First signs of carpal. HELP!

March 20, 2006 6:44 PM

Has anyone been able to head off carpal tunnel shortly after the symptoms start appearing? How?

I'm a 31 year old male in pretty good physical shape. I'm a video editor, so I spend about 8 hours a day at work with a mouse, and another hour or two at home with a trackball.
This wrist pain in my right hand just started within the past week...not too bad yet, but I don't see it going anywhere good.
Anyone been able to stave off carpal tunnel syndrome under semi-similar conditions?
Any help would be greatly appreciated.

posted by BillBishop to health & fitness (30 comments total)

Wrist splints at night (longer, if you can wear them in the daytime) are the mainstay of conservative therapy for CTS. They act to prevent ulnar deviation at the wrist.

On the other hand, wrist pain is not part of the typical carpal tunnel syndrome, so you may have misdiagnosed yourself.
posted by ikkyu2 at 6:53 PM on March 20, 2006

Stop mousing so much.
Seriously. Cut out ALL non-essential mousing. And double-check your ergonomics.
posted by ch1x0r at 6:55 PM on March 20, 2006

I had this problem years ago in my wrist and shoulder, I could feel it getting worse by the week. My solution was to start using the mouse in my left hand (I am normally right handed). It took a week to get used to it, but it cleared up the pain almost immediately and it hasn't come back.
posted by AndrewStephens at 7:09 PM on March 20, 2006

Do stretching exercises during the day. Bend your fingertips backwards. Hold out your arms from your sides and make kind of a crucifiction pose, stretching your wrist as far as you can. Get a squeeze ball and use it constantly.

Try to switch to the trackball during the day too. Keep a mouse hooked up for fine-detail work, but try to use the trackball the majority of the time.

These have worked for me. Any time I feel pain starting up, I make sure that I do the exercises at least every hour.

Try to get away from your computer on the weekends too. Just giving your muscles some time to rest will help more than anything else.
posted by Eddie Mars at 7:09 PM on March 20, 2006

I've gotten symptoms and stopped getting them many times, so you can definitely stave off getting completely disabled. Usually I fixed my ergonomics, and cut back as much as possible until I could manage to take an extended break.

What helped me: Ice. Stretches. Doing everything with the other hend. One of those desktop timers that makes you take a break every 50 minutes.
posted by salvia at 7:12 PM on March 20, 2006

Just getting a gel wristrest helped me out a lot.
posted by Faint of Butt at 7:15 PM on March 20, 2006

Are you sure it's carpal tunnel? Mouse use, especially on a laptop, can end up causing elbow-related problems.

(When your wrist stops hurting, you might want to fix the spelling on your tag.)
posted by ruff at 7:27 PM on March 20, 2006

What Eddie Mars said about stretching.

And I am with AndrewStephens: change hands. The first time is strange and it takes a week or so to get used to it, but I was surprised to see how fast my left hand and fingers could learn. Since then, I still change side every few weeks or each time I feel any symptom.
posted by bru at 7:41 PM on March 20, 2006

Careful of wrist splints. They can do as much harm as good. This is one of those times when it's really worth seeing a qualified occupational therapist and/or a doctor. (My boss-- not the sharpest crayon in the box-- did permanent damage by improperly splinting her wrist).
posted by gesamtkunstwerk at 7:42 PM on March 20, 2006

I developed an RSI from a combination of playing the piano and computing excessively. The only thing that cleared it up was rest.

In addition to previous comments, keeping hydrated, B vitamin supplementation, and losing weight (if your'e significantly over weight) may help.
posted by sockpup at 7:43 PM on March 20, 2006

I was doing digital retouching all day five days a week 6 or 7 years ago and began to get the dull pain ache in my wrist. Someone else above mentioned switching hands- I ended up doing this and it worked- however I also re-evaluated my posture. There are places online that will help you prevent Repetitive Stress Injuries- the one thing that helped me quickly was making sure my wrists were not angled upwards (or downwards) but were even with the keyboard/mouse.
posted by jeremias at 7:43 PM on March 20, 2006

I'll 3rd the recommendation to learn to use your other hand to mouse, it helped my RSI enormously, just by spreading the load. As bru said, it really doesn't take that long to learn.
posted by Jon Mitchell at 8:06 PM on March 20, 2006

Yeah, I was able to stop most of my carpal tunnel symptoms with the following:

1) Frequent rest breaks. A few minutes every half hour or so.

2) Improved posture. (Hint: My back doesn't touch the back of my chair.)

3) Correct keyboard height.

4) Switching to using my middle finger for the center button/scroll wheel instead of my pointer finger.

5) Wacom tablet for art tasks.

6) Switching to a headset for multiplayer game communication/chat.

I still get nasty knots in my right trapezius muscle from excessive mousing, but this has been relieved somewhat since I started strength training and yoga.
posted by xyzzy at 8:30 PM on March 20, 2006

My piano teacher suggests the following excercise (and it seems to work for me!): Hold your right arm straight out in front of you, palm perpendicular to the floor. Using your left hand, pull your palm gently towards your torso. Repeat for the other side. This exercise has the advantage of stretching out the muscles/ligaments/stuff in your wrist.
posted by fvox13 at 8:48 PM on March 20, 2006

BillBishop, I think I might be the only editor in this group - and I'm someone who meets/talks to other editors.

(yes, yes, ergonomics, breaks etc.)

The best thing that I hear about is a wacom pad. Be warned, it'll slow you down horribly for a week. After a week, you'll get better with it; holding a pen is very much more natural that mousing & keyboarding.
posted by filmgeek at 9:15 PM on March 20, 2006

Filmgeek: I'm thinking immediate solution is track balll at work, get the wrist-rester gel thing, watch the posture and ergonomics for things to improve....and do a little less computer time in general.
do you really think working with a tablet would be better long term than trackball?
posted by BillBishop at 10:25 PM on March 20, 2006

fvox:can you describe this excercise better?
do I pull on my palm and wrist and really pull the arm in to the body with it, or do i just pull on it while keeping the other arm rigid?
posted by BillBishop at 10:27 PM on March 20, 2006

There's lots of great information at this page, one of the oldest carpal tunnel/repetitive strain injury pages on the Web. Scroll down for links to GIF animations of useful stretches (go slower than the speed shown). The key point to remember, though is this: THERE ARE NO QUICK FIXES. But there are specific things you can do to keep symptoms from getting worse.

Cut out ALL non-essential mousing.

Yep. Hard for your career, but do what you can to reduce the amount of time you spend with a mouse in your hand. Maybe lay off the trackball at home for a few nights a week. Stop non-essential typing, too. Take this seriously if you want lasting relief. I had bad symptoms when I was a technical writer at a small software company, then hanging out on Usenet and/or playing Doom 2 for hours every night. I had constant throbbing in my wrists and thumbs and sharp pains regularly, and was an idiot for not going to a doctor. I got lucky after dumping the video games, then Usenet, then added an ergonomic keyboard, attempts at better posture, and some stretching exercises. But I know now what really saved me was leaving that job and doing a lot less typing and mousing in general. These days I take frequent breaks and stretch, but mainly just cut down the amount of time I spend at the keyboard as much as possible.

Our fingers were not made for such huge amounts of time doing this stuff.
posted by mediareport at 10:58 PM on March 20, 2006

I'm also a fulltime video editor, and let me tell you, the Wacom tablet has absolutely saved my career.

After nearly 12 years of mousing around on computers, the RSI guy finally came and bit me on the ass last year, when I started to wake up in the mornings with intense discomfort in my right hand. I found myself in the middle of client-supervised edit sessions, actually switching the mouse to my left hand after a few hours, which needless to say, significantly slowed my performance, and merely shifted the problem to my other hand.

After resisting tablets for years thinking they were too "wierd" for editing (although they seemed alright for graphics oriented programs I use like Photoshop, After Effects and Shake), I finally broke down and got a Wacom 6x8 Graphire3, forced myself to use it for enerything, and as I mentioned, it has made all the difference in the world.

And aside from relieving my wrist pain, the pen definitely speeds up your interaction with nearly all aspects of the computer's interface. It felt totally wierd and nonintuitive at first, but now the pen feels like an extension of my hand, and I cant go back to editing with a mouse, even if i *didn't* have RSI issues.
posted by melorama at 1:13 AM on March 21, 2006

I'll eleventh the suggestion to switch hands for your mouse. I am very right-handed, but made the switch to left pretty easily.

Tip: If you have trouble when you switch the mouse buttons over, visualise your left hand actually pointing at the screen (like you're giving directions), when you press the mouse button.

Point. Point. Point. There. There. There. etc.
posted by bright cold day at 2:37 AM on March 21, 2006

I started getting tingling and some mild pain in 1999. As a programmer who spends stints of 8-16+ hours a day at the keyboard, I was terrified. I've done three things which have (either individually or in combination) done miracles for my wrists:

1. Exercise, exercise, exercise. Somebody at the office had a gyro exercise ball. I started using it. Now I own three, two of which live by my desktop and laptop and one by the side of my bed. Whenever the tingling comes back, I take 3-4 breaks per day and work the ball as long as I have strength for on each wrist.

2. Better keyboard. (may not be relevant for you) If you do much keyboarding, you probably need to unlearn some bad habits. It is essential to keep your wrists straight in both tilt directions (left-right and up-down) and to a lesser degree in their rotation. After looking at expensive ergo-keyboards, I went cheap and got a Microsoft Natural keyboard. It had the right feature set: split at the correct angle to make the base row perpendicular to the imaginary line between your elbow and middle finger; reverse slope -- note that the normal "forward" slope causes your wrists to bend backwards all the time (bad); and canted slightly outwards to get the rotation correct. Luckily for you, they recently released a new version that brings back the reverse slope missing for the past few years. After learning how to type ergonomically, I re-taught myself how to type on my laptop. I no longer rest my wrists on the surface of the laptop, forcing them to hover several inches above the keyboard surface to keep the up-down tilt correct. I've also learned to adapt my finger position in a funny way to keep the left-right tilt correct.

3. Good trackball. I currently use a Kensington Expert Mouse (the one with the big-honkin' ball). I'm not sure how much a difference it makes by itself, but it allows me to apply the wrist-positioning lessons learned in step 2 to my pointing device. I try to use the trackball with either fingertip or whole-forearm motion. I have also replaced the ball with an 8-ball (bought at a local pool supply store). Aside from looking cool, the increased rotational inertia seems to make for a more pleasant mousingn experience. (Note that Kensington probably hires people to figure out the correct ball density, so YMMV on this one.)

In short, what worked for me was to exercise and to endeavor to keep my wrists straight as much as possible. The exercise is the real winner, but the straight wrists help you to do minimal damage once you start the healing process. 7 years later, I sometimes notice my wrists, but have largely averted any of the more signfiicant problems that cripple many of my coworkers.
posted by Mr Stickfigure at 5:54 AM on March 21, 2006

Two things have changed my life, both of which have been mentioned but need reinforced. More egonomic (and unfortunately, expensive) keyboard and mouse (moving to graphics tablet now) and yoga. Let me say it again, yoga.
posted by mrmojoflying at 5:57 AM on March 21, 2006

this mouse nipped it in the bud for me and for some friends of mine. highly recommend it.
posted by alkupe at 8:00 AM on March 21, 2006

I used to be a baker by day and a net-junkie by night when I lived up North, and that gave me some pretty severe carpal tunnel. I remember crying one night when I couldn't play cards with my spouse because I couldn't hold the cards in my hand, my wrist hurt too damn much and my fingers were stiff and unresponsive. I went to physiotherapy (paid for by Worker's Compensation) and learned basically the same stretches everyone else is recommending, and I got some wrist braces. For the first year I slept with my braces on every night (it eventually got to be comforting!) and since then I only wear them when I feel I need to - once or twice a week. I have almost completely recovered. The worst symtoms I get are waking with half of my hand numb, and that isn't an every-night thing.

That's my story, and my advice: see a physiotherapist if you can afford it. Do the stretches and exercises others are suggesting, sleep with braces on. Thanks for asking this question, though. I'm definitely going to get a trackball now, and maybe look into those gyro exercisers.
posted by arcticwoman at 9:05 AM on March 21, 2006

* Prefer using the keyboard instead of the mouse when possible. Learn to navigate with the keyboard, use keyboard shortcuts, create macros for repetitive tasks that require you to use the mouse. AutoHotkey (Windows) is very good for that purpose.
* Get a Wacom tablet, as suggested above.
* Get a good keyboard: If you can afford the hefty price tag, I recommend getting a Kinesis contoured keyboard. A cheaper alternative is the Datadesk SmartBoard keyboard.
* Consider getting the IMAK Smart Glove.
* For more information see the Typing Injury FAQ
* Consider switching to the Colemak keyboard layout (self link).
posted by Sharcho at 9:36 AM on March 21, 2006

I second the IMAK Smart Glove suggestion. I love them so much I have one for computing at work, one for computing at home, one at my rehearsal studio for playing bass, plus a spare one just in case. They are so much more comfortable and flexible than a typical hard splint.

Learn as many keyboard shortcuts as you can and avoid the mouse altogether whenever possible. With many programs, the shortcuts are so extensive you can do almost everything without ever touching a mouse. Not sure if that would work with something as graphically intensive as video-editing though.

Also, not all computer-related wrist pain is carpal tunnel, mine was diagnosed as tendonitis and lateral epicondylitis, so that may make some difference in your best treatment.
posted by platinum at 9:20 PM on March 21, 2006

Related AskMe on reducing keyboard usage
posted by Sharcho at 12:45 PM on March 22, 2006

reducing mouse usage, that is
posted by Sharcho at 12:46 PM on March 22, 2006

Bill, I know a bunch of symphony editors and FCP editors who switched over. They're slower at first. Really. the first week is the worst.

Left hand uses the WHOLE keyboard...right hand on the tablet.
posted by filmgeek at 5:18 PM on March 22, 2006

don't rest your wrists!

either move keyboard, mouse and mousepad to edge of table to prevent your wrist from resting or move them inwards if you have the room and rest your elbows.
posted by randomizer at 2:39 AM on November 18, 2006