Table of Contents
Gaming Until You’re Numb: 3 Simple Ways to reduce Carpal Tunnel Symptoms
By 1HP Staff·November 13, 2015
Article update: 2/14/2025
Introduction
Carpal Tunnel Syndrome is commonly thought of as one of the biggest issues in gaming today, however this is just not true. In the 8 years working with gamers we have only seen 1 case of true carpal tunnel. Now read that again, only 1 case out of 2500 plus! If you’d like to see which is more common than check out our year in reviews breaking down the prevalence of each diagnosis (2020, 2021, 2022).
What Really is Carpal Tunnel?
Anatomy
The anatomy of the wrist and hand can be a complicated one as there are 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves just within. However, the diagnosis of carpal tunnel (CTS) doesn’t have to be. Simply put, carpal tunnel is compression of the median nerve as it runs through the carpal tunnel. This tunnel lies where the forearm and hand meet and is formed by our carpal bones acting as the floor/sides and the transverse carpal ligament acting as the roof. Within this space the tunnel houses 9 tendons which help us to flex the fingers and thumb (Clicking buttons, gripping a mouse, toggle joystick, or type) and 1 of our 3 nerves. The median nerve is the only of these which runs through the carpal tunnel and is therefore susceptible to being compressed here.
Irritation or compression of the median nerve in this situation would result in numbness or tingling in a specific distribution of the thumb, index, middle and sometimes ring finger (Pictured above). The median nerve can become irritated or compressed for a variety of reasons, this includes insufficient rest breaks (Feng et al., 2021), overweight/obesity (Shiri et al., 2015), wrist positioning, repetitive gripping, swelling in the hand or wrist, sleep posture, anthropometric measurements, exposure to vibrating tools, and cold temperatures. Additionally, women are generally 3x more likely to develop CTS, but this is skewed as women have the potential to become pregnant and nurse their baby which causes increased swelling of the wrist Interestingly,, when focusing specifically on occupations like data entry—arguably the most relevant comparison for gamers—no significant difference in risk has been observed (McDiarmid et al., 2000).
Now that we know more about the anatomy of what makes up the carpal tunnel let’s look to see what could actually be happening.
Why Do I Have Pain?
This in no way is meant to say that someone is not having pain, but that the pain you’re experiencing is likely not due to a diagnosis of carpal tunnel. If pain is coming from the wrist in the area OVER your carpal tunnel then that does not indicate that one has carpal tunnel.
Instead, pain over this area of the wrist likely signifies strain of the tendons in our wrist which travels through the carpal tunnel. Let’s remember that there are 9 tendons (four flexor digitorum profundus tendons, four flexor digitorum superficialis tendons, the flexor pollicis longus tendon) that run through the carpal tunnel and are just as susceptible to injury if not more in repetitive use injuries. These tendons are our finger/thumb flexors tendons which when irritated become very localized in a pain region right over the carpal tunnel however this is not indicative of Carpal Tunnel Syndrome rather it is more clearly a sign of tendon irritation.
Tendonopathy remains a common culprit of gaming wrist pain as the actions being performed are repetitive and require a lot of button clicking, mouse gripping, and thumb motion with a joystick. These actions largely are in flexion, meaning the exact tendons/muscles that also run through the carpal tunnel. When pain is present many will rest or brace the wrist and while this may be necessary for a short amount, it is crucial to start working on strengthening the specific tendons as well.
Now again, anatomy is crucial for understanding the how AND why pain is present and hopefully this can allow for a better understanding of how tendon involvement is likely the cause of any wrist pain EVEN WHEN IT IS DIRECTLY OVER THE CARPAL TUNNEL.
Why Do I Have Numbness?
Numbness is a result of nerve compression/irritation at some point along the nerve pathway. Nerves have a long path down from the spinal cord to innervate and provide function to specific areas. Depending on this specific area can tell us a lot about which nerve is affected and where this may be having compression.
If numbness or tingling solely resides in the thumb, index, middle and sometimes ring finger then it is possible that the median nerve is involved which then could be seen as carpal tunnel syndrome. However if tingling/numbness is less consistent on location or the arm is also involved then it is less likely to be CTS and possibly a result of TOS possibly another entrapment site altogether.
Numbness may be paired with pain at times and this can indicate more tendon involvement that was discussed above. When tendons become inflamed and irritated then this can take up space within the carpal tunnel resulting in compression of the median nerve as it pushes it into the corner. Here is another reason why strengthening the tendons can be so helpful. Over a period of time in endurance focused strengthening the tendons are able to take on higher levels of load before ever becoming inflamed or painful.
Preventative Strategies
Previous strategies have looked at avoiding activities, bracing, and icing. These recommendations typically come after a very brief examination which is often not enough time to determine a diagnosis and so these are given to cast a wide net in hopes that these ideas work. However, this is not the best recommendation and can often lead to fear around activity or reliance on a brace. Individuals may also believe that there is no way around this aside from rest, but this is far from the truth. In reality, gaming is able to be continued, but might require a few tweaks that are discussed below.
Relative Rest:
Rest and recovery is and should be an essential part of our daily lives. Many times patients will fight this only to be proven wrong. Oftentimes people feel that they are less efficient when they take breaks or it is slowing them down, BUT this is far from the truth. What happens when an injury arises as a result of not including rest breaks–you then have to sit out OR you play more through the pain only to find it getting worse.
Instead, if a 5 minute rest break was included every hour and during a 8 hour gaming session this equates to 40 total minutes then that still far outweighs the many days, weeks, months that it can take to rehab back from once an injury does present. Maybe instead of the mindset “Work hard, play hard” we should instead consider “Play hard, rest hard”
When you are already feeling pain, you should follow general rules – the length of time you have been dealing with the pain should be proportional to how long you need to rest.
Time Dealing with Symptoms | Suggested Rest Period |
<10 Days | 1-2 Days |
10 Days – 3 Months | 2-4 Days |
> 3 Months | 6-7 Days |
Exercise
I understand that I just said to rest the hand and now am saying to exercise, but this is for good reason. Gamers can especially benefit from proper exercise to improve their health. Our Hands, forearms and wrists are used for endless hours. Exercising to improve strength, endurance, mobility, speed, coordination and even agility can not only improve our gaming performance, but also prevent us from going down to 1HP in the first place.
It is important for us to understand how to perform our exercises, especially if we have pain.
The rule of thumb is to perform the exercise right before the point of pain. So that means if I am asking you to perform a biceps curl. If it hurts halfway through the range, then curl it to the point right before it hurts. Mild Discomfort is okay, as long as the pain is not sharp.
0-5 = Discomfort range (Acceptable range for exercises)
5-10 = Pain (Not something encouraged to exercise too)
Self Massage
Massaging specific areas along the hand, forearm and hand can provide relief to areas of compression and improve blood flow; allowing a proper environment to heal. The goal of massage is typically to provide relaxation of muscles that are contracting to protect the area. With contraction, it provides further reduction of blood flow. Relief with self-massage can be achieved in several ways.
Instrument Assisted: Typically we prefer the use of tools to massage areas that are painful or sore. Whether it be a tennis ball, foam roller or even canned food, applying pressure through the use of these instruments can help greatly with relieving compression. With Carpal Tunnel Syndrome, we target muscles on the palm-side of your forearm that can increase pressure in the carpal tunnel. These are typically the muscles we use most when we’re gaming.
Exercises for Carpal Tunnel (But really Tendon irritation)
→ Exercises are targeting tendons, the more common cause.
1: Forearm and Hand Strengthening
We perform the following exercises to improve the strength, endurance and coordination of our gaming tools. This strengthening also allows for a focus on the tendons which more commonly become irritated.
Eccentric Wrist Flexion with Finger Curl
Grip Strengthening Exercises
*Directly working to strengthen the muscles/tendons which travel through the carpal tunnel.
2: Tendon and Nerve Gliding
These exercises are important to relieve any potential stickiness between the layers of tissue (What we call adhesions) and improve the blood flow to the tendon sheaths. Specific to CTS, Tendon and Nerve gliding exercise maximizes the amount of movement of the median nerve within the tunnel.
Hand Tendon Gliding Exercise
Tendon Glide with Thumb Stretch
Median Nerve Glide
3: Stretching
Stretching improves circulation and helps to maintain the proper ROM with your hand, wrist and forearm joints. It is also beneficial in providing relief to muscles that are being overused.
*Used to stretch the thenar eminence which is a group of muscles that is used to hold a controller or mouse
*Helping to directly stretch the tendons that run through the carpal tunnel
Lumbrical Stretch
*Stretching the lumbricals which in some individuals can actually crowd the carpal tunnel as it enters this when making a tight fist.
How to Reduce Carpal Tunnel in Gaming?
First realize, it’s probably not carpal tunnel syndrome, but it’s not impossible. Again, carpal tunnel is often used as a broad term for any and all wrist pain because both everyday people and even medical providers don’t have enough knowledge over what it truly is. Tendon involvement is much more likely and should first be ruled out and begin endurance strengthening and stretching to see if this is the true issue.
Carpal tunnel can be caused due to thickened tendons associated with overuse, but this can be treated and even prevented with proper management before it becomes an issue. Sure there are instances of chronic cases that when ignored can lead to nerve irritation or signs/symptoms to be aware of that maybe shouldn’t be swept under the rug. This can absolutely lead to cases, but again, this is preventable in most cases. From posture/ergonomics, endurance training for the wrist, diet/exercise, etc; true cases of CTS can be prevented/eliminated.
You’ll feel THIS if you really do have carpal tunnel syndrome
Numbness or tingling solely resides in the thumb, index, middle and sometimes ring finger. This is predominantly what someone should feel when they truly have CTS. Otherwise you might want to assume that CTS is the imposter.
If you still suspect the nerve is involved (again it is very unlikely…) you can try these.
If everything discussed above still points to the fact that you may possibly have carpal tunnel than be sure to try these strategies:
- Rest the wrist
- Splinting: This may be one way for individuals to rest the irritated nerve. A wrist brace allows for the nerve to avoid compression from bending of the wrist in either direction.
- Remember, this will address both the nerve AND the tendons. Tendons will become weaker as a result, but a never may have time to reduce inflammation.
- It is important for a gamer to know that this should be used as minimally as possible which is why it is most recommended to begin by wearing a wrist brace at night while sleeping. A frequent complaint is waking up in the middle of the night or early in the morning with numbness/tingling
- Splinting: This may be one way for individuals to rest the irritated nerve. A wrist brace allows for the nerve to avoid compression from bending of the wrist in either direction.
- Massage
- Prioritize massaging the bulky muscles in the palm of the hand (thenar/hypothenar region) as well as the forearm
- Utilize heat while avoiding ice (Hot/cold packs, warm water soak)
- Heat can be helpful before or during activity. Ice can be helpful during an acute flare of symptoms, but would likely be better to avoid due to the constriction that occurs with applying cold temperature therefore narrowing the carpal tunnel and decreasing blood flow.
- Tendon glides
- A good starting exercise to restore mobility between the tendons and the surrounding tissue by reducing adhesions and increasing blood flow
- Nerve Glides
- To restore mobility between the nerve and the surrounding tissue.
- Stretching
- Helpful in decreasing tightness and promoting elasticity in the transverse carpal ligament (Carpal tunnel)
Still confused? Then check out our pain pattern library consisting of the most popular injuries and their given location that is seen in gaming.
*To learn more specifically about carpal tunnel click here
Conclusion
In conclusion carpal tunnel is very rarely the cause for concern in gaming and instead a greater focus should be on building up our capacity through muscular endurance as this is one way to avoid pain over and around the carpal tunnel that is commonly mistaken for this diagnosis.
Understand that carpal tunnel or other injuries is not a death sentence for being able to game again and one can actually respond well with the right treatments and exercises listed above. If there is still desire to check out more than consider the Troubleshooter program developed by us for gamers.
References
- https://1-hp.org/fix-carpal-tunnel/
- https://1-hp.org/the-carpal-tunnel-conspiracy-is-the-healthcare-system-misleading-you/
- https://1-hp.org/blog/blog/how-to-treat-mild-carpal-tunnel-syndrome-for-gamers/
- https://1-hp.org/carpal-tunnel-from-gaming/
- American Academy of Orthopaedic Surgeons. Therapeutic exercise program for carpal tunnel syndrome.
- Baker NA, Moehling KK, Rubinstein EN, Wollstein R, Gustafson NP, Baratz M. The comparative effectiveness of combined lumbrical muscle splints and stretches on symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil. 2012 Jan;93(1):1-10. doi: 10.1016/j.apmr.2011.08.013. PMID: 22200381.
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- Feng, B., Chen, K., Zhu, X. et al. Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study. BMC Public Health 21, 57 (2021). https://doi.org/10.1186/s12889-020-10137-1
- Kim SD. Efficacy of tendon and nerve gliding exercises for carpal tunnel syndrome: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Aug;27(8):2645-8. doi: 10.1589/jpts.27.2645. Epub 2015 Aug 21. PMID: 26357452; PMCID: PMC4563334.
- McDiarmid, M., Oliver, M., Ruser, J., & Gucer, P. (2000). Male and female rate differences in carpal tunnel syndrome injuries: personal attributes or job tasks?. Environmental research, 83(1), 23–32. https://doi.org/10.1006/enrs.2000.4042
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- Shiri, R., Pourmemari, M. H., Falah-Hassani, K., & Viikari-Juntura, E. (2015). The effect of excess body mass on the risk of carpal tunnel syndrome: a meta-analysis of 58 studies. Obesity reviews : an official journal of the International Association for the Study of Obesity, 16(12), 1094–1104.