Can you share your stories / tips about dealing with typing related RSI (repetitive strain injury)?

December 3, 2012 11:30 AM

Can you share your stories / tips about dealing with typing related RSI (repetitive strain injury)?

Maybe 4 months ago, I had a sudden onset of RSI. Numb fingers, and a sort of knot-type feeling in my wrist. This was really scary, especially given that it sort of came out of nowhere! I freaked, took a week off of work, pondered a life as an invalid, and in generally was not in a good way. I am a programmer, and I really enjoy it, and the idea of not being able to program (or use a computer, even...) was terrifying.

That said, at the time, I did a couple of things
1. Talked to people at work who had experience with RSI
2. Talked to my Dr (a generalist)
3. Tried to use the computer less in my free time
4. Started doing pilates (this came from #1)
5. Started the Alexander technique (also came from #1)
6. Got serious about ergonomics

It's hard to know what actually worked, though I think it was mainly #6. My coworkers had some harrowing stories and some hopeful ones, but nobody really had a "silver bullet." Some people said to learn to type Dvorak, but my fear is that if I ever have to use someone else's computer (pair programming or whatever) I'll be at a real disadvantage. Pilates has been good, though whether it has helped is hard to say. Alexander technique didn't seem terribly useful. My Dr was pretty useless, he just said it was super common but didn't have any very helpful things to say...

Which is why I turn to MeFi. Does anyone have experience with RSI? Are there any unlikely causes of RSI that maybe I'm not factoring in? Anything you can recommend?

Right now I have ergo keyboards (am currently using http://www.amazon.com/Standard-Goldtouch-Adjustable-GTU-0088-Keyboard/dp/B005ZLTNN4/ref=sr_1_fkmr1_1?ie=UTF8&qid=1354562891&sr=8-1-fkmr1&keywords=goldtouch+pro, but want to try http://www.amazon.com/Kinesis-KB500USB-BLK-Advantage-Contoured-Keyboard/dp/B000LVJ9W8/ref=sr_1_2?ie=UTF8&qid=1354562891&sr=8-2&keywords=goldtouch+pro), and basically don't use computers in my free time (which is really tough!). I'd love to know about how people dealt with RSI. Mine has definitely gotten better, but it hasn't gone away... I'd love for it to go away. As is, I don't get finger numbness anymore, but when using a computer I can feel that "knot" style feeling in my wrists. Hopefully that second keyboard will help.

The biggest downer is that I essentially can't use laptops. I can, but if I do it for any amount of time (especially for programming), then the knot-feeling gets worse.

Halp!

posted by wooh to health & fitness (7 answers total)

Ack, I forgot to mention that I also now use a break software. 30 second breaks every 10 minutes, 5 minute breaks (where I stand and walk around) ever hour. I think this has also had a real effect.
posted by wooh at 11:30 AM on December 3, 2012

Anecdata: Job that was documentation-heavy so did a lot of all-day typing. Developed RSI just as you described. The brace and drugs did almost nothing. What worked was using an oversized microsoft ergo keyboard along with generic wrist stretching. Those two items took the pain away. Ended up moving jobs to one that I typed less so never re-occurred.
posted by anti social order at 11:38 AM on December 3, 2012

Diagnosed with Carpal Tunnel about 15 years ago... It hadn't gotten crippling yet, but my hands ended up numb for long periods of every day, and would drive me nuts tingling at night.

NSAIDs (such as ibuprofen) didn't make much difference. Those stupid wrist-braces made it worse. Stretching exercises (except as noted below) made no difference.

I eventually rearranged my work areas (including my home office) and changed my sleeping posture (don't put your arms/hands under your head, as much as you want to - Try to keep them out straight, a "body" pillow helps a lot with that), and although I still "know" when I've done something stupid during the day (heavy vibration bothers me the most), I have almost no symptoms today.

So - Ergonomics, ergonomics, ergonomics. You should have your screen straight ahead, with your eye-level at roughly 2/3rds of the way to the top. You should have your keyboard basically in your lap and slightly forward, to keep your elbows at an obtuse angle. Keep your wrists in line with your forearms, not bent back and not bent in. For some people, those god-awful split keyboards help, though I can't stand them. Also, pay particular attention to your mouse-arm. A "winged" desk helps a lot here, because you can wrest your whole forearm on the wing instead of putting all the stress on your wrist or shoulder (and thus, neck). And don't sit in just one "right" pose - Sitting with perfect posture for eight hours a day will still ruin you. Shift through a variety of positions throughout the day, to distribute the stresses across a wider range of muscle/joint groups.

Finally, take as many breaks as you can get away with. You don't need a full 15 minutes or anything like that, just stand up and move around for a minute or two. Bathroom, coffee, or just do one lap around your work area. And while up, stretch your whole body naturally (hands reaching behind your back, or the "yawn" stretch, or leaning into a doorway), don't focus on just your wrists.
posted by pla at 11:46 AM on December 3, 2012

Do you move back and forth between a mouse and keyboard a lot, or do you use lots of keyboard shortcuts? Do you have a decent chair with adjustable arms? (This ties into pla's note about where the stress lies.)

I've found that the quality of the switches on keyboards makes a big difference to me, more so than keyboard layout. YMMV. Try something from here, maybe? (I have my boss's Topre RealForce that he didn't like (!), and my hands and wrists have never felt better. Having an adjustable keyboard tray is invaluable too, but it sounds like you have that covered already.)
posted by supercres at 11:50 AM on December 3, 2012

It's been a number of years since I had RSI -- and I had it so severely that I had to stop working for more than a year. (It took 6 years for my worker's comp claim to make it through the system, by the way).

But I agree with pla. The way it was explained to me: when your fingers are typing, that's a lot of activity, but everything else is basically still. When your body is increasing it's activity, it sends out a call from the muscles for more oxygen in the blood. But your finger muscles just aren't big enough to be heard. Larger muscles are much better at calling out for more oxygen. So during breaks, it's important for me to shrug my shoulders, do arm circles, and move larger muscles.

For me, rsi is clearly related to my back, and the pathways around my neck, tops of the shoulders, tendons on down to my hands. So I got a lot of massages to "tenderize the meat" between my spine and shoulder blades. (in fact, having a numb spot there is the precursor to flare ups of rsi). Exercises where I pull my shoulder blades together (as if I'm trying to hold a can of tomatoes between my shoulder blades) help a lot.

Changing my posture was/is important. I slept on the floor for a few years with a rolled towel under my neck. I got breast reduction surgery (bra straps were digging into my shoulders, and I always felt like I should strap bocci balls to my back to act as a counter-weight). I insist on having a scissor-switch keyboard. I realized that I hold my thumb up "at the ready" when typing, rather than relaxing it -- that's bad.

Things that did not help: wrist braces (which really just serve to further immobilize your hands so that you can't call for oxygen). Any kind of "ergonomic" keyboard or mouse. Wrist rests in front of the keyboard. Those things made it markedly, immediately worse.

Also -- I'm a naturally anxious person. I was carrying tension around all the time. I slowly realized that I was always sitting on the edge of my seat (literally -- I never leaned back or relaxed). I remember laying in bed (ie. on the floor) at night and realizing that I was jutting my head forward rather than letting it sink into the pillow. Whether that was a result of the pain I was in or the cause, I do not know.

I had to cut my hair short (couldn't use my hands, fingers to rinse out all the soap), stopped carrying anything (I used to just shop for the day and tie the bags onto my belt loops), sold my car (I couldn't drive -- heck, even vibrations on the subway hurt). Slowed way down when doing laundry -- I couldn't pull wet heavy clothes out of the washing machine to move them to the dryer. I stopped making spaghetti -- because I couldn't twist it around the fork. And I learned to ask for and accept help from other people. I still always use the button on automatic doors rather than tugging and opening them myself.

I hope you don't suffer as severely as I did. But there is hope!
posted by vitabellosi at 12:10 PM on December 3, 2012

I used to have really bad carpal tunnel. Like, really bad. It genuinely felt like my fingers were in a bucket of icewater.

This wrist brace helped me a lot. The important thing about wrist braces is that they have to have the metal splint inside them, and you will have to bend the metal part so that your wrist is comfortable at your normal typing position, since the default position genuinely isn't the best.

The most important thing to remember about wrist braces is that you have to wear them consistently - not just when you are experiencing the effects of carpal tunnel. Even if your wrist is not currently under stress, your wrist bones can still aggravate your carpal tunnel since the nerve occupies more space between those bones due to the inflammation. So it will take a long time for you to recover and once that occurs, you want to manage your body so that you don't get it to begin with.

Ergonomic items that allow you have less wrist pronation (such as vertical mice) are also very important. My current setup is a Goldtouch adjustable keyboard. Left-handed vertical mice are hard to come by, so I use a Goldtouch mouse (which is at a 45 degree angle) for my left hand and a Evoluent vertical mouse for my right hand and switch off between the two. Most importantly, when I am at work I wear my wrist braces all the time, except for meetings. Some people used to give me strange looks for this, but fuck em. Your nervous system is much more important than other people's opinions of your fashion sense. (Besides, most wrist braces come in black now, which goes well with anything.)
posted by wolfdreams01 at 12:41 PM on December 3, 2012

I used to have really bad carpal tunnel. Like, really bad. It genuinely felt like my fingers were in a bucket of icewater.

I just want to clarify that I did not have carpal tunnel -- I had de Quervain's tenosynovitis (base of the thumb), tendonitis, bursitis, lots of inflammation, etc.. My ring finger and pinky fingers routinely went numb, and the tendon that extends from the elbow to the wrist (and connects to those two fingers) was "like a banjo string" according to my doctor. I had it in both arms. I was tested, but did not have carpal tunnel.

Which is to say -- there are a lot of different conditions that fall under the rsi rubric, so you will see a wide variety of responses about "what works".

I forgot to mention that one of the things I did (per doctor's orders) was to alternate heat and cold. I have no idea if this is a good idea for you -- but it gave me quite a bit of pain relief. (The ice water I soaked my arms in was brutal, but left me feeling better). The best experience I had was alternating being in a sauna with cool water swimming. I left that day feeling incredibly relaxed and pain free.
posted by vitabellosi at 4:05 PM on December 3, 2012