Wrist Pain from Mousing or Typing - Carpal Tunnel, Tendonitis, or Something Else?

First Published: February 22, 2020. Last Update: June 9, 2023

If you work at a computer all day you may – like so many of us – fear the dreaded carpal tunnel syndrome.

Carpal tunnel syndrome is only one of several possible causes of wrist pain. 

In this post, I’ll go over the basics of carpal tunnel syndrome including how it makes your wrist hurt, and how to distinguish this condition from tendonitis. I’ll even throw in some prevention tips.

Clarifying Carpal Tunnel Syndrome

Pain due to carpal tunnel syndrome can happen when pressure is put on a nerve in your wrist. This nerve is called the median nerve. 

Along with nine tendons, the median nerve traverses under a band of strong connective tissue that goes across the numerous wrist bones. The band serves as a bridge across those bones, and the area under the "bridge" is the carpal tunnel

The median nerve is located on and affects the palm side of your wrist. It also affects the area of the thumb.

What does the median nerve do?

As with all nerves in the human body, the median nerve communicates feelings and movement impulses, in this case, to the hand.

The median nerve sends movement messages to muscles of the wrist, thumb and first three fingers, on the palm side.

Specifically, the movement messages from median nerve to the hand help turn the forearm in, as well as spread the thumb out (away from the palm.) They also initiate bending of the thumb, index and middle fingers.

The carpal tunnel band (which has a fancy name I won’t burden you with here) runs perpendicular to the nerves underneath it.

When the carpal tunnel band puts pressure on the median nerve, you might experience numbness, tingling and/or weakness in the palm area and/or the thumb side of your hand, plus the first two fingers. Wrist or forearm muscles may be affected, too.

The location of the symptoms caused by this pressure is specific because the median nerve serves just the area discussed above – only. (The other two wrist nerves, i.e., the ulnar and radial, supply signals to different areas of the wrist and hand.)

Regardless of location, numbness, tingling and weakness are classical signs of nerve disruption. 

Is it REALLY Carpal Tunnel? Or Might it Be Tendonitis?

Carpal tunnel syndrome is often mistaken for other wrist pain diagnoses. Perhaps the most common of these are tendinitis of the wrist. 

But the two conditions are different. They affect different structures that may lead to wrist pain, and their symptoms are not the same.

With carpal tunnel, you’ll likely get the nerve symptoms mentioned above. 

But in the case of tendinitis of the wrist, symptoms tend to be linked to inflammation. So you might experience things like redness in the area, swelling or pain.

Either way, if the symptoms really bother you, get them checked by an orthopedic M.D. Generally speaking, getting symptoms checked early can only help you, especially in terms of managing any related long term pain or dysfunction.

The doc might give you a nerve conduction test, especially if you’ve got those tingling, numbness and weakness type symptoms. A nerve conduction test is the best way to figure out if you’ve got carpal tunnel syndrome. 

And having a nerve conduction test as soon after you start noticing the nerve symptoms is generally the best idea.

Inside the Tunnel - A Delicate Balance of Structures to Maintain

The carpal tunnel (area under that band of connective tissue) is quite narrow. This means that the ten structures located in the tunnel have to fit together snugly, but not too snugly. 

If their fit is too snug, the median nerve may fire, and/or one or more of the tendons may become irritated. This may lead to pain and other symptoms.

Staying close to the carpal tunnel band without touching it is a delicate balance for the median nerve and the tendons.

On the other hand, when the structures inside the tunnel fit well and don’t bump into each other or the band above them, you likely will not experience wrist pain or other symptoms.

For a More Comfortable Wrist, Change the Following Computing Habits

Often, it's our day in and day out movement and posture habits that lead to carpal tunnel syndrome.  

If you repeatedly do any of the following, you may want to reconsider how your hands and forearms interact with your desk, mouse and/or keyboard.

Contact Stress

Resting your wrist on the edge of your desk, especially when you do concentrated mousing work, and especially when the edge is sharp, is associated with a carpal tunnel syndrome risk factor known as contact stress.

Poor Wrist Positioning

Do you type with misaligned wrists? (Think “clawed” position of hands or wrists bent so that hands go backwards, towards you.) If so, this is another way you may be upping your carpal tunnel risk.

Generally, posture experts and ergo consultants like to see wrists in “neutral.”

You’ve achieved neutral wrist posture when your hands and fingers are extensions of the forearm. In this position, your wrist will be bent neither forward or back. 

Depending on what you're currently doing in terms of wrist position, you might experiment with your keyboard in “negative tilt,” where the numbers on your keyboard are higher than the space bar.  Many people report it gives their wrists good support and pain relief.

To get a negative tilt on your keyboard, you can purchase a keyboard tray with a negative tilt adjustment feature. Some keyboards have added bells and whistles, but at the very least, get the option to make the space bar higher than the numbers. The below Amazon ads (DISCLOSURE: I am an affiliate.) are all tilt adjustable. The 3M is a good brand, as is Kensington.

Limited Shoulder Motion

Let’s face it. Computer work is sedentary – with a capital S. 

When you’re stuck in a “hunchback” position all day, it’s really easy to forget that certain body parts – like shoulder blades – can actually move. 

Chances are, if your shoulder blades are misaligned, you’re also working with way too much tension in the forearm, wrist, hand and fingers. This extra tension is a compensation, because your shoulder blades are stuck, and as a result, your forearms and wrists don’t get the support they need for free and easy movement, so the muscles there work harder.

Repetition

Another carpal tunnel risk factor is repetitive motion. Repetitive motion is about constant keying and/or mousing. 

Be sure to take breaks from typing and mousing when you can. This gives the muscles a chance to relax, which is good from them. Also stretch.  

Actionable Science

Research suggests two important things I’d like to leave you with. First, an ounce of prevention is worth a pound of cure.

Start implementing better habits now, and also consider purchasing workstation accessories to help you avoid pressure at the wrists. Don’t wait until you get those nerves symptoms, because at that point, it may be too late. Research says that once you have these, there’s little you can do to relieve the pressure on the wrist that started the whole thing in the first place.

Which leads me to my second research based tidbit.

Studies show that a combination of a vertical mouse and a wrist rest works best for prevention. The vertical mouse places your forearm, wrist, hands and fingers in the handshake position which tends to be much less stressful on those joints. Use a wrist rest to help prevent excessive contact stress (which we discussed above.)

As far as vertical mice go, they come in a variety of feature packages. One high quality brand is Evoluent. With Evoluent vertical mice, you just need to pick the one corresponding to your dominant hand and all will likely be taken care of. No need to figure out which bell or whistle is right for you. It’s all in the design.

Prevent Carpal Tunnel with the Evoluent Vertical Mouse (DISCLOSURE: I am an affiliate.)