Carpal Tunnel Syndrome Anyone?

[Cyclezee]

Following a recent hand injury, I have developed Carpal Tunnel Syndrome. For those who are unfamiliar with the term, here is a brief expalantion of the condition Carpal tunnel syndrome Introduction - Health encyclopaedia - NHS Direct

This may or may not be linked to my original injury, it could be work or indeed cycling related. However it causes considerable discomfort and numbness in the affected hand and forearm.
Due to the upright riding posture, the most comfortable bike to ride is the wave frame Agattu. The Cytronex in contrast is quite uncomfortable at the moment, due to leaning forward over the handlebars and transmitting considerable pressure through my wrist.
I have experimented with different handle bar and saddle positions without any noticeable improvement.
The choices of treatment are splinting, physiotherapy and or a minor operation which will hopefully correct this problem.

What I would like to know is, have any other e-bikers been diagnosed and treated for this condition? What was the outcome and how did or do they cope with cycling?

J hn

 

[flecc]

Yes John, FatMog does, and heres the link to the post on that:

Carpal Tunnel Issues
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[Jeremy]

John,

I suffer this on and off in my right wrist and have done for a few years now. In my case it was brought on by doing lots of CAD work with a badly set-up mouse (using a wrist rest and getting the right relationship between chair and desk height is critical to avoid/control this, I've found).

In my case, riding a conventional bike always exacerbates it, no matter what I've tried. The main problem is with the wrist being reflexed by the angle of the arm coming down to the handlebars. I've found that an under-seat steering recumbent completely removes this exacerbation, and relieves my back (and bum) a fair bit too. I'd like to try and over-seat steered 'bent sometime, as I have a feeling that this might be better, but for now my bike is all I could hope for in terms of riding comfort.

I don't really know what the answer would be to riding a conventional bike with this condition. A wrist support would undoubtedly help, as would having the handlebars set as high as possible, perhaps, to minimise the reflex angle of the wrist.

One thing I do know is that this condition doesn't just clear up, it's something you learn to manage in order to minimise the level of inflammation and discomfort. I find that it very rarely bothers me now, but it's taken me a fair while to develop changed ways of working in order to reduce the chance of it being exacerbated.

Jeremy

 

[Cyclezee]

Gosh that was a quick response Fleccie! I note that FatMog hasn't posted since last September, back in those pre Kalkhoff days. It would be interesting to see how she is getting on, so I will PM her.

J hn

 

[Cyclezee]

Jeremy,
Thank you for sharing your experience. I assume you sought treatment, but that it wasn't sucessful. Have you tried medication?

John

 

[Jeremy]

Surgery is a possibility that I didn't (and still don't) want to entertain. Anti-inflammatory/analgesic drugs (Ibuprofen etc) work OK, but again I didn't fancy taking them on a regular basis.

I found (by a process of trial and error) that it was just a matter of adapting posture and behaviour really, although I will still sometimes do something daft that brings it on, like using a manual screwdriver or winding the leadscrew on the milling machine table too vigorously. Repetitive movements that reflex my wrist are the main thing to avoid, I've found.

Most of the time it's barely noticeable now, so I can comfortably co-exist with it without the need for anything major in the way of medical intervention.

Jeremy

 

[mikepepler]

Have you been to a physio? I was getting severe "pins & needles" in my right hand at night, and I suspected it was linked with using my chainsaw. I talked to my brother, who's a physio, and he explained that the problem was actually in my elbow. Gripping a vibrating handle (on the chainsaw, perhaps similar on a bike?) was inflaming the point where the tendons are anchored just below my elbow, causing the tendons to become inflamed along their whole length, making them swell up and squeeze the nerve in the carpal tunnel. So although the symptom was in my wrist/hand, the problem was actually in my elbow.

The solution was to get an "epi sport" clasp, like this one: Primary Care Supplies Group Limited > EPI-SPORT Epicondylitis Clasp They're actually intended for "tennis elbow", but work for any similar problem.

This might not help you, but it's worth checking out with a physio, as it worked for me.

Mike

 

[Cyclezee]

Thanks for that Mike. I have a Physio appointment in the Hospital where I work on Monday and will look into thoses devices.

J hn

 

[stevew]

My wife is a Bowen ( The Official Bowen Association UK - The largest Bowen Association in the United Kingdom (Bowtech) ) practitioner and this therapy seems to help with this problem.
Coming from another angle altogether, the Ergon Grips do improve comfort whilst taking some of the strain off of the bits that normally cause trouble.

 

[Chris_Bike]

Hi John,
Sorry to be a bit late here but,yes, I have suffered from Carpal Tunnel for some years. I had surgery on my right wrist about ten years ago and it was a complete success. I now get a little in my left hand, but it isn't really a problem.
Carpal tunnel isn't caused by cycling or other vibration-heavy acrtvities, but these do exacerbate the symptoms. I'm sure the Agattu is easier as a result of the suspension forks.
I wouldn't argue for or against surgery, but it worked for me.

 

[Cyclezee]

Hi Chris,
Thanks for your post and I am glad to hear surgery worked for you.
My reason for starting this thread was to establish if other e-bikers had this condition, and how they came to terms with it as far as cycling is concerned if it could not be cured. i.e. devices or techniques to aleviate or prevent it happening.
I am aware of the causes of Carpal Tunnel Syndrome (CTS) and have to disagree with you on that one. Vibrating hand tools, e.g. power tools are a known cause. I use 'micromotors' and small pneumatic driven chisels which do produce a small but constant level of vibration.
As Jeremy wrote earlier in this thread, doing what I am doing at this moment, using a keyboard and mouse, if it is not ergonomically setup can cause this condition.
With regard to cycling, have you ever ridden a Torq Mk1? They used to give my wrists and hands hell over anything rougher than a billiard table, not that I have ever ridden on a billiard table. I managed to aleviate that to a ceratain extent by fitting some nice thick soft grips.
CTS has many causes and can often not be attributed to one particular activity, but be caused by a a combination of activites.

J hn

 

[JamesC]

With regard to cycling, have you ever ridden a Torq Mk1? They used to give my wrists and hands hell over anything rougher than a billiard table, not that I have ever ridden on a billiard table. I managed to aleviate that to a ceratain extent by fitting some nice thick soft grips.

J hn

I have to agree that the Torq 1 can be hell on hands and wrists. Like you, I achieved some relief by fitting "comfort grips" to adsorb some of the vibration coming up from the front wheel, and was very pleased with the improvement.

However, this does not remove the vibration, but goes quite a long way to dampen it out,

During 6 months riding with the softer grips, spokes began to fail through fatigue, clearly demonstrating that higher frequency vibrations were still there.

Finally, I took the plunge to build a new wheel around the same hub motor, and the change was huge.

Using spokes with thin (1.8 mm diameter) centre sections rather than the hard 2.3 mm diameter, AND tensioning the 1.8 mm spokes to the top recommended level for the Mavic rim, the wheel became much more resilient to the motor vibrations, and, at last, a joy to ride for hands and wrists.

Details here.

James

 

[Cyclezee]

James,

Your post on curing the vibration problems associated with the Torq 1 is truly excellent, well done.

John

 

[Chris_Bike]

Hi Chris,
Thanks for your post and I am glad to hear surgery worked for you.
My reason for starting this thread was to establish if other e-bikers had this condition, and how they came to terms with it as far as cycling is concerned if it could not be cured. i.e. devices or techniques to aleviate or prevent it happening.
I am aware of the causes of Carpal Tunnel Syndrome (CTS) and have to disagree with you on that one. Vibrating hand tools, e.g. power tools are a known cause. I use 'micromotors' and small pneumatic driven chisels which do produce a small but constant level of vibration.
As Jeremy wrote earlier in this thread, doing what I am doing at this moment, using a keyboard and mouse, if it is not ergonomically setup can cause this condition.
With regard to cycling, have you ever ridden a Torq Mk1? They used to give my wrists and hands hell over anything rougher than a billiard table, not that I have ever ridden on a billiard table. I managed to aleviate that to a ceratain extent by fitting some nice thick soft grips.
CTS has many causes and can often not be attributed to one particular activity, but be caused by a a combination of activites.

J hn

Hi John,

When I said cycling doesn't cause it, I was quoting the surgeon who treated me. As I'm sure you know, CTS arises because the carpal tunnel (through bone) is restricting the tissues (including the sensory nerve) that pass through it. It's certainly true that vibration-heavy activities cause these tissues to become inflamed exacerbating the sense of "pins and needles". I suffered from it from my late teens and only really became aware of the problem when it was diagnosed in my mother (genetic component?). I delayed doing anything for 20 years and it was a protracted period of DIY plastering, not cycling, that finally forced me to act. No vibration there, just hard work! Surgery basically aimed to enlarge the carpel tunnel. I found that all cycling set it off, and it still does in the (untreated) left hand. By and large, I live with it, but I have never regretted seeking treatment for my right hand (I am right-handed). I think the Treks are particularly unforgiving because they have straight forks. I still prefer the dampening action of raked forks. In fact, substituting a decent pain of good old-fashioned 531 steel forks in the Trek might help!

 

[sopht]

I agree with your last point, Chris. In some respects I look back with some regret at springy steel framed bikes I had - or is that my then young bones?

Aldby, I hope you get some good relief for your condition soon. I can understand how the Cytronex riding position must be difficult. My bike has a similar sitting position and although I like it, I'm always looking to minimise stress on my hands. I bought some Ergon handlebars with incorporated rounded bar ends and almost indecently fleshy feeling grips. These work very well, absorbing the bumps and allowing frequent change of about 4 positions.

Not sure what I'll do when I get a Cytronex

 

[JohnInStockie]

I think I might be developing this. I have noticed since Ive had my Pro-Connect that my left hand goes numb after about 25 mins. My left wrist does feel like it is under pressure. The PC does have those splayed bar grips on it, but I think mine are at the wrong angle to give any support (time for the allen keys). Is there a best angle to have them?

John

 

[flecc]

I know many people think they are a bit old fashioned, but there's much to be said for the utility style wide splayed bars like those on the Kalkhoff Agattu and the former Giant Lafree, supremely comfortable and the more upright position taking all strain off the wrists.

I remember letting a racing bike and cycling club member friend have a ride on the Lafree, the first time he'd ever tried an electric bike.

When he returned he made just one comment "Wonderful handlebars".

Very telling, the impression the handlebars made completely overriding all the electric aspects that he'd never experienced.
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[Nick]

Better bars are on my list as flat bars place your whole arms at an unsympathetic angle, all the more so when your weight is on them. I've wondered about On-One's Mary Bars which attracts comments like And a special mention goes out to the On-One Mary bar, which has been a life-changing component. It is incredible: my hands no longer go to sleep, even on long rides. I’m putting this bar on every mountain bike I ever own, for the rest of my life. I've not looked at others yet but I like the general idea.

 

[flecc]

Here's the link direct to those Mary bars.

They look comfortable Nick, it's surprising how width also makes for more comfort, possibly because of the steering ease and finer turn control.
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[frank9755]

Another thing to try is adjusting the angle of the saddle up slightly at the front. This has the effect of tipping more of your weight back onto the saddle and off your hands and wrists.

It worked for me. I have had on and off wrist pain for years and felt that cycling was making it worse. I moved the front of my saddle up a couple of mm and they have hardly bothered me since, in 2,000+ miles.

Frank