car to make a left turn while heading south on Route 648 at Hollins Ferry Road in Ferndale. A car driven by Randy Coberly of the 1200 block of Thompson Ave. in Severn hit him head-on, the suit says.

If the correspondents on my desk are any vindication, there are multiples of people out there who enjoy hearing other people talk funny. They stretch for a writing implement when they hear someone remit a booper. (Have you figured it out yet? This is another column about malaprops. You knew it was coming, didn't you? I mean, some of the letters I received began with the words, "Dear Don Broderick, By now you are probably sick of malaprops . . .," and then went on to list about a dozen. So you just know I was going to have to unload one day.)

Getting a grip on carpal tunnel syndromeHere are two new products aimed at preventing carpal tunnel syndrome:Carpal Tunnel Prevention Glove is for cyclists, autoworkers, weight lifters and others who develop wrist injuries from repeated or prolonged gripping movements. It was designed by Dr. Robert Spitzer, a cyclist and neurologist at William Beaumont Hospital in Royal Oak, Mich., and the Wayne State University School of Medicine. Unlike gloves with pads across the median nerve -- the part of the wrist most prone to injury from repetitive motions -- this one has a groove over the nerve that directs lTC pressure from gripping outward to parts of the palm that can withstand pressure.

Layoffs in Md. outpace U.S. rate; no end in sightLayoffs in Maryland continued to outpace the national average, the American Management Association's annual downsizing survey reported yesterday.And there is evidence that layoffs may be getting more severe, despite economists' assertions that the economy is recovering.The professional group found that 53 percent of the Maryland-based companies surveyed -- eight out of 15 -- reduced their work forces between July 1992 and June 1993.Nationally, 47 percent of the 870 companies surveyed said they had cut back -- up 1 percentage point from the year-ago level.

Gomez has wrist surgery, expected to miss 4 weeksMINNEAPOLIS -- Third baseman Leo Gomez underwent surgery yesterday to remove a cyst from his left wrist and is expected to be out of action for another four weeks.The operation was performed by hand specialist Dr. Hugh Baugher, who also is treating Gomez for a possible case of carpal tunnel syndrome -- a nerve irritation that causes pain in the wrist and hand.Baugher told club officials the surgery was successful and Gomez should be able to begin working out in about two weeks.

CHICAGO -- We get all sorts of letters and phone calls about the job market. Readers want to know about resumes and health hazards. Are nonprofit workers stigmatized?And always, everyone wants to know how to negotiate an equitable salary.Q. I've been job-hunting for months now, and I'm beginning to wonder if I'm not being hired for jobs I'm qualified for because I never fill out the line asking what salary I expect to get. Am I doing the wrong thing?A. There's no way to know if that's the reason you're not getting the job. But the salary question does put you in a lose-lose situation.

CHICAGO -- We get all sorts of letters and phone calls about the job market. Readers want to know about resumes and health hazards. Are nonprofit workers stigmatized?And always, everyone wants to know how to negotiate an equitable salary.Q. I've been job-hunting for months now, and I'm beginning to wonder if I'm not being hired for jobs I'm qualified for because I never fill out the line asking what salary I expect to get. Am I doing the wrong thing?A. There's no way to know if that's the reason you're not getting the job. But the salary question does put you in a lose-lose situation.

A 53-year-old county police officer filed a $300,000 suit yesterday in Anne Arundel Circuit Court claiming injuries suffered in a 1992 car wreck left him with carpal tunnel syndrome in both arms.Officer John Intelkofer, of the 500 block of Cyprus Lane, Severna Park, alleges that on April 18, 1992, he had stopped his county police car to make a left turn while heading south on Route 648 at Hollins Ferry Road in Ferndale. A car driven by Randy Coberly of the 1200 block of Thompson Ave. in Severn hit him head-on, the suit says.

After one week of trying to make sense out of Janet Guy Purdy's workman's compensation case, I am ready to tear my hair out. How, after nearly six years, Mrs. Purdy has any hair left at all is anybody's guess.Mrs. Purdy is 33, a Harundale native now living in Pasadena with her husband and two kids. Five and a half years ago, she was forced to leave her $210 a week job as a silk screener and embroiderer with Lettering Unlimited, a Glen Burnie firm, after developing carpal tunnel syndrome. Carpal tunnel is a painful condition affecting the nerves and tendons in the wrist often caused by repetitive hand movements.

WASHINGTON -- Rain, snow and gloom of night may not faze postal workers, but repetitive motion injuries are stopping them in their tracks, say postal union representatives.Letter-sorting machines and other devices that require repetitive motions to operate have resulted in record numbers of employees contracting carpal tunnel syndrome, witnesses told a hearing conducted last week by the House subcommittee on postal personnel and modernization.Carpal tunnel syndrome is a painful condition that results from overuse of certain tendons and muscles in the arm and hand.