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RSI

I must be getting some kinda work-related injury or something... my left forearm hurts like hell... it's a throbbing and aching pain and it's constantly there...

Any tips to get it off quickly so I can get more real work done???

Wei
Monday, January 20, 2003

I get that a bit on my arm & wrist on the side that uses the mouse.
It got really bad 3 months ago, I could hardly bend that wrist, so I moved the mouse to the opposite side of the keyboard and used the other hand for it...
I moved to this job from my previous career as a labourer because I thought it was something I could do as I got older..after a decade of doing labouring work I have arthritis in my knees, one elbow goes sore in bad weather and my back works well so long as I dont try to use it.

After 3 years as a programmer, Im now *also* suffering from severe RSI in one arm, totally unfit (labouring kept me in very good shape), and high blood pressure.
Its a bizarre thing...when I shake my head now I can actually feel my cheeks move...Ive never had that before...

..I no longer believe that Ill live longer enough for finding work when Im old to be a problem...

Hasan Basri
Monday, January 20, 2003

If it's the forearm you're in luck. I had the exact same problem 5 years ago that I thought was going to prevent me continuing in the IT industry. Here's what I did

1) Go to a physiotherapist
2) Hopefully they'll take the 3 prong approach with you as they did me: a) cure with ice (10 mins max each arm twice a day), massage (with the tendons, not across) and ultrasound therapy b) strengthening c) ergonomics
3) after having the condition for about 2 years and living through hell I was "cured" in about 2 months. I have to keep up the strengthening and massage but all is good

Dave
Monday, January 20, 2003

Wei,

Back in my email tech support days I answered over 200 emails a day and my hands/wrists felt completely numb after I would get out of work.  A co-worker had one of these contoured keyboards (http://www.kinesis-ergo.com/contoured.htm) - and suggested I go out and buy it.  The price was a bit hefty at the time (I bought the pro model for about $290) - but a 'basic' model (non-hardware-remappable) will run you about $180 today.  Between this keyboard and using a mouse wrist rest (around $5), I haven't looked back.  The keyboard takes some getting used to - but within 2-3 days you will never want to use another keyboard again.  Within 2 weeks of buying this keyboard, my hands were back to normal.  No pain, etc.  Your mileage may vary, but a standard keyboard isn't very good on your hands.  Other "natural" keyboards are ok, but I was already using a microsoft natural kb when my hands/wrists were in shambles with no effect.  I don't have any relationship with Kinesis-Ergo - I just think the world of them for saving my hands from possible future damage and maybe even surgery down the line.  You might want to have a look at Ebay - they sometimes have one or two of these keyboards at a reasonable price (some people don't want to make the effort to get used to the keyboard's layout.)  Good luck and let us know what you decide to do.

GiorgioG
Monday, January 20, 2003

Had it twice, I gnored it, went away.

Daniel SHchyokin
Tuesday, January 21, 2003

shiatsu, yoga, massage, something should work for *you*.


though, i wuold agree with most of daniel's posts, DO NOT IGNOR IT.

these kind of injuries are like Carl Lewis losing his legs!!!!!!

Prakash S
Tuesday, January 21, 2003

I think in addition to any remedies you seek, you will need to look at your lifestyle also. Working for extensive periods in a static position is just such a bad idea on so many levels. Your metabolism goes through the floor so you end up packing on weight/eating like a mouse, you get all of the RSI issues, back pain, eye strain, sleep disruption and elevated stress levels.

Your body needs a certain level of physical activity to promote good health. There are some studies that show that people who are physically active have lower stress levels, and are better condition mentally as well as physically. Us IT guys/gals are in a really unhealthy industry. I am 28 years old, have a left eye that twitches as I write this, a mouse-callous on the heel of my right hand that is quite irritating, and a twinge in my lower right back. I have been doing this stuff for about 4-5 years and in theory could be doing it for another 25 or so.

Richard
Tuesday, January 21, 2003

If you want to try for the quick fix I would take a few days off and go do something fun and physically taxing.  No guarantees there, but I think it's your best bet.

I had a similar problem, but it lasted for months.  After a lot of frustrating and unhelpful visits to doctors I finally started to get a handle on it by going to a massage therapist, who gave me hard massage ("deep tissue") in my back and neck.  Not my arms.

Roughly concurrently I discovered the ideas of John Sarno (see _Mind Over Back Pain_).  He argues that lots of mysterious physical ailments are really repressed stress.  People who are in pain tend to be incredulous and a little insulted by this theory.  I wouldn't bother with Sarno unless your problem persists.  But if the pain goes on and the doctors can't help, you may want to come back to it.  It's helped me a lot.

Matt

Matt Conrad
Tuesday, January 21, 2003

I have found that the typical move-it-around-the-desktop-type mouse causes me problems since the weight of my arm rests on the small bones of my wrist.  Switching to a trackball mouse (where the weight rests on the palm of my hand) has made this go away. 

Ran Whittle
Tuesday, January 21, 2003

I personally use a Happy Hacking Lite keyboard ( http://shop.store.yahoo.com/pfuca-store/haphackeylit1.html ).  Eliminating the numeric keypad means I make a much shorter trip to grab the mouse.  (Plus, you can take the USB model with you to another computer.)

Also, I agree that getting other exercise will make a huge difference in your overall health, and depending on your specific ailment, may help you heal faster.

In my case, riding a recumbent bicycle turned out to be the way to go -- bicycling because it's aerobic, interesting, and I lived close enough to work that I could get rid of my car (nice side effect, that), and recumbent bicycling in particular because there's absolutely no strain whatsoever on my forearms and wrists.  I'll stop here, but email for further evangelism.

Different things work for everybody, but probably the last thing you should do is ignore it.  It might go away whether you do or not, but at least in the meantime you get a sense of being able to do something about it... which, since programmers tend to be control freaks, probably has a significant effect right there.  (=

Sam Gray
Tuesday, January 21, 2003

I developed wrist pains and a severe ache in my left shoulder (I'm a lefty). Switching to a contoured keyboard (I like the MS Natural) and a trackball instead of a mouse REALLY helped.

Oh, and get away from the computer for at least a few minutes every hour. That'll help a lot too.

Chris Tavares
Tuesday, January 21, 2003

MS Natural keyboard helps, and the best thing is a Wacom pen tablet instead of a mouse -- it forces you to keep your hand in a more natural "writing" position.

Frederik Slijkerman
Tuesday, January 21, 2003

The "best" thing to do really depends on the individual!

As a person who has had RSI problems for over ten years (although thankfully I currently consider myself in "remission"), I believe I've done enough research and had enough personal experience to speak with some authority on the matter.

The purpose of split keyboards is to put your arms in a more natural position.  If you have narrow shoulders (like me), then using a keyboard like the MS Natural keyboard is likely to aggravate things rather than help.

What you should do (rather than rushing to add wrist rests, get a split keyboard and a tablet) is to evaluate your working posture and habits.

IE
Is your chair properly adjusted?  Is your keyboard at the right height? How about your monitor(s)?

Do you spend a lot of time on the phone? If so, do you have/use a headset or speaker phone?

How fast do you type? The faster you type, the more likely you are to have problems or aggravate them.  If you slow down, it seems to be easier to stretch in between.  What keyboard layout do you use?  I highly recommend using Dvorak instead of QWERTY or AZERTY if you are typing in English because the acrobatics required of your fingers is much less.  (This doesn't mean that using Dvorak you won't have problems - it just often helps)

How much resistance does your keyboard provide?  There are some pretty good "low impact" keyboards these days that can really help.

What's your overall stress level like?  People with RSI problems tend to be type A personalities under pressure.  Regular exercise and learning to relax can really help here.  I've found the Alexander technique quite helpful, if you can get past the pseudo-science.

Do you drive a standard (stick shift)? This can aggravate an RSI injury.

Do you play impact sports like volleyball?  Or do you prop yourself on your elbows to read? Many people think only of carpal tunnel when they see "Repetitive strain injury" so this might not make sense at first glance - but ulnar nerve problems are not uncommon among computer users and thus not leaning on the nerve always helps :)

One neurologist I went to commented that RSIs often become problems because people ignore the warning signs.  Maybe some one has an intensive and prolonged session in front of the computer and ends up with some numbness.  The next day, instead of taking it easier or making a point to take frequent breaks (something you should always do), they complete their regular work.  Except the numbness gets worse (and worse etc) every day.  The nerves are already aggravated, so it takes less and less to trigger numbness and pain (a vicious cycle).  It's possible to break the cycle (unless you've done so much damage that you require surgery) but you're likely to be more susceptible to future problems - so once problems go away you should still do things like fixing your posture and taking regular breaks, relaxing and not overdoing it.  But that's the sort of thing my parents always used to tell me to do anyway :)

Do you use the mouse frequently? (This is a big problem for many people. I recommend keyboard shortcuts if you can manage, although you want to avoid holding down keys eg shift alot too because that can cause problems) How do you hold your mouse (gripping is bad)? Do you rest your wrist on the edge of the table when typing or mousing - then a proper wrist rest might help?  How do you hold your pen? If you don't hold it loosely and in a cup position - I wouldn't recommend going the tablet route instead of a mouse - you'll end up trading one RSI for another.  Incidentally, that's something to think about regardless. 

Not every programmer gets a repetitive strain injury, just like not all carpenters and blacksmiths used to get them either.  If you end up with warning signals and or a full blown RSI - figure out what you were doing that made you vulnerable (and typing all day isn't usually enough alone...).  It's not unusual for people who switch to using voice recognition after an RSI removes the keyboard as an option end up with problems speaking (a kind of RSI for the larynx) because they don't address problems in (eg) posture.

Anyway.

Phibian
Tuesday, January 21, 2003

Good points, Phibian. I guess the bottom line is: don't ignore it.

Frederik Slijkerman
Wednesday, January 22, 2003

Had massive problems in my shoulder, too. Physiotherapist
said I should switch the mouse to the other hand. It feels
very uncomfortable for the first weeks to have the mouse
in the wrog hand, but you'll learn it.
I'm switching the mouse now every some weeks and it helps.

AW
Wednesday, January 22, 2003

I strongly agree with GiorgioG: the Kinesis Contoured Ergonomic keyboard has worked wonders for me. I don't do any extended (>1 hour) typing without it. It gets some funny looks from people, but that's okay.

And if you're saying "It's too expensive", just think about how much it would cost you to miss work for more than a week, or to go to a doctor. An ounce of prevention and all that...

Chris Winters
Wednesday, January 22, 2003

Making some excuse to do something that moves my hands/arms away from the mouse/keyboard for about a minute or two every hour seems to keep things from ever getting serious for me. Even if its as simple as putting my hands on the side of the chair or behind my head while I read something.

I've tried switching keyboards, replacing my mouse with a trackball etc. While it appeared to solve some muscle aches, it never really did anything for the soreness/tenderness in my wrists/forearm. Changing my work habits is the only thing I've found that seems to have a long term effect.

Eric Moore
Thursday, January 23, 2003

IntelliPointer is ergonomic mouse software that reduces hand movement and eliminates hand strain. The user can rest the hand on a wrist rest and precisely reach anywhere on the computer screen with a small slow movement of the hand. There is no need to accelerate the mouse or lift and reposition the mouse or overstretch the hand. With IntelliPointer the hand always moves in its comfort zone. IntelliPointer reduces the risk of RSI and CTS and helps those that have symptoms.
Extensive information and free trial download are available at http://intellipointer.com

Mahmoud Razzaghi
Sunday, September 21, 2003

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