Treatment for Hand Strain from Computer Overuse
The primary treatment for strained hands from computer overuse should include education on ergonomic principles, exercises to improve function and muscle strength, and the use of orthoses for symptom relief, especially for thumb-based issues. 1
Non-Pharmacological Interventions
Ergonomic Modifications
- Adjust keyboard and mouse position to maintain neutral wrist alignment
- Position computer monitor at mid-level height to reduce neck strain and associated hand/arm tension 2
- Implement proper seating with armrests that support forearms
- Use ergonomic keyboards and mouse devices designed to reduce strain
Exercise Therapy
- Perform range of motion exercises to maintain joint mobility
- Include strengthening exercises targeting hand and forearm muscles
- Schedule regular breaks using the "20-20-20 rule" (every 20 minutes, look at something 20 feet away for 20 seconds)
- Incorporate stretching exercises for wrists, fingers, and forearms
Orthoses and Support Devices
- Consider splints or orthoses for thumb base support if indicated 1
- Use wrist rests for keyboard and mouse to maintain neutral positioning
- Long-term use of orthoses is advocated for persistent symptoms 1
Pharmacological Management
Topical Treatments (First Line)
- Topical NSAIDs are preferred over systemic treatments due to safety profile 1
- Apply as directed to affected areas for localized pain relief
Oral Medications (Short-Term Use Only)
- Oral analgesics, particularly NSAIDs, should be used at the lowest effective dose and for the shortest duration 1
- Paracetamol (up to 4g/day) is the oral analgesic of first choice for long-term use if needed 1
- For patients with increased gastrointestinal risk, use non-selective NSAIDs with gastroprotective agents or selective COX-2 inhibitors 1
Skin Care for Prevention of Irritant Contact Dermatitis
For those experiencing skin irritation from prolonged computer use:
- Apply moisturizer after washing hands, preferably from tubes rather than jars 1
- Consider overnight treatment: soak hands in plain water for 20 minutes and immediately apply moisturizer to damp skin nightly for up to 2 weeks 1
- Avoid irritants such as harsh soaps or frequent use of hand sanitizers 1
Treatment Algorithm
Initial Management (0-4 weeks):
- Implement ergonomic modifications
- Begin exercise program focusing on stretching and gentle strengthening
- Use orthoses if indicated for symptom relief
- Apply topical NSAIDs as needed for pain
Intermediate Management (4-8 weeks):
- Progress to more intensive strengthening exercises
- Continue ergonomic practices
- Consider oral analgesics if symptoms persist (short-term use only)
- Evaluate effectiveness of orthoses and adjust as needed
Advanced Management (8-12 weeks and beyond):
- Focus on occupation-specific training and endurance
- Implement preventive strategies for long-term management
- Consider referral to specialist if symptoms persist despite appropriate management
Common Pitfalls and Caveats
- Delaying ergonomic interventions can lead to chronic issues and more difficult recovery
- Overreliance on medications without addressing underlying ergonomic factors
- Failure to take regular breaks during computer work, which is essential for prevention
- Neglecting the neurogenic component of repetitive strain injuries, which may require specific neural mobilization techniques 3
- Using orthoses incorrectly or for too long without strengthening exercises
When to Consider Specialist Referral
- Persistent symptoms despite 3-6 months of appropriate conservative management
- Signs of nerve compression (numbness, tingling, weakness)
- Significant functional limitations impacting quality of life
- Suspicion of more serious underlying pathology
Remember that early intervention with proper ergonomic modifications and appropriate exercise is key to preventing chronic issues and maintaining hand function for computer users.