How can I relieve RSI wrist pain when using a computer?
August 13, 2016 9:42 AM   Subscribe

I've had RSI related pain in my right wrist (right side) now for over a year that's showed no sign of improvement. My work is all computer based (admin) and the software we used isn't very shortcut friendly, so I'm using the mouse all day. I've had to give up playing guitar (my favourite hobby) because it causes me too much pain to play. The pain is constant from the moment I wake up (around a 2-3) then gets worse throughout the day (up to about a 5) when I use my wrists. I'd love to take some time off to rest my wrist but I literally use it for everything.

Things I've tried that haven't made much of a difference:

* Switching to a CSL ergonomic vertical mouse - wrist still hurts when I'm using it.
* Setting up my desk to be more ergonomic.
* Wrist strengthening exercises given to me by a physiotherapist.
* Switching mouse hands - left wrist started hurting too.
* Antinflammatories
* Improving my overall level of fitness by going to the gym.
* Installing a break reminder program on my computers (Workrave) and making sure to stick to the breaks.
* Sleeping with a wrist brace - too uncomfortable.

I've looked into graphics tablets and rollerball mouses, has anyone got one of these they'd recommend?
posted by fallingleaves to Health & Fitness (30 answers total) 10 users marked this as a favorite
You will find a whole lot of writing on this topic, with conflicting advice. I've managed my own wrist problems for 20+ years with two things. First: taking it seriously, not just trying to "push through the pain". And second, paying attention to ergonomics, specifically having a good chair and my keyboard at the right height. I'm lucky that such simple things worked for me.
posted by Nelson at 9:47 AM on August 13, 2016 [2 favorites]

A trackball could be worth a shot - I actually prefer one for office apps, where you need to click and select (as opposed to gaming or drawing, where the mouse feels more natural).

Kinesis makes a roller-bar that I always thought looked like a good idea, though I've never tried it. They also used to make a head-tracking pointer peripheral - you had to wear a shiny disk on your forehead - but I can't find that product on their site anymore.
posted by Rat Spatula at 9:59 AM on August 13, 2016 [1 favorite]

Ice your wrist whenever possible and consider trying a different wrist brace at night until you find one you can sleep in. It could make the difference.

For me the ice and a brace at night got me to a place where the vertical mouse is usually all I need to get through the day pain-free.

Good luck.
posted by toastedbeagle at 10:00 AM on August 13, 2016 [2 favorites]

I used a graphics tablet and a pen when I broke my wrist and couldn't use a mouse. I liked it to much I stuck with it for years. It's very quick to learn and uses totally different muscles, you could wear your brace and use one, or in my case a full cast.
posted by fshgrl at 10:11 AM on August 13, 2016 [1 favorite]

I found the Kensington trackball helpful. One thing I really like about it is that you can program the buttons to develop shortcuts. Also, I find the very large ball it has easier to use.

I also use an ergonomic keyboard that has a lot of shortcuts. For instance, you can use the keyboard to scroll or for "select all" instead of having to use the mouse. I'm not at work right now, so I'm not sure, but I think it's this one.

And I wear a light wrist brace while I'm using the trackball.

These things have mostly done the trick for me, but everyone is different. Have you seen an occupational therapist? That helped me a lot. One person I know says surgery was life changing, and she wished she'd done it sooner.
posted by FencingGal at 10:27 AM on August 13, 2016 [2 favorites]

My ex took a break from weight lifting and began having tendon pain while at the computer. He saw a doctor. The doc told him it was because he had stopped lifting weights and would likely go away if he resumed. He resumed. It went away.

I consumed gelatin as a supplement daily for a year or two. My tendon pain went from crippling and seriously limiting my activities to annoying.

I also found it helpful to wipe down my keyboard and desk regularly and keep everything super clean.
posted by Michele in California at 10:30 AM on August 13, 2016

I found that rotating through devices was helpful. When. i had my worst wrist pain due to overuse of the mouse, I set up a trackball and a small inexpensive wacom, I would guess the equivalent of a 4x3 Bamboo, and randomly jumped from one input device to another. Wearing a wrist brace also helped.

I found that the pen-and-tablet input device was itself also significantly less RSI inducing, probably a reflection of the fact that stylii are a multi-thousand-year-old technology which may be presumed to be ergonomically optimized.

Additionally, have you investigated screen-macro recorders? These programs allow you to chain together common actions *including* cursor movements and inputs. They can be used to override poorly-implemented UIs that lack keyboard shortcuts.

Depending on your work environment, you may not be permitted to install customization software, but given that you are headed for a work-related injury that may require surgery and be eligible for workers' comp, one would think that rule might be excepted for you if it's in place.
posted by mwhybark at 10:30 AM on August 13, 2016 [1 favorite]

I should clarify - wearing a wrist brace while at work helped, not so much the sleeping with one.
posted by mwhybark at 10:33 AM on August 13, 2016

My (Thinkpad) laptop's trackpoint nub has generally worked well for me. You can buy keyboards with a trackpoint in them (I would particularly go for one like that with a larger space to rest your wrist on, rather than the newer more compact ones.) Weird suggestion, but since nothing else is helping...

A touch-screen monitor might also work.

My stupid-cheap ($150 used on ebay) Thinkpad X220 tablet has both of these features.
posted by needs more cowbell at 10:48 AM on August 13, 2016

+1 graphics tablet, I use one from Wacom. You're using muscles that you've developed after years of writing with a pen so the strain is much less. My RSI went away completely after a year of exclusively using the pen tablet.
posted by St. Peepsburg at 11:05 AM on August 13, 2016 [2 favorites]

The CSL mouse looks like you'd still be a bit pronated. I used a joystick-like vertical mouse for a while a few years back and my wrist pain cleared up.
posted by Johnny Wallflower at 11:47 AM on August 13, 2016

On my phone so I don't know exactly what a CSL vertical mouse is, but have you tried Evoluent's vertical mouse? And if you have small hands, make sure to get the smaller model. I tried the standard size first because it was provided by work and it didn't help until I special ordered the small size. My pain was hand and forearm though, not wrist.
posted by serelliya at 12:28 PM on August 13, 2016 [1 favorite]

Invest in another brace that's more comfortable - wearing one 24/7 for a month does the trick for me for a good while, unless/until I do something to aggravate my wrist again. What's uncomfortable about your brace? I've had ones where a metal rod was just located in a bad place for me (eg right up against the bony part of my wrist). Or ones where the thumbhole was too small and the fabric cut into my skin. Some are more adjustable than others. Try a bunch out and do some mods if you have to (I just made the thumbhole larger for one, once). You can also get a PT or OT to make a custom molded splint like this or this.

Mouse: I like something very small and low profile, so that my palm curves over it naturally, with responsive buttons, so I don't have to press too hard to click. I picked up my last one at a discount electronics shop for $5.
posted by cotton dress sock at 1:22 PM on August 13, 2016

I had severe tennis elbow last year - RSI, just further up - and also had to give up guitar which is part of my job, so I feel your pain, literally. I went to a physio for about three months who actually made the pain worse with his treatment and exercise plan. I had to stop going to him as the pain was so bad, and searched for another physio. He was amazing and within three days of my first appointment and with some much simpler exercises, I was already feeling a lot better. So keep in mind that not all physiotherapists are good at what they do.

I too, did most of your checklist and I also use a mouse a lot for work (it still flares up a bit when I use the computer too much). Strengthening exercises, as long as you're doing the right ones, are recommended as your best bet, and were what worked for me after fruitless attempts at treating with ice, anti-inflammatories, therabands, changing to left-hand mouse also, etc. Might be worth your while to check out another physio. Mine literally saved me from constant pain and fear of not being able to work anymore. It does ease with the right treatment, I promise!

Strengthening of the tendons and a physio who knows what they're talking about make a world of difference. I was sent for a CT scan for my arm as the first physio couldn't figure out the problem! Turns out his aggressive massages were making it all worse! Shop around, and good luck!
posted by cornflakegirl at 2:06 PM on August 13, 2016

Do you have a diagnosis? There are lots of RSI's. Different ones require different treatment. You need to know what's going on in order to know what to do about it.

I can't even venture a guess with the info you've included. Pain where exactly?? Any numbness? Pain/numbness worse/better in different positions?

Take it seriously and see a doc.
posted by mysterious_stranger at 2:44 PM on August 13, 2016 [2 favorites]

Kensington Expert Mouse. I bought one for home and one for work after developing wrist problems. Driver lets you program the buttons and wheel per app, and has other nifty helper features.
posted by mzurer at 3:12 PM on August 13, 2016

Have you tried sleeping with a soft wrist brace?
When I was diagnosed with carpal tunnel syndrome that was the number one recommendation from my neurologist. I bought over the counter braces and removed the metal shims. With the shim the were ghastly uncomfortable. Without the shims they were supportive and easy to wear. They give your wrists 8 hours of good anatomic rest every night.

It made all the difference for me and I am pain free today.
posted by SLC Mom at 3:25 PM on August 13, 2016 [1 favorite]

I am a huge fan of the logitech non-ambidextrous trackballs. It looks like they maybe don't make the corded versions anymore (i see some on amazon at ludicrously inflated prices), but this is a wireless one.
posted by juv3nal at 5:38 PM on August 13, 2016

I tried everything for a while. What worked for me was adjusting my workstation a lot, a much smaller wireless mouse (my problems started around 2000 when I got a graphics job and wireless mice weren't a thing yet), wearing a brace overnight, switching hands occasionally to give myself a break, ice, ibuprofen, and taking a break at home (no mouse using after work at all). I have no pain now and I basically mouse 18 hours a day, but I also don't do as intensive work as I used to since I switched jobs. Seriously, give the brace a try again. I modified mine a bit to make it more comfortable, but keeping my wrist immobile for at least 8 hours helped a lot. Also ibuprofen to reduce the inflammation while I was wearing the brace.

I saw a specialist and we discussed surgery, but I didn't do it. I'd probably consider it now if it came back. I would definitely try massage and PT if it came back, too.
posted by clone boulevard at 7:06 PM on August 13, 2016

Also, if it's bad enough you could probably get work to agree to install Dragon NaturallySpeaking. A lot of mouse commands can be done by voice. That might be work exploring. I have a coworker who uses it for everything, and a friend of mine (who is a coder) uses it all day, too, for similar reasons.
posted by clone boulevard at 7:08 PM on August 13, 2016 [2 favorites]

I have much less frequent, much less painful RSI, but I've found this short yoga video (free on YouTube) helpful - Yoga for Healthy Wrists by Yoga with Adriene.

She also has a longer video called Yoga for Wrist Pain that's more about how to protect your wrists while doing yoga, which may or may not be helpful for you.

When my husband had bad RSI in college, he found that it was great to ice, but really really bad to go back to work right after icing. He needed to let his wrists warm back up before doing anything, or it would be worse than not icing at all. He also found that typing in a cold room was bad, because his wrists would get too cold.

Sorry to hear about your RSI, and good luck fixing it!
posted by bananacabana at 7:11 PM on August 13, 2016

Height of the mouse made a massive difference for me when I had RSI. Also, have you tried a trackpad rather than a mouse?
posted by Candleman at 8:28 PM on August 13, 2016

Definitely try a few different night braces. Ive had a couple that were awful and a couple that were nice and comfy. Also ice dipping. Sounds woo but helped during the worst of it.
posted by misanthropicsarah at 8:57 PM on August 13, 2016

I second the suggestion to shop around for another physiotherapist. Try to find one that specializes in hands, wrists, & arms, if you can.

My partner has issues with his wrists, and found a good physio this year. He's a guitarist, too. Contrary to what we were both expecting, she didn't prescribe him strengthening exercises for his arms; she focused on his upper back and posture only and it helped, a lot. Seems that posture can affect nerves in the cervical spine, which then affects everything supplied by that nerve (hands/wrists/arms). So if you can find a physiotherapist that looks at things holistically, it might help more than the current physiotherapy you're doing.

Good luck -- I have chronic pain, and I know how heartbreaking it can be to give up a hobby because of it. I hope you get this fixed!
posted by stellarc at 9:25 PM on August 13, 2016

Switching to the Logitech trackball linked above eliminated both the pain from RSI in my wrist and the top of my hand as well as the gigantic knot that lived under my right scapula for about 15 years. I'm also super successful at gaming with the trackball. Headshots all around. It took me about a week to get used to it.
posted by xyzzy at 1:22 AM on August 14, 2016 [2 favorites]

Something that worked for me was not general exercise but specifically something that improves posture and core strength - pilates in my case.

However as other people have said above, there are a lot of causes of RSI with different solutions.
posted by curious_yellow at 2:00 AM on August 14, 2016

I'm seconding Rat Spatula. A friend of my has carpal tunal(sp?) and using a track ball has helped him a lot. He uses the one I have:

I know what you're going through, it's awful. I've watched my friend struggle with this problem for years. Back when it started, doctors were telling him it's all in his head!

If a trackball isn't your answer, I sincerely hope someone else comes up with something that works for you. Good luck.
posted by james33 at 8:14 AM on August 14, 2016

Have you tried fish oil? I get shoulder pain from mousing and it is much, much better when taking fish oil. I take 2-4 packets of Coromega per day. No fishy burps, and you can squeeze it into a smoothie or yogurt if the taste isn't to your liking.
posted by Serene Empress Dork at 8:46 AM on August 14, 2016

I had diffuse work-related upper limb disorder for about 8 years (it's no longer called RSI, btw). Tried lots of devices and treatments. Everyone had suggestions for another device or treatment. It would sometimes get a bit better, then worse.

Try a different physiotherapist. Search for one who specialises in your specific type of RSI - or at least, someone who can tell you what your type is.

If that's not an option, here are things that worked for me. They may be relevant, particularly if your pain is correlated to computer use:

- Software called RSIGuard. It's pretty cheap and incredibly effective. There is no good substitute for this software that I am aware of; it is far superior to any free auto-break tool I've encountered.
- Swimming backstroke & doing pilates.
- A LOT of physio and prescribed exercises (again, if possible - mine was largely free)
- Stopping searching for a quick-fix & realising it would need a multi-pronged approach
- Losing my fears that it was "in my head" and that I would be permanently in pain and/or end up unemployable. It *was* partly in my head, but I had to see that as empowering, rather than a source of resentment or shame.

There's a very good book called "It's Not Carpal Tunnel Syndrome!". Something in this book helped flick a switch in my brain about how I perceived my pain and my role in it. It's informed but sympathetic. Highly recommended.
posted by 8k at 5:24 AM on August 15, 2016

I've had some success avoiding real trouble by making sure I change up my pointing device occasionally. I rotate through an Apple Magic Mouse (really my favorite), a Kensington Trackball, and an Apple touchpad. If I get twingey, I change to one of the others.

I'm also a HUGE devotee of the Kinesis Advantage keyboard. It's super weird and takes a week or so of adjustment because of the idiosyncratic placement of some keys, but the hand placement is incredibly comfortable. I really hate traveling now, because typing on a laptop is significantly less comfortable than typing on the Kinesis. (One downside is that it's a $300 keyboard, but I've been using mine for TEN YEARS, so factor that in.)
posted by uberchet at 7:19 AM on August 15, 2016

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