The right hand of darkness
June 8, 2014 6:02 PM   Subscribe

My right hand and arms have slowly been developing an ache or cramp over the last two weeks that gets worse when I use a trackpad or smartphone. (I'm right-handed.) I'm also starting a software engineering internship tomorrow. What should I do to keep my hands okay?

(Apologies if this question was already asked. I searched AskMe and found questions about RSI or wrist pain, but they described different symptoms.)

My right hand tends to develop an ache in the palm, on the side of the pinky and ring finger. It gets worse when I have to curl my hand or fingers into a clawlike shape, such as using a trackpad or smartphone. Using the keyboard on my MacBook to navigate instead of the cursor helps the symptoms a bit, since it keeps my hands straight. After typing a lot, the fleshy part above the inner elbows of both arms, sometimes up to the wrist, starts to ache.

I didn't use my laptop or phone much for the last three days to see if the symptoms would go away, but they haven't.

I currently use an iPhone and MacBook Pro (laptop) and no special equipment (standing desk, mouse, tablet, etc). I do have a Wacom tablet, which I could try instead. I don't think dictation is an option for coding, but I could be wrong.

What exercises, equipment (especially keyboards), and software (Mac-compatible) should I try? If it comes down to it, what's the right kind of doctor to see? I'm kind of alarmed because I'm starting my programming internship tomorrow and can't really take a break from typing. I hear horror stories about people losing the use of their hands, and I'd like to avoid that.
posted by glass origami robot to Health & Fitness (18 answers total) 12 users marked this as a favorite
I'm going to go ahead and assume that "Using the keyboard on my MacBook to navigate" refers to a text editor of some kind, especially since you mentioned software engineering. I know this might be a big change, but a modal editor such as vi would eliminate a lot of hand movement related to cursor control.

You also might try holding your phone in your left hand, but not exclusively.
posted by yath at 6:19 PM on June 8, 2014

When I did my summer internships at a large software company (Yahoo), they had an ergonomics consultant who you could schedule an appointment with, and all interns were encouraged to take advantage of this. I got a lot of good advice about positioning my hands for better typing, sitting with the right posture, and so on. Assuming this is a reasonably large company, ask your manager if the company provides any resources like this - they want you to be able to be productive. (If you happen to be in the Bay Area, I believe this is the consultant I saw.)
posted by dreamyshade at 6:22 PM on June 8, 2014

Response by poster: yath: I code in emacs, use vimium to navigate Chrome, and use Mac shortcuts everywhere else (opening and closing windows and so on).

Also, yes, I'm working in the Bay Area.
posted by glass origami robot at 6:27 PM on June 8, 2014

Ring and pinkie fingers are 'fed' by your ulnar nerve- are you by chance resting your elbow or proximal forearm on a hard surface when you do these activities? This actually does sound like the onset of a RSI. That deep, achey, nervy, nagging discomfort that makes you want to take off your arms for a while.

Were it me, I'd try rest (no non-essential computer work or phone), ice (20mins on, 20 mins off for 2-3 cycles a couple times a day) and NSAIDS (like ibuprofen or naproxen). Make sure that you aren't sleeping on your arms at night- prop/block yourself with pillows if you must. Continue the treatment for a few weeks after it starts to feel better. If it DOESN'T start to feel better in a week or so, I'd head to a doctor. Better to nip RSI in the bud than to let it go chronic.

Source: former massage therapist who had bilateral cubital and carpal tunnel releases (surgery) due to RSI. Obviously Not Your Doctor.
posted by PorcineWithMe at 6:38 PM on June 8, 2014

Best answer: You need to start taking regular typing breaks. They help so much. Use a program like AntiRSI to force you to take short breaks regularly. I do a 5 minute break every 30 minutes, and a 10 second break every 5 minutes. You really don't want to risk injuring yourself seriously.
posted by vasi at 7:13 PM on June 8, 2014

I found this (and the two books it mentions) to be a good resource when I first had issues with RSI.

What's helped me is stretching, regular breaks, and introducing more variety. There was no single ergonomic keyboard/mouse/etc. that worked - things would get better for a little while, then usually relapse. But mixing it up helped a bunch; I use a left handed trackpad and traditional keyboard at work, and a right handed trackball plus ergonomic keyboard at home.

Be sure to see a doctor about it if things don't improve pretty quickly. I was stupid and pushed it to the point where I had trouble picking up pots and pans when cooking. It can take a long time to get better if you let it go that far.
posted by revertTS at 7:54 PM on June 8, 2014

It gets worse when I have to curl my hand or fingers into a clawlike shape, such as using a trackpad or smartphone.

Instead of using a trackpad, try using an ergonomic mouse. I had similar symptoms from using a standard mouse, and using an Evoluent vertical mouse fixed it.
posted by His thoughts were red thoughts at 7:57 PM on June 8, 2014 [2 favorites]

Best answer: Exercise. I found these really live up to their description:
Carpal Tunnel Syndrome exercises that really work
posted by monospace at 9:00 PM on June 8, 2014 [3 favorites]

At times I had to resort to a wrist splint at night / at work.

It isn't going to win any awards as a fashion accessory but it works.
posted by hobo gitano de queretaro at 9:01 PM on June 8, 2014

You don't say if you use an ergo keyboard but you must, starting right now. I use a Microsoft "Natural Ergonomic Keyboard 4000", a big trackball (Kensington "Expert Mouse") plus two regular mouses one for each hand, to vary the way I manipulate the computer. The MS keyboard is much better than a standard one, though not the best ergo one can buy; the MS ones wear out quite fast too, maybe last a year of full-time use, but they're not so expensive.

My Tai Chi teacher gave all his students a wonderful set of exercises that make all the difference in keeping my sedentary body from seizing up. The hand and arm ones are especially good for fixing carpal tunnel and other RSI problems. They're similar to the ones in the video monospace points to but more elaborate. If you're interested memail and I'll try and produce details.
posted by anadem at 9:45 PM on June 8, 2014

I forgot to add that you should get a headset for your phone, if you're using it for any length of time. Somehow holding a smartphone puts my hand in total spasm pretty quickly.
posted by anadem at 9:48 PM on June 8, 2014

Best answer: A major contributor to symptoms like the ones you describe is posture. There's literally no way to have 'good' posture using a laptop without an external keyboard - either you're looking down at the screen, generally leading to tight neck and shoulder muscles - or the keyboard is way too high. Also, yeah, avoid resting your wrist on 'edges' of anything.

Tight neck and shoulder muscles? Don't care about that? So, the tendons/nerves in your hands run the entire way up your arm - they might be trapped by tight muscles at one end, but you only notice it at the other end. Think about whether you've ever had any neck or shoulder pain in the last few months that you might have ignored.

So, the first thing I suggest doing is to use an external keyboard, and put the screen and keyboard at the right height.
posted by Ashlyth at 10:13 PM on June 8, 2014

using the wacom tablet instead of a mouse will help a lot - you don't twist your wrist when holding the stylus, so you keep your hand in a much more natural position.
posted by 5_13_23_42_69_666 at 11:59 PM on June 8, 2014

Things that work for me: Vertical mouse because it doesn't stress me as badly as the trackpad or regular mouse. Use the other hand for trackpadding whenever possible, to spread the load. Warm up my shoulders with arm circles (like this but one arm at a time, 10x/side, forward and back) in the morning, and maybe once more during the day. Stretches for the wrist and elbow like what monospace posted. Strength work (chin-ups, dips) once the immediate pain went away, to prevent it coming back.
posted by daveliepmann at 12:40 AM on June 9, 2014

What exercises, equipment (especially keyboards), and software (Mac-compatible) should I try?

I love my Freestyle keyboard. It took a day or two to get the hang of using it and to position it properly, but since then I haven't had any pain at all, in contrast to when I was using a standard keyboard. It's totally worth both the cost and the annoying "hey, your keyboard's broken. har har har" comments that you'll have to suffer through from every person who comes by your desk.
posted by cmonkey at 12:49 AM on June 9, 2014

I had similar issues that, initially unaddressed, developed to severe pains in my shoulder joint. Moving the mousepad in front of me and later to a cutting board placed in my lap did the trick - after about two months I was able to return to the previous arrangement, but now I use a mousepad with a gel cushion. The symptoms did not return during over tho years that passed since.
posted by hat_eater at 2:45 AM on June 9, 2014

See a physical therapist and get some nerve flossing exercises as a starting point.

Every 30 minutes, yawn, arch your back, turn your hands palms forward and bring them behind the line of your body. (Brugger's exercise, but I haven't found an online source I like).
posted by flutable at 12:29 AM on June 15, 2014

Some good advice in here already.

I've had symptoms that sound similar to yours, at one point pretty bad.

The single thing that's ever made the biggest difference for me was giving up Emacs. You mention vimium - are you using one of the vi(m) emulation modes in Emacs? If not, that might be worth a shot. I haven't really dug in, but I hear good things about evil-mode?

I've tried various ergo keyboards, but none have ever stuck for more than a year or two. For a long time I was mostly on IBM Model Ms or the newer USB clone by Unicomp, but the last few years I've mostly used ThinkPad keyboards to code, either on an actual ThinkPad or one of these USB ones when on a desktop machine. The eraser mouse is a lifesaver.

Are there shell commands (or sequences of same) you type way too often? Adding a handful of aliases and wrapper scripts has saved me a lot of keystrokes lately.

An extra monitor can save you a lot of physical context-switching actions with your hands, especially if you're going to be in a role where you need to monitor running systems or in-house chat, or if you just do a lot of the "hack, refresh in browser, hack" cycle.
posted by brennen at 12:58 PM on May 15, 2015

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