How do I deal with wrist pain?

July 24, 2006 10:39 AM

Wrist pain, RSI? How do I deal with it?

I've been in a lot of pain the last two weeks while using the computer. My right wrist just seems to be giving up. It seems to be from mouse use, as typing isn't so bad. I'm sure its RSI, but I've not been diagnoised with it yet.,

As a computer professional, I kind of need my wrist. In fact, I'm right in the middle of a huge project and this is slowing me down enormously.

Can anyone give some advice as to what I can do to get through the next week or so? I have a doctor appointment scheduled for Friday, but that's a long time and a lot of productivity lost away. I've tried wrist pads, a wrist brace, and even a trackball. I've tried left hand mousing but its too slow. Aspirin helps a little. Ibuprofin makes me sick.

Nothing about my work space is ergonomic. My employer believes in buying everything cheap, so the desk I have predates computers and the chair is probably 10 years old, and was the cheap special then, I'm sure. I'm doing my best to make due with what I have, but I really can only raise my chair a bit to get my arms in line with my keyboard (which is up too high.)

posted by anonymous to health & fitness (27 comments total)

Stretching exercises
Wrist braces,
A mouse pad with a wrist rest,
A trackball if you can stand it,
frequent breaks,
you know, the basics.

If you are in pain, you had better rest now. Working through the pain can lead to permanent damage.
posted by caddis at 10:47 AM on July 24, 2006

I have similar problems and after seeing 3 specialists who all said that I had "pre-carpal tunnel syndrome" and recommended a cock-up splint (which did more harm than good) I saw an accupuncturist who diagnosed me with simple tendonitis and sent me to the dollar store for a very cheap wrist brace (ACE brand not necessary). I've found that as long as I wear a band that stabilizes the tendon that runs on the underside of my wrist then I don't usually have problems. In a pinch I'll even use a bandana (or my left hand) to tighten around my right wrist whilst I use a mouse.

I also use a tablet and stylus in place of a mouse and have found it to be a wrist-saver. Using the stylus is much less aggrevating than a standard mouse.

Good luck, I know how badly RSI wrist injury can be.
posted by mezzanayne at 10:49 AM on July 24, 2006

streches
posted by caddis at 10:54 AM on July 24, 2006

JWZ's my wrists and welcome to them is my default What You Should Do™ advice for anyone with an RSI problem.

Until you see your doctor, the best thing you can do is take it easy on your wrists. Grab a program like AntiRSI to enforce keyboard/mouse breaks. (not sure of a windows version, but there appear to be options)
posted by alan at 10:56 AM on July 24, 2006

I am not a doctor, but I have been through various RSI issues. My main problem is tendonitis, which manifests as extreme aches and pains in the wrists and lower arms. To get through the next week or two, you could do the following:

(1) Start taking lots of ibuprofen for 1-2 weeks to reduce the pain and the swelling. I took 600 mgs 3 times a day for a couple years when I was in physical therapy, and it really did help reduce swelling so I could heal somewhat, but eventually I developed an ulcer, so I try to avoid it now except for very brief usage. Ugh - just reread and realized ibuprofen makes you sick - maybe try Tylenol - I believe it will do you more good than asprin.

(2) DO switch mouse hands. It took me 1-2 days of slower work to learn to mouse with my left hand, but it was SO worth it. Now I switch mouse hand every 2-3 weeks and it really prevents my arms from becoming too irritated.

(3) Take a 1-2 minutes break every 45 minutes where you stretch your arms, do 5 slow toe-touches, lightly jiggle your arms. Download Workrave or Eyecare Reminder - both are decent freeware/shareware programs that remind you to take breaks. (Your back may be a good part of the problem, even though the pain is in your arms - back stretches will help too - really!)

(4) Use a heating pad on your arms at night, or even as soon as you get home from work. Stretch your back and arms gently before going to bed.

(5) Order 2 Smartgloves through ebay or an online retailer. They are awesome.
posted by chr1sb0y at 11:00 AM on July 24, 2006

The most important thing I've done to alleviate this is to correct the ergonomics of my desk. The most impactful thing has been raising/lowering it to the right height. For me, this is just above my knees. I try to sit with my feet flat on the floor and my knees bent at 90 degrees. I use a chair with adjustable armrests and try to only rest the bones of my forearms on those, and even then not all the time.

If you are feeling pain in your actual joint, like sharp local pain in the bones of your wrist, then try icing it. If, on the other hand, you have long, hard strands of muscle in your forearm, try a heating pad to relax those muscles. I have found: heat for muscles, ice for joints.

Above all: do not ignore pain. You could wind up with permanent nerve damage that would prevent you from being able to type at all, or, worse, even dress and feed yourself. I know you "need your hands," which is why I'm urging you in the strongest terms I can to take a break when the pain flares up like this. I have seen two friends lose their work and passtimes outside of work because they worked through the pain and eventually destroyed their motor functions.

I see a massage therapist every 2 weeks and that helps with the muscular stuff. The joint stuff you need to simply work at by correcting your posture and limiting your usage. I would suggest you examine your entire day, looking for ways to remove strain from the arm in question. Get a car with an automatic transmission. Masturbate with your other hand. Seriously, whatever it takes.
posted by scarabic at 11:03 AM on July 24, 2006

I hate employers who won't spring for even basic ergonomics. You might want to mention where you live so folks can help you find out if there are any regulations which might help you convince this cheap fuck that an adjustable desk is more economical than a worker's comp claim.
posted by scarabic at 11:07 AM on July 24, 2006

chr1sb0y, I just saw smartgloves at a store near me, but thought they sounded too gimmicky. Maybe I'll have to give them a try anyway.

Scarabic, yeah, that's been a problem. My direct boss has tried to get us at least better chairs, and failed. If it makes a difference, I'm in Milwaukee, WI. Though I don't believe there is anything that regulates ergonomics here. Unless I missed it.

I'm trying to just get by for the next week and a half because I then have vacation. Away from computers. If I can make it through til then I have a whole week of recovering to do. :)
posted by [insert clever name here] at 11:18 AM on July 24, 2006

How long did you try a trackball for? I found that the switch to split keyboard + trackball - home and work - brought my pain from a constant 7-9 to an intermittent 2 in about 4 weeks' time. I had to correct the way I was sleeping to finally get rid of daily pain, along with wearing a wrist brace.
posted by Lyn Never at 11:21 AM on July 24, 2006

Is the project something where you need the mouse, or can you learn keyboard shortcuts and use those instead? I find that an ergonomic keyboard helps a lot with wrist pain too.
posted by clarahamster at 11:23 AM on July 24, 2006

My wrists got angry at me for mousing too much. Here's what I did:

1. Switched to a vertical mouse. Then when my wrist gets sore, I switch back to a normal one. Alternating between differently ergonomic devices really helps me far more than any one device because my hands aren't making the same old motion hour to hour.
2. Switched from KDE to ion, a keyboard-driven window manager.
3. Turned on "focus follows mouse" wherever I go. Most of my mouse clicks are selecting a window; if I can select that same window just by mousing over it, my hands are much happier.
4. I also alternate between two different keyboards (one, two) pretty constantly throughout long coding binges.

Steps 1 and 4 were a bit pricey, but they're cheaper than medical care. Steps 2 and 3 were free.
posted by amery at 11:30 AM on July 24, 2006

You can buy an adjustable keyboard platform for keyboard and mouse for around 100 bucks. Google for AKP. Also, get your employer to stop being pound foolish or sic OSHA on them. (Assuming you're in the U.S.) You should really have a good ergonomic chair (~$800) and keyboard/mouse tray.

In the short term, try VERY gentle stretching and relaxation. Maybe a massage. You can ice it at night.
posted by callmejay at 11:47 AM on July 24, 2006

Amery, how do you like the vertical mouse? I was looking at getting one the next paycheck. I do have a microsoft "natural" keyboard, which I believe is the reason why my wrist doesn't seem to hurt as much when typing. Something like the first one looks great. The second one just looks scary. :)

re-keyboard shortcuts. I know most of them, its unfortunately a lot of mousing as I'm editing images.


Here is a bit more information and a possible weird question. I suspect both need to be addressed to my doctor but maybe someone with similar experience would know. While it is my wrist that hurts, I feel a mild numbness in my forearm, inner part of my bicept, part of my shoulder, all the way to my shoulder blade. I have to assume its related, but I don't know.

I also get these severe headaches. I didn't think it might be related until this weekend. I used to get them all the time; then they stopped about the time I took a break from computer work. And said gone for about 3 years. A few months ago they started again, about 2-3 months after I started working on a computer again. I wonder if it might be some kind of tension or something causing the headaches? Perhaps a bit of a crazy idea - I'm sure I'll have to ask my doctor, but does anyone one know if its possible?
posted by [insert clever name here] at 11:48 AM on July 24, 2006 [1 favorite has favorites]

the headaches could be related to eye strain. you might want to get your eyesight checked.
posted by jimw at 11:53 AM on July 24, 2006

In addition to all the other suggestions, you might try weights. I use really light ones for my wrists, and work on heavier ones for everything else, and it keeps my wrists much happier. (When I don't work out for awhile, my wrist pain comes back.)
posted by Margalo Epps at 1:18 PM on July 24, 2006

Another vote for using a Wacom tablet and stylus in place of a mouse. My wrist hurt when using a regular mouse; I haven't had any pain since.

Also, I use it with my non-writing hand, so that my dominant hand isn't scrunched up all day and all night (I also do a lot of writing and drawing in my leisure time).
posted by cadge at 1:50 PM on July 24, 2006

I've been in a lot of pain the last two weeks while using the computer. My right wrist just seems to be giving up.

This is ringing alarm bells to me. If it seems like your wrist are giving up, they already have. Wrist pain is not normal at all, and any typing you do through the pain will damage them further.

Studies have shown that once you are in pain, any unit of work you do does twice the amount of damage than the previous unit of work. The pain will snowball very quickly, and the result could be catastrophic.

I'm right in the middle of a huge project and this is slowing me down enormously.

This is also ringing alarm bells. Please realize that you are comparing the importance of working hard on your current project versus never being able to work on any computer projects ever again.

You have to stop typing entirely. If you do not stop typing right now, your body will force you to stop soon anyway. Within a week or two, the pain will catch up with your pain tolerance limit, and you will be in serious trouble.

Your story is my story two years ago. I am dictating this message using Dragon NaturallySpeaking, because after two years I have still not recovered my hands. Next semester I will return to school to learn electronics, because my current career is no longer viable.

Run to the doctor. Take a medical emergency leave from work. Quit using keyboards entirely for a month. Learn how to use Dragon NaturallySpeaking. And read a lot. I recommend "it's not carpal tunnel syndrome", by Suparna Damany. This book is excellent, and it contains references to all other good books and web sites available. You should also post your situation on the Sorehand mailing list. Dr Damany reads and post to that list, and so do other RSI specialists.

You shouldn't be typing. If you want to discuss this further with me, you are welcome to call me. I will send you my phone number in a private message.

Good luck
posted by gmarceau at 2:01 PM on July 24, 2006 [2 favorites has favorites]

Try air typing to get a good sense of the heights you need for your chair and desk and keyboard and mouse. Then see if you can at all duplicate this with your current setup (use stacks of books, get your desk lowered, whatever). Also, look into buying or borrowing the book from the RSIRescue folks. It's a very thorough and well-researched book.

Be very specific when you talk to your doc -- apparently there's a big difference between pain on one side of your forearm and pain on the other (i.e., surgery totally wouldn't help one of these conditions).

When I was working my way through this and [eventually] healing, the pain migrated to different places in my arm and I felt even more miserable ("now it doesn't even hurt in the same place!") but, for me, that was a sign that my arms were getting back to normal.
posted by oldtimey at 2:23 PM on July 24, 2006

I have a similar problem with mousing, though I could type on a keyboard all day without a problem. Here is my response to a similar post, but in short, I wholeheartedly agree with the Smartglove and physical therapy recommendations, they have really made a huge difference for me as short-term aids, though you clearly need to work with your boss on some long-term changes as well.
posted by platinum at 3:11 PM on July 24, 2006

Just wanted to second the suggestion for the stretches that caddis recommended. These stretches can not only help prevent injury, but can actually help relieve some of the discomfort.

By all means, switch your mouse to the other hand -- it may slow you down, but it may save your wrist. Doing so saved mine -- I was getting to the point where I couldn't even turn a key in a door or hold on to a coffee mug. Now things are way better (though not totally back to normal).
posted by treepour at 3:43 PM on July 24, 2006

how do you like the vertical mouse?

For what I do (point at the terminal window where I'm programming), it's more than adequate. Fine motor control is a bit harder than on a regular mouse, but you learn to adapt. I just wouldn't play a first person shooter with it if I cared about my score, that's all.
posted by amery at 4:07 PM on July 24, 2006

One thing I have learnt from my experience with RSI is that it can take quite a lot of time and mental & emotional energy to find out how to deal with your particular problem. Some of the specific solutions suggested here might work for you but some won't (I like the MS curvy keyboard for example, but it puts your right hand quite far out to the side which can be bad).

But one thing I think is probably good for everyone is this software, RSI Guard - it measures breaks based on yr mouse/keyboard usage, and has a 'clickless mouse' function which is great, and stretch demoes.

And another thing: don't panic! Although I disagree strongly with the view that RSI is a psychotropic condition, I did find that reading/hearing about people who ended up with long-term or permanent injuries frightened me so much that it a) made me ignore/put off dealing with it until I was in agony, and b)actually made it feel worse! (yes, the two are probably related).

A lot of people (though not everyone, I know) can recover completely from severe RSI. After several years of recurring RSI, lots of different kinds of treatment, equipment, exercises, etc, I think I'm finally getting closer to a sustained recovery. The hard thing is to balance taking it seriously with being optimistic.
posted by 8k at 4:14 PM on July 24, 2006

Do hand stretches and exercises, but also exercise and stretch your entire body. Be careful not to hurt yourself, of course. Try massages (I recommend sports massage. Tell them about your injury so they know what the problem is.), acupuncture, and the chiropractor. Make your seat and desk ergonomic at work, and upgrade your mouse, keyboard, and monitor if you can. Make everything at home ergonomic also. Like everyone has said, don't work through the pain.

Be sure you're sleeping and eating well, as your body will heal itself better when you're well rested and healthy. Practice good posture.

I agree with 8k that RSIs probably aren't completely psychotropic. But stress will make people's muscles cramp up, and they will lose mobility and strength, which leads to RSIs. Watch out for that.

I used to get dehydrated. In the office I'd drink coffee, which would make me dehydrated, then tired, then make me slouch. That's bad for RSIs. Watch out for that, too. See what you can do to make your employer pay for ergonomics, and also, check your worker's compensation eligibility. Good luck.
posted by halonine at 4:54 PM on July 24, 2006

Not to be a shill, but a Kinesis keyboard might be exactly what you are looking for. The only thing it'll strain is your wallet.
posted by lunchbox at 5:39 PM on July 24, 2006

I've had carpal release surgery. (It had gotten to the point where both hands went numb if I had to drive for more than about 10 minutes.) I still get the weakness and some other odd symptoms. (Apparently I will always have something called flexor synovitis or something similar. As well as tendonitis, of course) What was recommended to me is: Once every hour stop and do five minutes of exercises for the hands. If/when the muscles on the back of your hand get hot, or the area on your wrist where the nerve goes through the tunnel, use ice on it for a minute or two at a time (or if you can't stand that long, for as long as you can take). My physical therapist suggested keeping a dixie cup or two in the freezer (if you have a fridge at work with a freezer), and just placing it/them back in to refreeze when you get done.

I wish you luck. Try to get it under control before you actually need surgery to use it and/or you have any permanent loss of use.
posted by Meep! Eek! at 7:31 PM on July 24, 2006 [1 favorite has favorites]

I am also in recovery from a serious RSI injury which left me using Dragon Naturally Speaking for a short time, as I was unable to do, well, anything, with my hands.

People tend to jump on the ergonomics bandwagon as an instant fix. In my experience, this is only one part of the solution.

gmarceau is correct, that any typing you do through the pain will damage you further. Let me say that for you again, in case you missed it. Typing through the pain is damaging you further.

Having said that, I know exactly the feeling of working through the pain, because you see no alternative to getting the work completed, but knowing all the while that it is doing further damage.

The first question I would ask, is on a scale of 1 to 10 (with 1 being not very bad at all, and 10 being the worst you can imagine), how bad is the pain on a daily basis right now? Me personally, I can live with 5 or under. At that level, I know I still need to do some stuff to prevent further injury and decrease the pain, but I don't need to stop my regular activities.

Above a pain level of 5, I know I need to modify my activities. In particular, reducing my computing time.

This might be a good way for you to make the decision right now as to whether your current pain level is bad enough to halt or reduce your work.

IANAD, but I also experience the pain from the wrist, through the forearm, up to my shoulder, and into my upper/center back. In my case, this is multiple RSI injuries, including Thoracic Outlet Syndrome - a compression of the nerve bundle between the top of the spine and the shoulder. This gives me blue or white hands sometimes. The pain in my forearms is tendonitis/tenosynovitis. From there I also have damaged several nerves in my hand. You may have multiple problems.

Until you can get to a doctor, I would suggest the following:

1) Anti-inflammatries (ibuprofen)

2) Get some general exercise which will not further exacerbate your pain. I go to a gentle yoga/stretching class, and this helps. Some gentle swimming could be good, or even just a brisk walk.

3) Get enough sleep. Your body repairs while you sleep. Be careful that you are not compressing your arms. Keep your wrists & arms straight if possible. If shoulder pain is an issue for you, don't sleep with your arms above your head.

4) Use icepacks to reduce swelling in the evening, and keep your hands warm during the day. You can easily do this with wheatpacks, or by running your hands under warm water. (This may not be such an issue for you in the Northern Hemisphere Summer right now, but it's winter down here!)

5) If you do nothing else, install some microbreak reminder software, such as Workrave. If you're in pain, give yourself 5-10 seconds microbreak every 3-5 minutes, and a 5 minute break every 30-45 minutes.
It's difficult to force yourself into the habit, but everytime you are prompted for a microbreak, shake your hands, roll your shoulders, take one big breath in and out, and then you're back into your work again.
On the 5 minute breaks, get up and walk around. I tend to use this opportunity to go to the bathroom, get a drink, read the front page of the newspaper, carry a document to a colleague across the office etc, to force myself to move.

I also found it helpful to reduce my mouse/keyboard use in small ways, such as setting up extensive email rules to filter my email and save me some work etc.

I second the recommendation of "It's Not Carpal Tunnel Synrome" - this is probably the only book you need to read.

I hope these suggestions help. Feel free to email me if you wish.
posted by girlgeeknz at 7:41 PM on July 24, 2006 [1 favorite has favorites]

I'm betting that the headaches and arm numbness will be related, and caused by stress in your upper back and neck. Tight muscles there make your head hurt and pinch nerves. This is a typical symptom of a monitor which is either too low or positioned off-centre.

First get your chair height right. Your bum should be at a height such that your thighbones are pretty much horizontal when your feet are flat on the floor.

Once that's set, get your keyboard height right: sitting upright in your chair with your shoulders relaxed, your forearms should be pretty much horizontal when your hands are on your keyboard. The mouse should be on the same level as the keyboard.

Finally, your monitor needs to be right in front of you and set so that the top of the screen is at your eye level when you're sitting upright in your chair. If it's too low, you'll either dip your head or slouch, either of which will hurt you if you do it all day.

If your employer has not provided you with a workstation that can be set up this way, your employer is negligent, and if as a result of this negligence you end up with RSI that stops you working for any length of time you could sue for big big money and very likely win it. You need to find a politically acceptable way of making your employer realize that a few hundred bucks spent on good ergonomics is very very cheap insurance.

IANAD, IANAL, TINMA, TINLA. I have learned these things in the course of using computers professionally for twenty years. Like everybody else, when I first started programming I would do my best work leaning back in my chair with my feet on the desk and the keyboard in my lap; but when I started hurting (in my late twenties) I started paying attention to ergonomics - and all the pain was gone within two days of getting my workstation properly set up.
posted by flabdablet at 4:35 AM on July 25, 2006