9 Non-Surgical Fixes for Your Aching Wrists & Arms

Question: Just as with most people who work on a computer for a lot of the day, I am a little concerned about getting carpal tunnel syndrome. In my medical coding job, I am on the computer at least six hours a day at work, and I may average an hour or so at night when I get home. What are some of the warning signs for carpal tunnel, and what can I do to prevent it?

Answer: You are wise to think about carpal tunnel syndrome early. Many professionals ignore the signs, and by the time they get around to doing something about it, their wrists and hands are so bad that surgery is necessary.

Head off that trip to the OR by checking out this sampling of carpal tunnel symptoms and possible non-surgery solutions, courtesy of the National Institute Of Neurological Disorders And Stroke (NINDS):

What are the symptoms? According to NINDS, symptoms begin slowly. Frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers, is a bad sign.

“Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to ‘shake out’ the hand or wrist,” NINDS states.

As symptoms get worse, the tingling may present itself during the day, as well as an inability to distinguish hot and cold via touch. “Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away,” NINDS reveals.

Bad news, ladies: “Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men,” the Institute explains.

No matter if you’re male of female, having carpal tunnel is costly. In 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome — half of those workers were out of work for at least 10 days. “The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker,” NINDS says.

What can I do? Have your hands and wrists checked out by a doctor. “Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor’s direction. Initial treatment generally involves resting the affected hand and wrist for at least two weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending,” according to NINDS.

There are several non-surgical treatment options available, including:

• Drugs: Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease carpal tunnel symptoms that have been present for a short time or have been caused by strenuous activity. “Additionally, some studies show that vitamin B6 (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome,” NINDS says.

• Stretching: Stretching and strengthening exercises can be helpful in people whose symptoms are disappearing. These exercises may be supervised, either by a physical therapist or an occupational therapist.

• Alternative therapies: Acupuncture and chiropractic care may help your carpal tunnel, though there is little data to support these practices’ effectiveness.

• Position your keyboard properly: Your wrists should be able to rest comfortably on the table in front of it.

• Wrist rest: Get a wrist rest if your keyboard is too high and you have to bend your wrists to hit all of the keys. This kind of wrist bending causes carpal tunnel syndrome.

• Seating: Make sure your seat is at the correct height. If the angle between your forearm and your upper arm is elevating upward, raise your seat. If your forearm and lower arm are pointing a slight amount downward, lower your seat. Also, try getting a chair with an adjustable back and arm rests.

• Sitting properly: Your legs and your lower arms should be positioned at a 90-degree angle with your body. If your legs are too high, raise your chair.

• Maintain proper posture. Curving your back puts stress on your back, wrists, waist, neck, shoulders and other areas.

• Feet location: Make sure your feet rest comfortably flat on the floor.

We’ve got the links to help you keep your wrists, back, and other body parts one happy, correct-coding machine.

Quick. Take a look at the lady on the left. Does your posture at work or at your home computer — RIGHT NOW — resemble hers?

If you’re like me, the answer is ‘no.’ And if you’re like me, you have the aches and pains that come from bad workstation ergonomics.

Whether working in an office or from the home, medical coders need to pay close attention to good ergonomics. We spend a lot of time at the computer, our heads bent closely over coding reference books and doctors’ notes.

The work-from-home crowd is even less likely than the office crowd to pay attention to good ergonomics. When I first started working at home, I put off buying a desk and simply plopped myself down for hours on the bed, the coach, or at the kitchen island. I ended up with chronic low back pain that required several visits to the physical therapist to correct.

While working from the couch can be a nice change of scene every once in awhile, work-at-home gals should spend most of their time at their desks.

There are lots of resources to help you make sure you’re desk keeps you pain-free as possible. For example, check out this how-to page from the American Academy of Orthopedic Surgeons or this checklist from OSHA.

Special tip for medical coders: Lots of computer workstation ergonomics sites recommend document holders, a complicated proposition if you’re trying to juggle three coding reference books AND a paper op note. Some solve this problem by using online coding reference tools such as Encoder Pro, Supercoder, or Find-A-Code. Many coders I know have two computer monitors at their desks so they can toggle easily between multiple screens to check the multiple reference sources they’re working with.

Medical coders who are seasoned presenters know they won’t convince clinicians to improve their documentation unless they give the docs hard data. So let’s learn how to get that hard data into your PowePoint slides quickly and easily.

Adding a chart to your PowerPoint presentation sounds like a simple matter, but you’re probably wasting valuable time with this step. For instance, if you have your data already in an Excel workbook, do you still manually add the data to your PowerPoint chart? Check out these 3 ways to add charts to your PowerPoint presentation and find the best process for your needs.

To add a chart to our presentation in the most efficient way possible, we’ll:

• Build a brand new slide that includes a chart using the slide’s content layout.
• Add a chart to an existing slide in seconds.
• Create a chart from an Excel workbook that updates when we edit the Excel data.

Figure A

Once you know the points that you want to make in your PowerPoint presentation and the data that supports those points, you need to decide how to insert the data. We’ll show you how to add a chart to your slide — even if you want to use data you already have in an Excel workbook.

Use a content layout

The easiest way to start is to use a content layout that includes a chart icon. To do so, right-click on the slide and choose Slide Layout (Layout in PowerPoint 2007). Choose any layout that has the word Content in its name. For example, the Title and Content layout looks like Figure A.

To create a chart using a content layout:

1. Click the Insert Chart icon. The default chart (a 3-D column chart) appears with a datasheet containing dummy data.

2. Replace the dummy data with the data you need.

Manually enter data into this datasheet to replace the existing data if you don’t have it elsewhere in electronic format

If you have data in Excel, open the Excel file, select the data you need (including the column and row titles), and copy it to the Clipboard. On your slide, click in the datasheet’s upper-left cell and paste.

3. Right-click in any blank area inside the chart, and choose Chart Type to open the Chart Type dialog box.

4. Choose a chart type, and click OK.

Insert a chart on any slide

If the slide’s layout doesn’t contain a chart icon, you can still insert a chart. From the menu bar, choose Insert | Chart to display the default datasheet. Then continue with Steps 2 to 4 from the “To create a chart using a content layout” section. (In PowerPoint 2007, choose Chart in the Insert tab’s Illustrations group and continue with the rest of the instructions for 2007.)

Insert an Excel object that updates with your data

Sometimes, you may already have a chart in Excel. You can select that chart in Excel and then copy and paste it onto your slide. This procedure inserts an Excel object, which means that PowerPoint retains the connection to the Excel file. If you need to edit the chart, you can double-click on the chart and the Excel file opens within PowerPoint.

What do you do if your data changes often? Price listings and financial data may change from day to day, but you need to make sure that the data on your slide is up to date. The answer is to create a link between the two files.r />

To insert an Excel object with a link:

1. We recommend that you place the Excel chart on a separate Chart tab. If necessary, you can right-click on a tab, choose Insert, select Chart, and click OK. Then create the chart on that tab, or copy and paste it there.

2. Choose Insert | Object from the menu bar. (In PowerPoint 2007, click the Insert tab, and choose Object in the Text group.) The Insert Object dialog box opens.

3. Choose the Create From File option on the Insert Object dialog box’s left side.

Figure B

4. Click the Browse button and navigate to the Excel file. Click it and click OK. At this point, you are back in the Insert Object dialog box, as shown in Figure B.

5. To maintain a data connection with the Excel file, select the Link check box.

6. Click OK to place the data on the active slide.

7. Your slide might not display the section of the worksheet that you want, or might display data rather than the chart in Excel. Double-click on the chart to open Excel, display the Chart tab containing your chart, save, and close. Your chart should now appear on your slide, as shown in Figure C.

Figure C

Extensive editing of an Excel spreadsheet may prove awkward from a slide in PowerPoint. For this reason, we recommend finalizing the data in Excel as much as possible before you bring it into PowerPoint.

Update your Excel links manually

The reason you link to an Excel file is to ensure that your chart always matches the data in your Excel file. If you make a change in the Excel file, the PowerPoint file updates automatically. Sometimes, however, you need to update the slide manually. To update a link, select the linked object, right-click on it, and choose Update Link.

Once you insert your chart, you’ll want to make it more visually appealing than the default settings. For a few quick chart-formatting tips, stay tuned for an article titled “Double your chart’s curb appeal with a few quick formatting pointers,” coming soon in My Coding Career.

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