RSI is one of those things (ADHD, autism and dyslexia are other examples) that start as a label some scientist puts on a specific set of symptoms that cannot (currently) be linked to a specific condition [1], becomes popular and then get used for a zillion things with more or less the same symptoms (Wikipedia lists edema, tendinosis, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, De Quervain syndrome, thoracic outlet syndrome, intersection syndrome, epicondylitis, tenosynovitis, radial tunnel syndrome, and focal dystonia as possible conditions underlying RSI)
Since 'RSI' may have many causes, it is unlikely a single treatment will help everybody. This article, in particular, looks like anecdata to me.
Having said that, the suggestions others give to sleep and exercise almost certainly can't hurt and if they may hurt you, you probably already know how fragile your body is.
Exercise breaks during work have the added benefit of introducing breaks. If I had to bet, those breaks are more important for RSI-like symptoms than the exercises themselves.
Reddit has arrived: a plausibly researched answer that's so far off base it pains me.
Physician here, and my wife is an occupational therapist. RSI is like saying you have a cold. Yes, there is a problem, no it's not specific, but it gets us to the right chapter of the book. Some of the things you list have very specific causes and treatments that have nothing to do with RSI.
The article would be more like a case report: an interesting, uncommon source of RSI. Anecdata? Yes, but the interesting data is often the edge cases.
When faced with these symptomatically classified issues without a case-specific identified root cause, it still is nice to have a stable of simple (and medically believable) options to try.
Even the methods that didn't work for the author might be more applicable to others, if they have different root causes. In a situation where there's typically no precise clarity as to the root cause, shotgunning solutions is reasonable self-experimentation.
In fact, that's often how doctors prescribe treatments; shotgunning starting from suspecting the most common root cause and working down, testing to see if that's the root cause by seeing if the treatment for said root cause happens to be working.
“RSI” from typing too much in an uncomfortable way or using bad equipment is too serious to brush off.
For anyone reading here, if you’re regularly feeling any level of pain while typing, take an immediate break to figure out what’s wrong. If you let it persist it can do you serious damage.
There are a number of ways you can relieve your symptoms. Scale back your typing and keep trying ideas until the pain goes away. If pain persists or if it is acute/severe, go see a doctor right away. A doctor can much better diagnose you than internet commentary.
(1) Make sure your wrists are in a straight and neutral position while typing. This is in my opinion (having talked to many people with RSI and watched their typing style) the #1 contributor. Other arm/hand/finger position problems can also contribute, but keeping the wrists relatively straight and relaxed is the first most important step to take. Try to pull your keyboard in close to your body and tilt it so that its top is parallel to your forearms (the right tilt to use will depend on the height of your desk and chair and the shape of your body) and stop resting palms, wrists, or arms on a palmrest whenever actively typing (leave your hands “floating” above the keyboard, with just fingertips resting lightly on the home row). If the keyboard’s flip-out feet won’t let you get to the appropriate angle, try propping books or something under the near or far side, as needed.
(1a) More generally, pay attention to your body, and try to notice any muscles/tendons which are statically loaded while you type. Ideally you should be able to be in a position where your muscles are mostly relaxed, and only being used to actually press the keys.
(2) Try to avoid typing for too many hours a day, or for too long at a stretch. (Take a break to stand up and walk around a bit once at least every 45m or so. Go to the bathroom, make yourself a coffee, walk around the block, whatever.)
(3) Examine your seat and desk. Try to make sure your back is as straight as possible and your arms are in a relaxed position. Consider switching seat positions at least a few times throughout the day. Most office workers have their desks set too high compared to their torsos (this is because standard office furniture was designed for medium-tall European males to write with a pen on paper, not for people of arbitrary size/shape to type on a keyboard). You can either lower your desk or raise your chair to compensate. Consider alternative types of chairs (e.g. saddle seats) or an adjustable-height (e.g. sit–stand) desk.
(4) Try to eat a balanced diet, get enough sleep, exercise a few times per week, and avoid too much stress in your life. Obviously you should try to do these things anyway, but they can absolutely contribute to typing pain.
(5) If those changes don’t help, consider changing your physical keyboard/mouse hardware. A split keyboard with sufficiently “tented” sides eliminates the need to pronate your wrists, as is required for one-piece keyboards. This allows the elbows to be brought closer to the body, the shoulders to be relaxed, and generally reduces static load on several tendons/muscles. Consider an “ergonomic” mouse, a trackball, a roller mouse, or similar, or try to eliminate extraneous mousing. Consider changing the keyboard layout to avoid awkward stretched chords (“emacs pinky”), or even get a Maltron or similar row-oriented keyboard. Get a keyboard with switches that actuate halfway through the stroke (not a standard rubber dome keyboard), and try not to smash the keys hard into the bottom of the stroke while typing – aim for a light, fluid “dancing” style of typing.
>“RSI” from typing too much in an uncomfortable way or using bad equipment is too serious to brush off.
The article wasn't brushing off RSI, just pointing out that none of those things worked for him, and that emotional stress and cold seemed to be the major factors.
I certainly agree that you should look into ergonomics, but additionally you should definitely consider emotional stress, as there is ample evidence that stress may be a significant factor in many types of chronic pain.
I didn’t suggest that the OP was brushing off RSI. I was talking about the somewhat dismissive tone of the poster I was directly responding to. It would be a shame for someone to read such a post and think, “Oh, RSI is an umbrella label for many things. Nobody knows just what my problem is. I’d better just tough through it.” Or similar. Umbrella label or no, RSI is serious business, and can severely impact people’s lives/careers.
I agree with you that features discussed in the OP like being too cold or having emotional stress in your life could contribute to the problem.
This article is totally missing the basics. Exercise. I promise it will make ALL the difference. Get yourself a pull-up bar, and if you're feeling extra fancy, a dip bar.
Push-ups, pull-ups, dips, and sit-ups. Every day. You'll be a coding machine. At the VERY least, push-ups. Every hour or two, take a break, knock off ten push-ups, walk around a bit, get some water, get back to work. I'll do this right at the office, often in the server room.
A good chair helps, but all of this other nonsense is unnecessary. Exercise, and nutrition is the key to basically everything in life.
You have to be more specific than 'exercise' for this type of injury. Biking (as sibling comment points out) does not put you in a very ergonomic position, and is primarily cardio. Biking is simply not going to improve things, and may make it worse.
What I've learned in the past two years of intense PT is the most important thing is to focus on fixing muscle imbalance through strengthening (specifically, avoiding upper crossed and lower crossed syndromes). These put the body in a better position and reduce the load on neck muscles, which in turn reduce referred pain and muscle tightness into the arms and wrists. Most RSI-like symptoms are actually problems starting in the neck.
Having a well-balanced body that is durable is an amazing protector against all sorts of poor physical environments. The article alludes to this by saying 'improve your posture', but that's not very specific - posture improves when you have better balance between muscle groups.
Of course, improving ergonomics, body mindfulness, getting adequate rest, temperature, etc are important as well, but those alone don't do it, nor does cardio.
FWIW I found biking terribly aggravating for RSI. It really is not an ergonomic position. I'd recommend nearly anything other than biking. Swimming, weight lifting, basketball, etc. Anything where you aren't still sitting.
I adore cycling but I've had to stop as I started to develop RSI, first in one wrist, and then in the other. I actually think it was cycling that was the proximate cause.
General gym workouts help, so long as I use weights and machines with care. But I have gone back biking after forgetting about the wrist pain, only for it all to come back and become chronic again.
Last year I got into lifting for the first time ever (I'm 35). I got on a program, just doing a couple of heavy compound lifts three days a week, and the change for me has been night and day.
It doesn't take much time to learn how to do it correctly, and it's a lot more fun than running. All those aches and pains have gone away. Seriously, I can't recommend enough getting into lifting.
Actually, I had a similar experience. For that reason, I decided to work on a side project precisely to encourage people to get started lifting weights and lose the fear of going to the gym: https://ezworkout.org
That is slick! I'll be using this next time I go to the gym. One of the big problems it solves for me is boredom - I lifted for a couple years but couldn't stand doing the same workouts week adter week. I do realize you're supposed to switch it up, but your app makes it easy :)
I bought a power cage and a barbell so I could lift in my basement. Wasn't a huge fan of the gym either. Never enough squat racks, and I felt bad locking one down for an hour.
Barbell: Rogue 2.0 bar (cheap at $250, perfectly fine for newbie)
Power cage [0]
Realistically, the most expensive part of the setup was...the weights. Shipping that shit costs a lot, and they're not cheap to begin with. I bought some bumper plates for deadlifting, and a bunch more as regular plates. Total weight is like 400 - 500 lbs, I forget exactly. All in all, it cost me like....$1400 or so. Worth it if you know you're gonna stick with it, but you should probably start in a gym and make sure it's gonna stick.
Oh, and if you want advice on getting started, let me know.
What worked for me was going to a good crossfit that focused on lifting. A power or olympic lifting gym would work too. Having someone who knows what they are doing help me was very valuable. Now I know enough to go out on my own.
Sounds like a poor use of a shared resource since the only one of those exercises that requires a squat rack is a squat. I guess it's fine if there's no one else at your gym.
Not necessarily. The safety pins on a squat rack (or power rack, not sure what the difference is) are handy if you're scared of dropping the weight on an OHP, or if you don't have anyone to spot you on the benchpress. If you move the rack's pins to the outside uprights, lower down near the floor, and put the bar there it makes it much easier to load/unload plates for the deadlift. For me, taking weights off of a bar on the floor is the absolute worst when you're exhausted after a heavy set.
But yes if you're using a squat rack for anything other than squatting, and the gym is busy, give others a turn. Or at least let them work in with you.
I'll second that. Push ups can make wrist problems worse if not done carefully. Do them on your fists or holding a bar instead of palms flat down to reduce unnatural bending of your wrist.
I would stress varied exercises. Push-ups are known to exert stress on wrists, you need to do a variety of heavy lifting exercises (if you already have RSI, start gradually and watch YouTube videos how to do it right)
Exercise has helped my back pain ( I exercise 3 times a week) and my wrist pain sometimes comes back but only if I have been playing video games in addition to coding for a full day. Even then its pretty rare now. I do use ergonomic mice and keyboard though.
Yes, no doubt the ergo stuff is good preventive measures. I don't skimp on cheap chairs, keyboard, mice or mattresses. Exercising for sure is helping you in every aspect of your life, not just sitting at the computer.
I generally agree that exercise is the key, but pushups can be terrible for tendonitis in the shoulder/upper-arm area. Just wanted to warn people from my experience.
It took me way too long to realize that coding all day and games all night is a recipe for pain. Working out is not fun, but it's absolutely necessary for serious software work.
I got over some bad RSI pain and then decided to start doing pushups again. It came back for several weeks. I probably over did it. I have some trouble with going all-out on workouts. I want to get back into strength training, but I am worried that upper body exercise will just re-aggravate my RSI.
Working on large, compound muscles, like that I wouldn't recommend every day. I would spread it out to no more than 3 times per week where you can exercise without any muscle stiffness and pain.
If you have the stiffness and pain in your muscles, hydrate yourself well, take the day off from these exercises and substitute light stretching to work on your flexibility, but always always drink plenty of water.
Used to have serious wrist/arm pain. Used to spend a lot of keyboard time, but also used to exercise a lot.
Anecdotal, but what worked for me was stopping walking around with my hands in my pockets. Seriously! Must've been something to do with body tension - once I figured out that letting my arms swing freely when I walked places, instead of keeping them rigidly in my pockets, the pain went away and hasn't come back.
This. What I discovered from my own RSI pain was that RSI is not caused by bad computer posture or doing any thing too much. It's caused by not doing other things enough.
For me, it was not exercising my wrists in any way. When I'd code, my wrists would be in one position which would eventually start to hurt. But then I took up rock climbing. In climbing, my wrists were forced to strengthen and be put in many other positions. And my RSI pain just went away. I wasn't coding any less than before. But in the time I wasn't coding, I was doing the exercises necessary to keep my wrists healthy.
Also, as an aside, most people's pain tolerance is also terrible. They let their mind take minimal pain signals from their bodies and magnify it tenfold until its excruciating. Some basic meditation training will teach people to minimize what little actual pain they have, which could also allow most to continue working through the pain.
You sound like someone who has never been badly injured, nor lived long enough to deal with an aging body.
Exercise does work wonders. And will solve SOME problems. But some problems really do need their own solutions. And sometimes it does take time and effort to figure out exactly what that solution is.
I have a regime of dumbbell exercises plus at least 5x25 pressups spread through the day.
In this I'm lucky to work from home - not everyone has the freedom to knock out a set in their office environment.
Maintaining condition goes far in mitigating the stress of the particular motor repetitions required by our profession, but I also find that periodically firing up the physical engine calalyses problem solving too.
I used to have a lot of wrist trouble (carpal tunnel I assume) from drumming and computing incessantly, but as long as I stick to the regime, I have no issues.
I get cold hands - more appropriately, a cold right hand - if I'm using a wired mouse. A wireless mouse keeps my hand warm.
That said, the suggestion about fingerless gloves is spot-on. Some folks just get cold easier: For me, cold hands could just be related to hormones (female here). Chronic due to the recurring nature of it all, but seriously not a big deal.
Just a thought in case it helps someone: a family member of mine always had cold hands, and a doctor prescribed a special prescription antiperspirant. Making his hands dry also made them warmer.
Same for me. I am very thin, slim hands. My first smartphone nearly destryoed my hands.
1. Stopped using phone in subway. I used to look down - strain my neck.
2. 30 Pushups everyday
3. Once a week walk/run 5 km
Fixed it.
The best exercise, for myself, for the "RSI" (tendinosis most likely) in my right forearm is archery with recurve and longbow in particular, not so much with compound.
Any pain I have in it is halved, and it feels much looser and stretched out. And as a bonus my medium distance vision also gets a workout.
I bought a power tower for chinups and pullups earlier this year but unfortunately it contributed to aggravating both my elbows and forearm.
One note - you can't just do pushups and call it a day. You need to work your back muscles to keep balance between those muscle groups. Pushups alone will cause your shoulders to roll forward, exacerbate forward head posture, and lead to upper crossed syndrome, which is already a major cause of many computer related RSI issues. Personal experience speaking here.
I used to get mild wrist pain until I started going to the gym 3 times a week.
Last year I broke my arm, metal plates put in, then taken out, ended up with nerve damage and no feeling in half my hand, 3rd surgery to fix the nerve.
About 3 months ago pain started to come back. Doctor gave me the all clear to go back to the gym. Started 2 weeks ago. Pain gone completely.
Hanging from a bar, is actually the start of your path to doing a pullup. Next you jump up, and slowly lower yourself, over and over. Pretty soon you will be doing your first real pull-up.
TL;DR: Similar problems, fixed diet, lost a bunch of weight, started exercising daily after achieving normal weight, all problems thing of the past. True for > 5 years now.
Both of my wrists were broken in my youth, in separate incidents. To make matters worse, one didn't heal correctly and needed to be re-broken.
Until my late 20s I obsessively spent long sleepless days at the computer, all classic qwerty keyboards, either model M or classic thinkpads later. My wrists would bother me at the computer, but they also would hurt when it rained, or other random moments. When I would try do some push-ups, my wrists would hurt like hell before I got anywhere near the expected muscle fatigue. This was generally accepted as expected and how things would be forever (or worse) thanks to the broken bones, according to those I consulted (doctors and family).
Except I wasn't minding nutrition, physical activity, or sleep at all, and lived in an environment (fly-over state) with an unhealthy food culture and awful climate. Without making a conscious deliberate effort, the default outcome was to slowly become fat and sick.
Fortunately a startup relocated me to the bay area, where I discovered even walking up a mild hill had become a strenuous, exhausting activity. Having a great climate, accessible local produce that actually tasted good, and a newfound interest in enjoying a life beyond the keyboard with the abundant outdoor beauty and activities, improving these facets of life came easily and I dare say I played little role beyond cooperating.
For ~5 years now I've been doing 300-600 push-ups daily, two sets in the morning and two in the evening. My wrists never bother me, not during push-ups, not at the computer, my injuries are a forgotten memory that I'm only reminded of in threads like these. There's usually also some sets of ~12 hand-stand push-ups, and holding a hand-stand for a minute while doing leg-spreads against a wall.
The only reason I'm able to sustain this daily routine is my weight got down to ~165 (5'8") from ~225. This didn't result from exercise, just vastly improved nutrition fixed my weight. After my weight was normal, the activity started because it was easy, fun, and painless. Words can't describe the pleasure of doing calisthenics with a body 25% lighter than it used to be. My experience exercising now is a daily celebration of being alive and well, and the feedback these activities provide keep my life in check.
I've also noticed that as I became stronger and more adept at push-ups, I was less abusive to my wrist joints and instead distributed the weight across my fingers and even slightly elevated the heel of my palm rather than leaving the area inactive (letting the wrist joint just take up all the abuse as I repeatedly drove my weight into the floor through it.) This wasn't possible for a long time because all the other muscles had to develop and catch up to the chest which was always capable of doing 20-30.
For those of you saying your wrists are ruined from daily push-ups, I'm dubious of your claims. My wrists seem to only become more resilient as I do more push-ups. If you're overweight, have gout, or something else caused by poor nutrition then you should probably address that instead of ceasing the activities altogether. There are more or less abusive techniques to push-ups, and if you're doing them daily in large quantities, you should be able to develop a painless technique, be nicer to your joints by activating the muscles in the area.
Nerve damage is serious business kids! If you feel it coming on, you need to pay attention and take action. Don't wait until you start randomly feeling needle stabs all day like I did while in the middle of a year long, high pressure, large code volume project. Doc told me to get surgery. I cured it myself the hard way instead. Huge inconvenience for many months. Very happy with that decision today. Here's what worked for me:
* Two keyboards and two mice. One set on my desk. The other keyboard on my lap and the other mouse on a pedestal at my side. I would switch up which keyboard/mouse I was using every 10 minutes or so.
* Typing like I couldn't move my hands. Literally letting them hang limp and moving my arms a lot.
* Pay attention. Take breaks. Notice what feels bad. Notice when you need to change up what you are doing --probably many times an hour. Take off your watch/rings. Watch out for resting your forearm/wrist on anything.
I had some pretty bad RSI that I thought was going to kill my career also.
Turned out, I managed to eliminate it by completely changing my keyboard technique to tuck my thumbs underneath my fingers when typing. I'm surprised no-one ever told me about this before.
The action of tapping the space bar with the corner of your thumbnail instead of smacking it with a big lateral thumb tap makes all the difference in reducing strain on your carpal tunnel.
If your arms are at rest beside your body while standing, the 'natural state' of your fingers and thumbs in this position is the exact same hand posture you should maintain when typing. If you are instead performing an up-down movement with an unbent thumb, that can lead to RSI problems.
I've made a few extensive posts about this here before too. Had 24/7 RSI paint for years. At the worst I couldn't hold a mouse.
Thousands of dollars of ergonomic chairs, keyboards, and so on made it so I could work but still had constant pain.
Started doing pushups (which I had avoided because I thought they made it worse.) Four weeks later I was using a laptop and suddenly it hit me I had been typing for 30 minutes with no pain. Life changing. Zero pain now and I can work 12 hours straight.
Definitely is some combination of the muscles and tendons tightening up in the arms and shoulders. The pain being in a different spot makes in misleading.
I've been saying this for years to my colleagues. Pushups is key to basic overall muscle health. A simple exercise, can be done anywhere, and works your entire body. You'll no longer have lower back pain either. Take a break every hour or so, bang out ten pushups, go get some water. Get back to work. No big deal.
I really don't think one can emphasize the health and life benefits of any sort of full-ish body strength training. I'm a huge proponent of full body movement based barbell training, but exactly like you said, pushups, pullups, that sort of thing makes every aspect of your life better. No one has ever regretted getting even a little bit stronger.
I love rowing for conditioning. It's up there with prowler/sled for puke factor if that's what you're going for, and it's great for general cardio if you don't like uncontrollable body tremors.
I've dealt with RSI and carpal tunnel syndrome for almost two decades, off and on. Some of my triggers are chairs with arms (I almost can't help but lean on them, making my posture horrible and disrupting blood flow), bad weather (rain and cold), stress, depression (all pain is worse when you're depressed).
My first real recovery came when I got an Aeron and lowered the arms enough to where I couldn't lean on them, switched to a tiling window manager and stopped using the mouse (I am back to normal mouse and window manager these days, but when I feel the twinges of pain, I will sometimes switch back), and fixing the source of some of my stress (money was a stresser back then, and I took a contract job that paid well and got my debts paid off and some savings in the bank, so I could get back to working on the stuff I wanted to work on).
I don't know which of these things was the real cure, though I do know that using a chair with arms I can lean on is the fastest way to bring the pain back.
I suspect it is never "cured", it's just managed. Since figuring out my triggers it's been rare that I've experienced the pain for more than a few hours or days, and taking a walk, massaging my hands and wrists, etc. can usually get me back to work.
I was a bit paranoid about this in my mid 20's, so I learned touch-typing the Dvorak layout (well supported on all major OS's, so no problem using it everywhere), got myself a decent mechanical keyboard a few years later and I use vim for editing since forever (fewer key-combos is good against RSI, so modal wins out here). Most recently I have switched the Ctrl and Caps keys on my layout, which reduces a lot of stress on my pinky finger. People think I'm a total geek (which is OK considering I'm in IT), and this works quite well in my daily business.
Now in my mid-30's I have no problem and enjoy typing very much, so I guess the best thing to do is start with the precautions before the damage is done. Of course my conclusion might be very much premature, but I'm carefully optimistic.
I did the same. When I was in my 30s my hands were cramping while I was typing so I learned dvorak and then built up the skill to switch between them easily. Now it's dvorak at home and qwerty at work, and no cramping since. That was 20 years ago or so.
> How big of a difference did Dvorak make for you?
I've been a Dvorak user for ~20 years. I only use a laptop, am working on it basically all day every day, and have terrible posture. And I've never had any RSI issues.
IIRC with Dvorak your fingers only travel about a third as much as when typing on a regular keyboard. Even if it hasn't been scientifically proven or whatever, imho anyone in the tech industry who isn't using Dvorak is crazy.
If you worked as an orchestra conductor, would you spend your weekends going to EDM shows without hearing protection? Of course not, because you make your living using your ears. Same idea.
While I'm not a Dvorak typist, it seems to me like the benefit from getting your keyboard at a proper height and maybe doing some hand and wrist strengthening is going to be bigger than switching keyboard layouts.
Just using Qwerty for a few sentences feels awful. It doesn't hurt, of course, it's just a few sentences, usually on someone else's computer. But it's like using chopsticks to eat oily rice, when you're used to eating potatoes with a fork.
The longest one-handed QWERTY words are "sweaterdresses" and "stewardesses" as far as I know.
But anyway, as a programmer, you spend more time hitting key chords and special characters, which aren't much better in Dvorak and are probably part of why programmers are so prone to RSI despite in absolute terms not typing that much compared to, say, a secretary.
I spend lots of time typing emails, documentation, HN comments, comments within code, and so on -- this mostly fits the secretary distribution of keypresses.
Even when I'm writing code, alphabetic characters and normal punctuation are still by far the most commonly used. It's only the rare punctuation []{};: that's worse off, and even within code I still type for more S characters than semicolons.
If this concerns you, there's Programmer Dvorak layout, but I prefer to keep compatibility with a wider range of computers and use standard Dvorak.
My pain started coming back this year. One thing that always helps my mouse hand, is to rest my arm on a raised surface (currently a portfolio), but I've used a textbook before. This caused my hand to drop down to touch the mouse, instead of being pushed up, and changed the body part that gets anchored and pivots when moving the mouse from my wrist to my elbow. That really helped a lot.
I still had issues with my left hand, and for me what has helped this time around is a ComfortBead Wrist Rest along the bottom of the keyboard. I'd used it years ago and wasn't convinced, but this time it's clearly and definitely helped a lot.
In the past, I've sometimes gotten some relief by switching which hand is the mouse hand. Every once in awhile I'll let my left hand control the mouse for a bit.
One useful approach is to use dramatically different mice on different PC's. I find focusing on the one true way, sets you up for RSI in your new setup.
> and changed the body part that gets anchored and pivots when moving the mouse from my wrist to my elbow.
I'm not a doctor, etc.
I set my mouse acceleration pretty high. I have a relatively small mouse, Logitech M325. My forearm, elbow and shoulder don't move at all when I move my mouse.
To move the mouse from one corner to the opposite diagonal, the mouse just moves under my fingers. Most of the time my wrist doesn't move at all.
I've been a programmer, and later jobs that type just as much, since the eighties, and I've never had any kind of RSI. Of course that's me, my body and activity, YMMV etc. But this is worth a shot.
It's also extremely fun to watch a colleague try to drive my mouse and drive off the cliff.
EDIT: Thinking about this a little more. First of all "I've never had any kind of RSI" could just mean that I'm not susceptible to that type of injury.
How I hold my mouse: (works for me)
If I hold my arm up a bit, so that my upper and forearm are something like a V, hand held loosely out and relaxed, then the thumb and index form something like a V, and the fingers are loosely spread out. This puts my thumb about an inch, inch and half below my index.
Now I drop my hand down over my mouse (I don't actually go through this procedure, this just gets you to my position), maintaining that hand configuration roughly. This puts my thumb and pinky just below the bottom edge of the mouse, index on the left button and middle resting lightly on the weel, and ring finger just under the top edge of the mouse on that side. If I pick up the mouse it's held by the thumb and pinky, with a little extra support from the ring finger. To use the right button I move my middle finger over as necessary.
Note that I don't have to move my middle finger forward or back to use the wheel, it's already there. If things get wheely I can lift the middle up a bit. For my hand, this puts the back of the mouse below my highest knuckles.
There are depressions on both sides of the mouse, which look like the natural place to hold it. But if I move my thumb and pinky up into the depression, that pressures my index and middle up. To depress either button or mousewheel it feels like I'm slightly overextending my fingers, and I can feel more effort in my forearm muscles. I also feel effort in my wrist to hold my hand up like that.
When I move the mouse, the outside edge of my pinky and side of my thumb drag on the desk (or couch, at the moment).
If I do lift the mouse up, I just hinge my wrist up a bit, I don't lift my forearm. And my hand hardly moves out of its place, to the point that I sometimes have to clean gummy gunk off my desk, within about the area of a single hand, in one specific place.
So this works for me, I think, because I let all my hand/finger positions and muscles be as natural and lazy as possible. Plus, the mouse fits my hand well, and I've been doing it like this for a long time.
Side note: I hate track pads, and always disable mine, for whatever that's worth.
As already mentioned, everyone's RSI is different so no one solution works for everyone, and if you have RSI, you should try everything until you find something that works for you.
The two biggest wins for me have been a standing desk for posture improvement, and wearing wrist braces at night.
I got an RSI injury on my left hand and was unable to type normally for a few years. I went so far as to learn Dvorak RH which, even though I got reasonably good at it after a couple of years, was still crappy for programming.
After a very dark period of taking jobs that required less typing (Kafkaesque jobs at mega-corps involving mostly fixing other people's bugs), I'm better now because of:
1) Using an Apple keyboard, which even though it doesn't look ergonomic, the reduced key travel has helped immensely.
2) Using JetBrains' IDEs instead of vim. If you are a bash/vim/tmux (or equivalent) user like I was, try coding in your favorite language in a JetBrains IDE. Automated refactoring and code completion are your friends.
3) Try drinking red wine. The resveratrol in red wine is a natural anti-inflammatory.
It's not so much the key travel as the overall 'feel' relative to how your muscles learned to type. Everyone's different and react differently to different keyboards. What's most likely the issue is the not-conscious feedback loop that tells your fingers when to stop pressing. With some keys you type lightly, other types of keyswitches lead you to mash the keys with a high force until you're bottoming out on the pcb. It's that impact that generates high forces.
Does that mean that if I type very hard and I feel there's no hope for me to learn not to bang on the keyboard, the most, well, healthy keyboard for me will be the one with the longest key travel?
Maybe for some? I had been using an "ergonomic" Microsoft keyboard for years, but found that it was the amount of force and distance to depress a key that was causing me problems.
I'm using the Microsoft Sculpt keyboard at work at the moment, which has a similar ergonomic layout but less travel than my old Natural. It's also really nicely made (magnetic stand + battery cover, and fairly sleek design).
However, one fairly significant issue is that the top row uses buttons instead of keys. It doesn't bother me too much, but I can imagine that would mess with some people's workflows. Also the corresponding "ergonomic" mouse was the worst I've ever used. It's like a large ball that forces me to stretch and grip constantly to keep my fingers on the buttons. I replaced it almost immediately.
It is, but I had the same experience as GP FWIW. For me mechanical keyboards are the absolute worst; light touch, short travel, and switching to Dvorak are what saved me.
I used Sarno's book to cure myself back in 2002 and this approach has been successful ever since. Occasionally I will have some issue (though rarely wrist pain), and I can make it go away quickly by addressing the psychological root cause.
I highly recommend reading his book "The Mindbody Prescription"
Me too. It was a big cognitive leap to accept that the pain could be psychological, but once I'd made it and accepted it it worked. Still get pain from time to time, don't worry about it and instead try and work out what's bugging me that I'm not engaging with, and this nearly always gets rid of whatever it is.
I had to quit programming for six years because of an RSI. In attempt to get around it, I even spent a year and half (painfully) writing a new kind of 'higher level' text editor better for use with motion sensors [1]. Now it's been ten years, and I still don't exactly know what the cause was/is, though I've got it to a point now where it's at least tolerable.
I think the most confusing factor here is the (potential) mental component to these injuries. I personally ruled that out as a possibility for the first five years or so just because it didn't really fit into my understanding of things that I could experience physical pain via something mental. The idea was tantamount to calling the pain artificial, which I knew was very much not the case.
The article (and others here) mention Dr. Sarno. I also read a couple of his books, and a couple more from others who think in the same basic framework. It helped. I'm certain there is/was a mental component—but I don't think Sarno et al's framework is good enough yet (don't get me wrong though—it does work for some people). Aside from results being imperfect, the fact that much of it is grounded in Freudian psychology is an obvious defect. I think they've hit on some techniques that can help, but the theory is bad (which prevents them from effectively refining the techniques).
My latest idea on what has caused all of this: I had some kind of physical injury early on (maybe tendonitis), and it eventually resolved itself. However, I developed this habit of very anxiously monitoring/testing the wrist/hand pain whenever using mouse and keyboard, which would cause the muscles to tense to the point of being painful. Unfortunately, my mind failed to distinguish between the original pain and that caused by tensing, so I continued operating under the assumption that I had some RSI, and continued vigorously worrying about it and attempting to solve it.
The only thing I can think of doing now (and which I am actively doing), is getting better at meditation so I can hopefully one day let go and not worry and tense up while using mouse/keyboard :/
Sarno's program completely cured my RSI. My highly-regarded surgeon was ready to operate for cubital tunnel, which had been getting progressively worse for about 2 years. I was to the point that I would feel pain all the time while typing, and had some tingling/numbness. I was concerned about surgery, so I decided to try some alternatives first, and the stuff from Sarno was amazing. It was scary as hell to just tell myself that the pain wasn't real, and that I wasn't hurting myself, but I figured it was worth a shot.
It's been 10 years since then. I now have zero problems, no special exercises, no ergonomic keyboards, chairs, desks, etc. I also regularly play ARPGs like Diablo 3 and Path of Exile, which make most people with RSI cringe.
I agree that Sarno's framework is not perfect. I'm not sure I buy his explanations as to why it works, but it does work. The key is that there is a huge mental component to RSI (or, at least, to some cases of RSI) that most people don't acknowledge. The monitoring/worrying about damaging yourself does something to those muscles/tendons that builds up over time.
I started having back issues about five years ago. It got so bad that getting out of bed in the morning was a struggle. I was diagnosed with a herniated disc at L4/L5. I tried chiropractic, acupuncture, and massage therapy to no avail. Then I came across one of Sarno's books. I remembered Howard Stern singing his praises years ago on his show, so I decided to at least give it a shot. I was very skeptical, but within the first twenty pages Sarno had described my situation to a tee. I started following his advice and saw immediate results. I was back to running and doing yoga within a few days and a couple weeks later I was back in the gym doing dead lifts. Aside from an occasional flare up during stressful periods, I haven't had any issues since then.
However, I don't agree with Sarno's view that the mind uses pain as a diversion from psychological or emotional issues. I think it uses to pain as a way to get our attention, to let us know that we need to deal with those underlying issues.
Your interpretation matches my experience, too. It seems more like the mind uses pain and anxiety to call attention to the fact that something is wrong, rather than to distract us.
I am another Dr Sarno advocate. I had been out of my startup for two months, in utter despair. I happened to bump into a friend who recommended the book and free online course. It changed my life.
Another Sarno cure checking in. I had debilitating "RSI" for two years. Read The Mindbody Connection by Sarno and within just a few days I was feeling much better. Within a couple of weeks I was virtually back to normal. It's been almost two years now since my recovery and I am doing great. I would highly recommend Dr. Sarno's books to anyone with "RSI".
(warning, anecdotal) I have been behind a computer full time (>= 8 hrs/day) (usually including weekend) for over 30 years now, I take breaks for exercise, cooking & parties and have done for most of that 30 years. I have found, for myself anyway, that RSI has zippo to do with the amount of typing, mousing or work I do. I have done years of 12 hr days full on typing and I have gotten beginning RSI symptoms from a few weeks of stressful meetings with very little typing in between.
As I was young then and did not want to waste time not being able to lift my arms or move my wrists, I experimented and found that, again for me, it's just 100% stress. Any exercise (none, too little or too much), working 20 hours or 2 hours are completely unrelated for the onset; if there is a stress factor (like; our new product is not selling!! back then) I would get symptoms immediately and they would get worse once started when typing/mousing more if the stress factor stayed constant.
After that and other health events triggered by (much heavier) stresses, I got my brain to not stress (took me a lot of years) and that worked. I can just work forever behind a computer (which I usually don't need anymore, as I found also that it's completely useless to work many hours / day) without any effects for the past 13-something years.
I got RSI some 26 years ago, due to entering a university CS environment where the workstations and terminals had very light action keyboards. I was used to hammering on stiff, long-travel behemoth keyboads, and of course continued that same pounding on the light ones which shocked the tendons, since I was basically tapping my fingers hard against the keyboard base with no shock absorption from the keys.
The fact that I was doing curls with 45 lb dumbbells in the gym didn't help the wrists, either, not to mention playing guitar.
I ended up with pain, tingling and numbness. The university sports med clinic prescribed a NSAID (naproxen). That did provide some relief.
I overcame the RSI by working exclusively through a DEC VT100 terminal (the actual DEC VT100). Its heavy-duty keyboard with stiff action and long key travel didn't irritate my wrists. Eventually I went over to the light-action/short-travel keyboards that are now ubiquitous.
This may help someone out there. I had chronic tennis elbow for years, tried a huge array of options to fix it and failed... until: I found a _vertical_ mouse.
Wish there was more competition in ergonomic input devices. Was just searching for a new mouse and couldn't find a vertical mouse with acceptable reviews.
Ended up forgoing the vert. mouse altogether and buying a Logitech MX Master to replace my Logitech G500 (which I've used for many years and is now discontinued) and I'm pretty happy with it so far. I'm even pleased with its gaming performance (probably not OK for highly competitive or pro gamers, but np for me). Mouse was visibly sluggish over Bluetooth but works great over Logitech RF.
Although the MX Master is not billed as an ergonomic device, it fits my hand better than the G500 and I already feel some relief of the slight pain in my right wrist.
I've used a Kinesis Advantage keyboard for about 3 years (and the MS Ergo 4000 for several years before that, in response to pain that developed before I even turned 20) and it's been a godsend. Would like to find a good ergo mouse before I'm forced to.
The DXT Mouse by Kinesis is the absolute best mouse I've ever used. It's ambidextrous so you can switch back and forth to do wear-leveling. It's crazy comfortable. You may have to raise it up on a book or something though next to your keyboard due to the different way you hold it.
I switch back and forth between a DXT mouse and a trackball every couple days so that I'm not always doing the same motions.
I also use auto-click software so that I don't have to click the mouse. I use RSI Guard which has this feature.
The Microsoft Sculpt Ergonomic mouse is semi-vertical (this might depend on how you hold it) and tracks better than the Evoluent mouse I was using before, although the ergonomics are probably not as good. The build quality is also better IMO than the Anker / Sharkk vertical mice popular on Amazon.
Haven't tried the DXT mouse mentioned in the other comment.
Yup, vertical mouse solves most of my right-side issues. It can't be one of those cool-looking vertical mouses either (e.g. Anker, Evoluent). While those do help, it's not enough for me. I get the most relief from an actual joystick vertical mouse.
Not a vertical mouse, but surprisingly good. Only miss mice when playing around with graphics software. I have it in PS/2 and USB, and they did a hack job with the USB hardware, it's very low resolution. PS/2 connector gives a very smooth and nice trackball experience if anyone is tempted.
I had problem with my right hand. Majorly due to mouse usage. I'm not typing much (even being software developer).
I have also tried different physical activities but it's only solving problem temporally.
So my lifehack: switch mouse to left/right hand from time to time (or at work left handed, at home right handed). That's it.
Yes, it's a bit awkward on beginning, but take that as challenge. And it will bring less harm than pills. In couple weeks you won't have problems to use mouse with any hand.
Of course if you're typing a lot and you have problem with both hands due to keyboard usage my solution will not work for you.
I also switch back and forth which hands I use the mouse with. I use the Kinesis DXT mouse which is an ambidextrous vertical mouse. It makes this use-case very easy. switching hands is as easy as pressing a button and moving it.
I also recommend using auto-click software so that you don't have to click the mouse as often. I only click to click-drag, double click, and right click.
I also use the CVim chrome extension to browse with a keyboard.
When I first started getting RSI, it was in the mouse arm, up near the shoulder. I did something similar, but wound up with a mouse on each side of my keyboard. That cleared it up reasonably well, and since then my main mouse has always been on the left.
I think that the combination of a keyboard with a numeric keypad (wiiiide) and a right hand mouse is the main trigger, not the concentrated mouse usage with one hand. If I could find one of the narrow model M keyboards, I'd consider moving back to the other side.
The other things I've done have all centered on being aware of where nerves are near the surface, and never putting pressure there. If you're getting numbness in the thumb and first finger, it's likely carpal tunnel. If it's all over, it's more likely at the elbow.
Go vertical, kids. For keyboard, I have used a Kinesis Freestyle w/ the Ascent explicitly designed for this purpose but now I just use the Matias Ergo Pro with some tripod parts to keep it vertical https://geekhack.org/index.php?topic=79810.0 (since the pic I have changed a bit but nothing significant, I have these four parts now forming an adjustible, 12" long column: 1/4" to 3/8" male-male spigot, Manfrotto adjustible column, Triopo Short Column, 3/8" female to 1/4" male adapter). The huge advantage of this vs the Kinesis is the super light weight so you can travel with this setup easily. And despite the end result is quite wide it actually collapses into smaller parts so I can just pack them in the same padded tablet bag as the keyboard. Alas, the same bag is now out of production and I honestly have no idea what to recommend. In the same forum you can find other solutions to keep it vertical.
For mouse, Evoulent is good and I have used many generations of it and I can tell you the difference is negligible so you can just go on eBay and buy an older generation for cheap. It is a b!tch to travel with as it is really oddly shaped. Oh well, nothing is perfect.
I've always wondered why they don't make keyboard halves that attach to arm rests on the typical office chair. So your arms are lowered for more blood flow, and the wrists and elbows in a more natural/neutral position. I'd buy it.
In the meantime, I have a MS "natural" keyboard, and a vertical mouse as well. Those have solved all my RSI/wrist pains.
Going back to flat or compact keyboards and horizontal mice is extremely annoying. Not just the muscle memory gap, but the positioning just feels wrong.
My experience is that vertical keyboards only alleviate some problems and even cause new ones. They do relieve pressure from the ulna and radius being in a twisted position and they obviously relieve pressure from the side of the hands. On the downside, they put strain on the shoulders and neck since the arm is held freely in the air for prolonged time. Vertical keyboards also don't help with issues due to spreading ones pinkies too far for reaching control, shift and enter. For me the Kinesis Advantage was overall a far better relief. None of the measures I tried were however more effective than stretching and upper body strength training.
I had the problem despite of arm rests. Keeping the hands in a lifted position was the problem, moreover even a slightly bad pose caused my hands to bend downwards to reach the keys, which is also suboptimal. Armrests themselves are not optimal for supporting the arm because the surface area is small and hence the pressure is high.
Never even considered going "vertical" for a keyboard. I wonder if a future laptop utilizing this would have a screen hugged by two keyboard-buns? Future tech sandwich.
The thing about these pains is that they can come from, and be cured by all sorts of things.
I once got a terrible pain in my right arm, couldn't click with my fingers, couldn't move my mouse. After a week I saw a doctor and he said I was tense in my shoulder, which wasn't causing any pain, and showed me a stretch.
Stretching for 2 days cured me, and I've never had the problem again.
The take-home message isn't that you should stretch, but that the cure for these things can be almost anything.
Here's my anecdote. I had painful but not debilitating RSI-like symptoms for a couple of years. For me, fixing this came down to a set of fairly simple things: the Kinesis Advantage keyboard mentioned in the article, setting a timer to force myself to take rest breaks, focusing on posture when working. At least in my case, the issue seems entirely mechanical, and I'm sceptical of psychological and emotional explanations like Sarno's.
It can contribute though. I typed at high speeds for years without issues, it wasn't until I took a stressful job typing all day and my muscles were constantly tense that I got RSI.
I've found that there are a number of different prescriptions for RSI pain, and that you have to experiment until you find what works for you. But that's complicated by the fact that it's hard to run experiments on yourself because there are so many confounding variables.
In any event, to add to the anecdata, someone below recommends not resting your arms/wrists on anything and letting your hands float above the keyboard. I've tried this, and the small muscles in my back that keep the arms lifted would become sore bundles of fire that eventually would spread pain throughout my back/neck/arms/wrists.
I found, paradoxically, that totally resting my arms splayed wide on my desk combined with a Kinesis Freestyle so I can keep my wrists straight (this wouldn't work with a regular keyboard) is the ideal setup for me.[1]
Not saying this would work for everyone.
[1] I have a standing desk combined with a high chair oriented such that the desk comes a bit higher on my chest than a sitting desk would, such that I can just rest my arms on the desk. The keyboard is not elevated and is basically flat to the desk surface, and is separated and angled such that my wrists are not bent.
I've been a software engineer for nearly 30 years and I was diagnosed with tendonitis in my first 5 years but I have managed to hold RSI at bay. I pay attention and if any pain surfaces I take action that day. I do not ever, ever wait.
This is what I do:
1. short regularly enforced breaks. I use WorkRave to take a break every 10 minutes for a minute and 6 minutes every hour. I skip these breaks if I'm fine but use them if I have any soreness.
2. A keyboard that allows my hands and wrists to be vertical and can be configured for any slant. I use a comfort keyboard, not easy to find anymore.
3. Ice baths. If my wrists are sore at all I immerse them in an ice bath for 7 minutes each, morning and evening. This really works. So cold it hurts.
4. Pressure point massage therapy. Releases tension in the muscles. It hurts but works. I do that once in a while.
I would pay for a version of WorkRave that worked properly on my Windows 7 work laptop. It would be nice if it prevented me from issuing commands on my Windows 10 touchscreen too, so I can't just scroll through articles cheating on my break.
I can attest to the pressure point massage. After having two sessions (three was recommended) I could use the computer for a few months without feeling any pain nor the need of using a wrist strap (or whatever it's called).
Just as an aside, don't neglect your neck. I have had a couple bouts of pain, that felt for all the world like it originated in my left wrist. Turned out it was a pinched nerve in my neck. Physical therapy and a standing desk were the cure for me. (Of course it might have just cured itself too).
I've had a little on-again, off-again RSI trouble over the years. A couple of years ago, this topic came up on HN, and I picked up a very useful tip. Somebody shared that they had (heard|learned|observed|whatever) that most of the damage resulting in RSI happens while you sleep, not while you type. So they started wearing a wrist brace to bed and it fixed their problem. In my case, it turned out that wearing the wrist brace to bed also helped tremendously. Usually if I have an RSI flareup, I make it a point to wear the brace to bed (and possibly also during the day a bit, but not all the time) for a few days, and the pain goes away.
All of that said, knock on wood I guess, as I haven't had a serious flareup of wrist pain in quite some time now. Not sure why, but I'll take it.
While I used a lot of aids, trackballs, special keyboards etc, the one thing that really made the difference for me was weight lifting exercises for the wrist.
I had a friend who had problems and discovered through research that reversing your mouse buttons does it. The tunnel/tendon used by the middle finger is much better for some reason with the constant clicking.
This resolved it for him, my wife and me as well. I hope it helps someone else.
I have off-and-on pain in my right index finger. (Arthritis is one possibility.) Some of the time, I turn my mouse hand a bit and use the middle finger for the left button.
Try actually reversing them so you always use the middle finger all the time. It takes a little getting used to, and using someone else's computer (or them using yours) is a pain. But I find it takes just a day or two to see big differences.
You also can simply move your mouse to the other side of the computer, and run it with your left hand. (You can reverse the buttons or not, as you prefer.)
The author's experience is consistent with my own... Most incidents of wrist/hand discomfort that I've experienced have started in cold or drafty environments. In these cases, I've found fingerless gloves have helped, as have breaks for walks and warm water rinses.
I'm certain that inadequate blood flow is a major contributor to RSI, and that's probably one reason that exercise seems to help so much. Unfortunately, I think, environmental temperature is often overlooked as a source, maybe because it can affect individuals in so many different ways (e.g. https://en.wikipedia.org/wiki/Hunting_reaction).
I believe that the primary cause of my hand pain is my forward head posture. This can create trigger points in the scalene muscles of the neck which cause sattelite trigger points in my forearms (especially the extensor muscles) and in my upper arms as well. These trigger points then refer pain to the hands. Self-massage using a lacrosse ball has pretty much eliminated my pain and seems to significantly increase bloodflow to my hands.
NOTE: be very gentle the first time you do self massage of the scalenes with your fingers. I went too hard and my scalenes swelled up for 3 days and I experienced the symptoms of thoracic outlet syndrome, ie. I had numbness from my collarbone to my middle and ring finger on my left side. It went away once my neck healed.
It definitely seems circulation related: whenever I use a computer with cold hands, it causes tension and then pain.
I make sure to never use a computer with cold hands. I recently purchased this Far Infrared heating pad to heat my hands. It really does work a ton better than traditional heating pads with resistive coils. https://www.amazon.com/UTK-Infrared-Electric-Therapy-19-Inch...
Also, it is critical to correct the weakness and structural problems in the body. I do yoga, strength training, and swimming and these seem to be helping keep the trigger points from coming back. I am also doing shoulder mobility exercises with a stick and following this guide to correct my forward head posture: http://posturedirect.com/forward-head-posture-correction/
Just under half of the exercises prescribed by my physio are in that last link, and I expect that many of the remainder are coming up in a future appointment.
I had a similar experience: keeping my hands warm while keyboarding made all the difference.
Before this I was at 20% use for 3 years, tried multiple things, went to multiple doctors, etc.
I also: wear a pil-o-splint while sleeping so that area of my wrist can relax at night, make sure my hands are warm and that I've stretched before starting for the day, and changed my typing posture so that my hands are mostly flat and wrists don't touch the desk/keyboard while typing.
Finally, I stopped using emacs and the like because of the control key induced hand/finger stretching. Vim is more RSI friendly in my experience because there is less stretching required to use it.
Got a hand grip exerciser: https://www.amazon.com/dp/B01AJ6HZLG?psc=1 wonder if this just helps with blood flow like suggested. Perhaps then maybe rubbing some warming lotion might help as well.
I use an IBM Model keyboard. It is a larger keyboard so there is less sideways bending at the wrist, but Kinesis keyboard might be better there.
An adjustable standing desk. I try to stand as much as possible, and then adjust the height to keep arms relaxed.
So far feels much better, sometime pain goes away completely, but still not 100%.
My left hand started aching about two years back, mainly when I was in Emacs. (I have the key to the left of "A" remapped to "CNTRL".) So I switched to Vim, which involves fewer painful single-hand key "chords". The pain went away within days, and has not returned. Of course, I'm not happy with the new Mac keyboards that lack an ESC key, so I am teaching myself CNTRL-[ as an alternative, and am happy that this splits the keys across two hands, which causes no pain.
For me tho soluton was switiching to the Dvorak Keybeard.
The reduced travel of my hands has really helped.
All it took to switch was:
1. Practice in KP Typing Tutor 1 hour a day for 3 weeks.
2. Change my computer configuration. (The first week of change was the hardest, I was at 50% my normal speed).
3. Done.
Changing to another keyboard has a price you won't comfortably use other people's computers.
And they won't be able to use yours.
But the benefit of being without pain is so worth it.
In this thread there will be many people with many different degrees of RSI who have solved it using a variety of different solutions. That is because the symptoms can be caused by a variety of different things. The defacto standard high level overview is https://www.amazon.com/Its-Carpal-Tunnel-Syndrome-Profession...
This and the book in the comment previous have both been helpful to me, along with good physiotherapists who understand trigger point release.
I use a split keyboard with a graphics tablet in the middle and a mouse either side of the keyboard - this gives me a good variation of hand position. Right hand mouse is vertical.
I find stretching, weights and cardio to be beneficial. The stretching helps to keep the nerves free from impingement, the cardio keeps a good blood flow, and the weights are rebuilding strength and muscle that atrophied during the year where it was too painful to use my hands & arms.
Thanks everyone in this thread for sharing your techniques - it's always good to hear what other people find effective.
The real solution is we should only work 30 hour weeks. Try telling that to your boss though, it's often hard enough to get an ergonomic pencil.
Weightlifting and exercise are the only surefire ways I've found of combating the kinds of pain I experience as a programmer. I was able to utilize my doc's recommended steroid injections (and Kratom from Indonesia) in order to get myself to a point where I was working out every day. Years later, I haven't had to deal with any of those issues any longer. I am also a much better programmer for being a generally much healthier person.
I fucked my wrists by spending 8+ hours a day on a laptop from age 12 to 22. I have one of those at home, and one at work. They are really good. I went from being able to type 25 hours on a regular keyboard to 50 hours a week with minimal pain on this one.
The sculpt has empty space in the middle (above the space bars), I always liked the thinkpad clit mouse - so I hacked a small trackball in the middle of the keyboard.
The original Microsoft Natural keyboard saved my career.
Two weeks out of school, I had unendurable pain in both hands. I bought a Natural keyboard, the pain went away immediately, and only comes back when I use a laptop keyboard for coding for more than an hour or two.
The fact that it comes back after an hour or two of laptop keyboard use strongly suggests that you've not addressed the underlying issues. That's one of the key things I see cropping up repeatedly here - "I've found something that helps with my pain, if I stop the problems come back."
I regularly use laptops, standard keyboards, and have no problems. When I had RSI, it was bad enough that I couldn't hold a fork for almost three months, and typing was an exercise in agony.
Seek help from a good physiotherapist, but you'll need to do some research to find a good one.
Also, see if you can find the bad habits you have that promote your injuries. I have upper body muscle tension and poor posture, and when I first recovered from my RSI I was having problems all the time with writing, typing, absolutely everything. It turned out that those problems weren't bad feelings, my hands and forearms had lost a significant portion of their strength, yet I was working just the same as I had been beforehand.
Growing up, my family computer was set up with a very specific model of Logitech trackball, the one shaped like a standard mouse with the off-center ball that rests under your fingers, not your thumb.
It's the only trackball of its kind I've ever seen, every other model is either a tiny thumb-ball, or an enormous whole-hand deal.
They stopped making them years ago, and now you can only find them from scalpers on Amazon for upwards of $4-500.
It's frustrating, because I'd love to get back to using a trackball, but every other model seems less comfortable to me than a normal mouse.
I started having indicators of Carpal Tunnel about 10 years ago. I had heard good things about certain wrist supports while typing, but I'm a Systems/Network guy; so I frequently do other things than just sitting at my desk. Wearing a wrist guard was very inconvienent.
So, I started wearing one at night while I slept. It took a couple of months, but I've never had problems since.
I finally got RSI. I knew it would happen eventually since I'm on my computer all the time, so I just accepted it. When the pain in my wrist became too much, I'd shift positions or take a rest.
Then one day it occurred to me that I had gotten RSI right after getting a new watch. I loosened the watch by one notch and all symptoms disappeared.
None of the comments so far seem to have picked up on the mention of caffeine. For me this was the revelation; paying attention to how a strong cup of coffee alters my posture and increases tension from my back through to my wrists. I also notice myself long-pressing shift/ctrl/alt keys in a state which I can only describe as 'over-determination'. (Funnily enough, a large pot of green tea delivers a steadier dose of caffeine and doesn't seem to produce these negative effects)
Not everyone is affected this way and I believe the root cause that caffeine exacerbates is the particular kind of stress you feel when you want to get something done already, a typical state of mind to be in running a startup. Stress and psychological factors feed directly into bad posture and this is why taking regular breaks only upped my stress levels as now I needed to work even faster.
Lastly on the level of equipment fixes, ensure your elbows are supported by arm rests.
To anyone who has ever had pain or soreness or numbness after a prolonged coding session and it went away after some rest, pain is the first sign. Eventually what happens (and what happened to me) is that you need more recovery time to get back to a baseline normal. And eventually that baseline normal becomes a combination of symptoms: residual numbness, soreness, or pain.
Please don't take your ability to "pound" away at the keyboard for granted. And please don't make jokes about RSI ever. It is not a joke, unless you think a "punch line" of seriously thinking about having to type a lot as a liability for your career.
Swimming is quite possibly the best exercise. See http://totalimmersion.net for an alternative to the Red Cross endorsed and rather inefficient "pretend you are a human paddleboat" method.
Good luck! Ignoring the problem will not make it go away.
There is no definite answer. It can and sometimes it can't. Hand and wrist problems are not always just hand and wrist problems. Sometimes they are a symptom of improper alignment and/or stress on the shoulder joints. If that is the case, swimming, a zero-impact (to your joints) activity, through exercising the full-range of motion of your shoulder and related joints can help relieve some of that stress/tension that filters down to the hand and wrist.
I do pretty much everything wrong in terms of ergonomic working. No wrist rest, no typing technique, sit however fits the day. The only thing I don't have in common with the OP is that I'm constantly hot. Sitting in a room with no heating at 1000m above sea in the Alps right now, wearing a light track suit and only registering a mild cold. I haven't turned on heating in ages, actually.
The article does suggest psychosomatic causes more than anything, imho. Especially people with neither medical training (me included) or prior contact with that phenomenon (me excluded) often seem to think about this as a question of willpower, a conscious decision or a few sessions with a therapist. I beg to differ. If your hands pain you to the point of forcing you to change careers and there's no physiologically pinpointable reason, I don't see how the most complex parts of our bodies could not play a leading role.
I have light wrist pain that is worse some days than others.
What helps me.
1. Heavy deadlifts. This helps grip strength a lot and strengthens my wrists.
2. Posture. I removed the arms from my chair, like SwellJoe mentioned.
3. Posture. Keeping my hand positioned on the keyboard properly. Don't rest the wrists on my laptop.
4. Stretch.
I had an RSI "scare" about ten years ago while I was a student and similar things worked for me. I started to wear fingerless gloves or other things to keep my joints warm while typing and I took steps to reduce non-physical stress. I also took more breaks and made an effort to keep my hands aligned better. I did the latter two first and by themselves didn't notice any change but all together, my pain went away.
Now I try to not type with cold hands when possible, try to keep my joints neutrally positioned and not type for too long at a time. I also used a mechanical keyboard for a long time (which requires very little pressure to activate the keys) and learned the Colemak keyboard layout. I haven't had any relapses although on busy days I can sometimes feel pressure building in my hands (I then take a break and do some stretches).
I've had similar problems. And the same thing worked for me. Seeing that it worked for this person as well, reaffirms that this might be a permanent solution. Whenever I code without long sleeves, I start to feel pain again. I haven't tried hand warmers; I might have to try that too. It makes sense though. Carpal tunnel and other repetitive stress syndromes come down to low blood flow. I've also used aspirin to beneficial effect, when the carpal tunnel starts flaring up. And the aspirin helped as well. At the end of the day it seems like it's all about blood flow. Doctors wanted to do surgery and I turned it down, and just keeping the blood flowing, by staying warm has helped quite a bit. (Of course, along with regular breaks too.)
The mobo chair mount has been the most transformative product that reduced/eliminated RSI for me.
For years, I tried to find better tables, better chairs, better mice/keyboards, postures -
The problem turned out to be in the seams between products, not the individual pieces.
The mobo mount solves this by throwing away the table component from the keyboard/mouse equation - solving most posture problems. Try it out.
I arrived here with 167 comments already present, and am very surprised to find I am the first to offer the following:
A few years ago, I started feeling frequent hand and wrist pain. At the time I was writing a lot of code and also a lot of text. To attempt to fix it:
1) I learned more keyboard shortcuts and refactoring tools, so that I could write more code with less finger use.
2) I picked up a voice dictation system, went through the tedious process of getting comfortable with it, and switched to it for nearly all of my non-programming work.
Between these two things, I estimate my keyboard use declined by perhaps 75%. My productivity increased. Pain completely disappeared. Total cost, a few hundred dollars, including a decent wireless headset.
- You can test your wrist posture by putting a pencil on your wrist. Your wrist should be straight. I emphasize this because it's one of the most contributing factors to RSI.
- Therapy alternatives include: physical therapy, medication, acupuncture. I did not try the acupuncture personally. Physical therapy was greatly useful, especially the stretches: https://www.youtube.com/watch?v=xAKOpnqvttI
- Use the right keyboard. A short keyboard helps your elbows, a mechanical keyboard helps your fingers. Ergonomic keyboards as well as vertical keyboards did not yield results for me. Even when used under the supervision of an ergonomist.
I went to an occupational therapist and she gave me a program of exercises and as long as I do them I can keep my RSI in check. I definitely recommend occupational therapy if you think you are developing RSI. Of course you should also make basic ergonomic improvements like getting your keyboard at the right height (unless you have a keyboard tray it probably isn't); those are helpful too.
e: Also the Sarno book this guy recommends has always struck me as pseudo-scientific nonsense. I like Pascarelli and Quilter's Repetitive Strain Injury and Damany's It's Not Carpal Tunnel Syndrome!
e2: Also if your first impulse is to go buy a wrist brace that is completely wrong.
Kudos to him. Among other things, I consumed gelatin daily for a year or two to feed the damaged tendons and ligaments, which helped significantly but didn't fully resolve the issue. It is resolved (at least for now), without surgery or drugs.
I cured chronic back pain that I have been suffering for a decade with Calcium and Magnesium supplements. They are cheap - 1 dollar for 20 effervescent pills - and make me feel 10-15 years younger. Another benefit is better sleep (no more chronic tiredness) and less anxiety.
If you have chronic pain check out Ca and Mg - they are essential for muscles. My discovery was by chance, I have been going to doctors, gym, yoga and massage for years with no results. Even run blood tests and they still didn't catch it. Now, I can tell by the feeling in my body when I need a Calcium.
TL;DR - Calcium is for muscle pain. Magnesium is for better sleep, chronic tiredness and anxiety.
I was in pain for a year or more. I got a forearm massage to eliminate the knots. Then I changed my typing style to be more about comfort and less about what the typing instructors wanted. No problems in the 15 years since.
I credit my never having had typing-related stress with being a self-taught typist. My hands rest naturally with wrists straight, unlike "home row" position which would have the wrists bent, and there are several keys which I type with either hand.
(I have had mouse-related grip stress, which I solved by switching to a trackball.)
My wrist was aching from twisting to hit the arrow keys and numpad, as I would keep my arm in the same position and just reach by angling my wrist. I got a 60% mechanical keyboard with a function layer and it is great.
Have you tried the Dvorak keyboard layout? Programmer Dvorak is a much more natural way of finger flow than qwerty and you can see (via statistics) that is reduces the "miles" your fingers "walk"
I also bike to work every day. I was not having chronic pain, but mild discomfort and one thing that made a difference was changing my bike handlebars to more be more upright instead of a flatbar style. These are the handlebars I ended up with and couldn't be happier. http://store.velo-orange.com/index.php/components/handlebars... They Allow my wrists to stay straight instead of bent back.
my pain issue stemmed from my neck which i eventually realized was due to poor posture/forward head position. i'd highly recommend reading this article [1], which finally made it click for me. turn off your adblocker since there's a bug on the page which will hide the content, and ignore the amateurish presentation. there's some very good information on the site which helped me finally rid myself of pain
About 15 years ago I made the decision to halve my mousing strain by becoming equally adept at mousing with either hand and either with a mouse or a trackball. I have both plugged into my computer all the time, and I swap hands and devices a couple times a month.
A great keyboard is important too. I only use IBM model M's made around 1984.
And as is discussed at length in this thread - exercise! I hit the gym for 2 hours between 5 and 7pm and let almost nothing interfere with that.
I have RSI pain yes - it comes with the job - but it's reached a steady-state that I can deal with.
I had crippling pain along my left side. I saw several doctors about it; they prescribed drugs that helped the immediate pain but didn't solve the underlying problem.
Then I read on https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072780/ that wearing a wrist brace AT NIGHT helps overcome carpal-tunnel. A good wrist brace cost me about $20; I've worn it every night since, and the carpal tunnel has gone away for me.
It was recommended to me by my PT when I had hand pain, and it's helped me not only with that but back pain, headaches, and plantar fasciitis. Probably a few more, too. If you ask me, it's the best $16 investment you can imagine.
Within 2 days of using the techniques in this book my pain started to improve significantly.
Once you address the trigger points, tools such as the Powerball, captains of crush grippers, and thick rubber bands can be used to strengthen the flexors and extensor muscles of the forearms.
Only a year or so into my career I started getting pain in my upper right back from using a mouse. I tried various adjustments to my desk/chair setup but eventually it got to the point where I couldn't use the mouse with my right arm anymore without unbearable pain and it would linger when I wasn't working.
I was able to solve the problem completely by starting to use a trackball with my left arm. I still use a mouse with the right when precision is necessary but 90% of the time I use the left and trackball.
I had carpal tunnel syndrome to where I lost sensation in three of my fingers, and could not grip properly in that hand.
A chiropractor helped me recover. It took three months, a bit more attention to how I sat and leaned and used my computer equipment. But the pain in my neck and upper back went away, the pain in my arms and shoulders went away, and the sensation and strength came back in my hands.
I didn't rush out to get a special keyboard, though my 1984 Model M keyboard is already special, just not in an ergonomic way.
I'm sure tensing up due to cold doesn't help. However, for me an ergonomic setup (in particular mouse and keyboard) has done wonders. Pain isn't 100% gone all the time, but it's not crippling agony where I can no longer make a fist.
The other thing that makes a huge difference to me is sleep. Days I don't sleep long /well my wrist and fingers hurt more. I don't know if this is due to giving the body more time to repair or feeling more relaxed (less tense) throughout the day.
A very simple way to fix wrist problems is to switch hands for the mouse. I had carpal tunnel bad enough to stop me from using a mouse at all and then I tried switching hands. At first my useless left had couldn't click on the side of a barn. After a week or so I was using my left hand with no problem and after a month I was as good as with my right.
A year later I happened to be using a mouse with my right hand and I discovered there was no pain. So I actually fixed my problem.
My senior year of university I suddenly became unable to click a mouse. Perfectly fine before, and I loved using mice for normal work and things like First Person Shooters.
But suddenly the curling "clicking" movement of my index finger stared causing extreme pain. Still does, to this day, even making that movement in the air. Typing is fine for some reason.
Transitioned to full-time TrackPoint use (USB ThinkPad keyboard), or TrackPad on my Macbook when I'm not at my desk.
One thing that has improved wrist pain for me is reducing inflammation. Avoiding sources of inflammation like excess sugar and other high GI index foods, low quality processed oils, biotoxins, allergens have helped me reduce my RSI.
Foods and supplements like omega 3, coconut oil, ghee, turmeric, lots of greens, bone broth and more have helped to keep the inflammation down.
Exercise is also super helpful but may not addressing the root cause of the problem.
The thing that I found works wonders in preventing RSI pain is those silicone gel keyboard wrist rests [1]. Get one (softer the better) and also one for your mouse. Since using these I have not had any pain.
I had it pretty bad and thought my career might be over. Then by mistake, I bought a truck with no power steering, and then started doing push ups first thing in the morning. Also I spent hundreds of hours making my desktop mouse free and have dozens of flux-box macro, and various IDE key board sequences memorized so that I never had to move my hand to the mouse and back.
I've found the "Time Out" mac app helpful to force myself to take breaks and stretch/stand/rest-eyes periodically. I disabled the Skip button recently which has been a bit annoying but valuable.
Also, years ago I started using a trackball mouse instead of a normal mouse (or the laptop trackpad which is the worst for my wrist). It has helped a ton.
I did tone down the frequencies some to be more
Manageable. Even a 12 second break every 15 monutes or so does a lot. And it doesn't break the flow much at all
Sarno worked for me. Ignore his "rage" theory derived from Freud and just use his techniques. It worked for my arm and wrist pain. Now, whenever I experience ANY bodily pain (knee, back, hip, etc.) I assume it is subconsciously generated and use Sarno's techniques. If that fails then rest + advil will usually do the trick.
I bought a kinesis advantage, learned colemak, and started using a cheap wacom bamboo tablet w/ my left hand (I'm right handed.)
The latter was the best thing I think.
I tried a trackball for a while. Switching hands entirely and getting used to a tablet where you only move your arm coupled w/ the kinesis advantage cured my rsi symptoms.
Mine was from my mouse. Two year into my career, my RSI was so debilitating that I was worried I had to stop programming.
I changed mice, changed how I held my mouse, and 20+ year later have never had a flare up. I now use a regular mouse, and just pivot my wrist when I use it, and haven't had a problem since then.
In my case weight of mouse is important. Light mouse is much better, cordless mouses with battery was killing my right hand. I got Mueller Wrist brace and it helped a lot when away from computer.
The worst thing are stupid standard desks. 75cm height with keyboard on top. At home I build my own desk with 80cm height and keyboard+mouse shelf.
RSI is a category of problems, and everyone will have their own specific flavor of problem. While there is a lot of good advice out there, just ask a doctor. They can diagnose exactly what is wrong, and filter the advice down to the problem that you actually have.
I never thought of cold causing RSI, but I've never had that problem. Good to know it might be a cause if it ever comes up again. I did have a bit of RSI about 10 years ago, but hardware fixed it for me.
Ok, this home remedy has worked for me and my family - Dip your hands in Hot water + Mustard oil + salt. A few times and the paid is gone for 1-3 months based on how frequently you keep up with bad posture (working with laptop in bed etc).
I suffered from intense pain on wrist/arm. After starting the gym (weight lifting + cardio), the problem ended. Zero. I mean, it's been 10 years without ANY pain. The benefits are many for those who work sitting all day long.
I can not stand keyboards with high pressure threshold on the keys. My constant Ctrl+C, Ctrl+V, Ctrl+F, etc.. was causing tremendous pain on my pinky finger, from having to press down on the Ctrl key so many times.
I've had this specific problem and solved it with Dr Sarno's book. It changed my life. I was able to create a startup (that I longed to do..) and I've never been happier.
I started having really bad wrist pain and numbness in my hands and fingers. It ended up being the desk height that caused it. Got a lower desk, pain vanished.
After 6 years of struggle with this career ruining pain, I finally found my remedy in Homeopathy. Medicine name is "Bellis Perennis". In olden days it was a popular medicine to treat RSI of Pianists and Stitching workers. I had taken "Belllis Perennis, 1M potency" 3 times(about 20 small pills each time) in only one day. That's it. No need of taking it again. If pain doesn't go away in a week try 1 more day after 1 week. No side effects, since it is Homeopathy. Since I am not a doctor, Please check with Homeopathy doctor before taking it. Thanks..
Or check a licensed Medical Doctor who understands biology.
1M potency in context:
> 30C (diluted 30 times), 200C (diluted 200 times), 1M (1000 dilutions), and 10M (10,000 dilutions).
> A popular homeopathic treatment for the flu is a 200C dilution of duck liver, marketed under the name Oscillococcinum. As there are only about 1080 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 more atoms to simply have one molecule in the final substance.
what helped me was being more aware of the position of my hands during sleep. if I slept with my wrists in a bent position that tended to cause issues during the day with typing. Keeping them straight while sleeping helped a lot.
It looks like it is pretty common for companies to neglect air conditioning. What's the point in having fancy office if the air makes you dizzy after an hour and no amount of coffee can make a difference or the temperature. One days cold as f, another day let's all go naked and drink ice tea...
Since 'RSI' may have many causes, it is unlikely a single treatment will help everybody. This article, in particular, looks like anecdata to me.
Having said that, the suggestions others give to sleep and exercise almost certainly can't hurt and if they may hurt you, you probably already know how fragile your body is.
Exercise breaks during work have the added benefit of introducing breaks. If I had to bet, those breaks are more important for RSI-like symptoms than the exercises themselves.
[1] A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism (https://en.wikipedia.org/wiki/Disease, via https://en.wikipedia.org/wiki/Condition#In_medicine)