Treatment Advice

Break the hidden muscle spasms with intensive, deep massage and myofascial (muscle and fascia) release by a trained therapist. The muscle spasms will initially pop under the therapist's touch. As they resolve they will crunch a little, and eventually roll smoothly when pressed. This can take as long as eight weeks to resolve, and more weeks to rebuild healthy tissue. You may find that ice packs relieve the discomfort from the process itself.

Eliminate adhesions that are entrapping nerves with vigorous, localized massage. In normal activity, you won't even notice these spots, but when pressed, they will feel just like a splinter does - a small but intense irritation. Although a therapist will probably be most effective treating these, you may be able to treat them yourself by pinching the spot, and while holding it, performing the type of movement that the muscle would ordinarily cause. It took a therapist 21 sessions (two a week, 45 minutes each) to zero-in on and break through the fibrous tissue on my ulnar nerve at the elbow. "The surgeon who operated on my arm never once probed to look for this spot."

For the short-term, reduce your workload as much as necessary to facilitate the healing process.

For the long-term, adjust your workstation, your energy level, and your concentration, to maintain a posture in which your shoulders and are not collapsing into your chest. Emphasize diaphragmatic (abdominal) breathing to reduce pressure on your chest

Have a therapist perform active stretching to increase mobility where the nerves are most likely to be pinched or compressed, such as the brachial plexus and the area under the collarbone.

Increase muscle vitality and stamina with strengthening exercises. Especially emphasize muscles that hold your shoulders back, and those that hold your arms up, and extend your fingers. These are all likely to be in a state of constant fatigue. I have found the "lat raise" machine in my gym to be very helpful. With it, you raise your folded arms (like a chicken clucking), with weights on top. Use a thick rubber band to do lots of finger exercises.

Restore flexibility, resilience and range of motion with self-stretching exercises.

To counteract nerve entrapment, perform motion exercises called "glides", in which you move your arm from one position to another, without any force or resistance, to put a nerve or tendon through its maximum range of motion.

Establish workstation ergonomics that enable you to work in the most neutral (least stressful) positions. (Consider a vertical mouse, Vertical Mouse to eliminate pronation of the mouse hand [Jan 01, 2004]).

Adopt keyboarding techniques that emphasize the use of large muscles, such as the shoulders and upper arms instead of small muscles such as those that drive the fingers. In extreme cases, you may have to resort to typing with three fingers on each hand. Use the same principles with the mouse.

Exploit every possible opportunity to reduce or displace the incessant, repetitive tasks of keyboarding. This can include everything from breaks to productivity techniques such as voice recognition.

Address lifestyle and work habits to reduce your level of work-obsessed tension, and create a more favorable balance between the destructive and restorative forces acting on your body. Work on improving your sleep patterns.

Do a serious warm-up routine before each work session. One way is to use a hand cream and rub your hands vigorously until your hands get warm. Try to warm up several times a day.