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How did you treat it when you were symptomatic, and what did you do since then to ensure that it won't repeat itself? What was the most helpful?

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9 Answers

Mine appeared about a year ago and included both arm pains in the Ulnaris muscle and pains in the actual fingers and their surroundings. It started rather abruptly and was partly an overuse problem (finger pains), and partly the result of a terrible non-ergonomic setup: chair with no lumbar support, table too high, laptop screen too low, laptop keyboard too small (muscle pains). Another reason was probably stress, since my idea of forcing myself to be productive was to constantly worry about school and deadlines. Stress causes your muscles to tens up, which adds to the overall strain, and I read that there is also some chemical involved that is released to the blood stream when you're pressured/angry, and in large doses can cause muscle damage. I was familiar with the concept of RSI, which was why I was able to embark on a hardcore panic trip when I realized what was happening, but I was working under the assumption that this is something that only happens to old people.

I did a bunch of things to help myself through this problem, which included both changes to the work environment and medical intervention.

The work environment/setup changes included the following:

  • Bought an ergonomic chair. This was also how I learned that selecting a chair is not trivial. I didn't test it enough in the store and essentially made the mistake of fitting myself to the chair and then deciding that it was right for me, when it really wasn't. I mention some of what I learned from this experience in my answer to this question. For a while after making the purchase I really hated the chair, until eventually I figured out that I can use a pillow to fix its deficiencies.
  • Bought a small table that had a keyboard tray at the appropriate height for me. The appropriate height turned out to be really low (about a meter high), which is how I learned that just about any table I come across in real life is too high for me (I'm a bit short for a guy). I try to work from home as much as possible and if I have to work in the university's computer room I usually place my laptop on my lap.
  • When I moved to a new apartment I discovered a miniature ironing board in the closet. I put it on the new table and now use it to raise the height of my laptop screen to eye level.
  • Bought the Microsoft Natural Ergonomics 7000 set. I was really looking forward to working with it but I couldn't get used to the mouse and the keyboard itself was too big and required more pressure on the keys than I was used to from my laptop. Eventually I bought the Microsoft Comfort Curve 2000 to serve as a cheap ergonomic keyboard in my mother's house (which I return to on the weekends) and discovered that its flatness and light keys are a much better fit for me than the huge Natural Ergonomics keyboard, and bought another one to replace it.
  • I made myself learn proper touch typing so that I could work without looking down at the keyboard. At first it was uncomfortable because it seemed to require more muscle strength than hunt and peck, and my pinky fingers were quite traumatized at the time, but I compensated by using the weight of my fingers to reduce the amount of force I needed to press the buttons, and over time my muscle strength actually improved (I even gained muscle mass in the arms).
  • My problem with mice was that it was uncomfortable to hold them in the standard way because it put pressure on the area at the base of the fingers, which was quite tender at the time. To be able to hold the mouse at an angle and thus alleviate the pressure I switched the left and right mouse buttons so that I could hold my mouse from the side (picture here). I also switched the mouse click settings in Windows to hover==select, click==double-click, to eliminate the strain of double clicking.
  • To reduce the mouse use I learned some Firefox hotkeys and installed the Speed Dial addon. Most of my site navigation happens through ctrl+N).
  • I tried the Microsoft speech recognition software as a way to dictate blog posts, but abandoned it after a while. It's pretty good, but we need more than 80% accuracy for it to be practical.
  • I installed WorkRave to remind me to take pauses. At first I let it be quite disruptive, and set it for a 30 seconds break every 5 minutes, but I relaxed this over time. Today I actually don't use it anymore.

Some lifestyle changes I made were:

  • Took an overall break from typing. It happened in time for the summer break so it was pretty feasible to do this.
  • Forced myself to relax. Back then, every time I got angry I started feeling pains in my arms due to my muscles tensing up, so it was obvious to me that this had to stop. It's less of a problem now, but still leads to a bit of discomfort so overall I try to get over my "someone's wrong on the internet"-esque impulses.
  • Started to exercise. When my lease was done I moved into an apartment that was a 30 minute walk distance from my university to force myself into a daily hour of walking. Signed up to a Yoga class and swimming lessons. Stopped taking the elevator and wearing my back pack "on the side".

As for getting medical help that was a bit problematic. At first my family doctor didn't think much of the pains and tried to treat it first with a dietary supplement of vitamin E and calcium (I think), then gave me anti inflammatory drugs which only alleviated the symptoms. Eventually I was sent to an orthopedist who gave me a cream which was again mostly treating the symptoms, and sent me to physiotherapy, where I was given treatment with waves. The idea behind this treatment was that the waves heat the injured area from the inside in a way that heating from external sources can't do. The heating alleviates the pain and increases blood flow to the area, which encourage healing. This was actually one of the things that helped me the most. I literally felt myself getting better after a few treatments, and after they were over I continued to "practice" it by placing my hand under hot running water, specifically at the kitchen sink (there's something about the weight of the stream and its speed that encourages blood flow in a way that a shower stream doesn't).

Overall the things that helped me the most were the physiotherapy and the added exercise (it's amazing how much exercise helps. Nowdays when I skip my daily walks I immediately start feeling various pains in my back and arms). Learning to relax and taking a break come in second. In the long term the changes to the work environment and the infrequent nature of working on programming assignment are what kept me from reverting to the bad state I was in, and to actually improve my muscle strength. Occasionally taking some anti inflammatory drugs and using hot running water are my current methods for dealing with pains when they do arise.

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I've had a few instances over the years. Based on visits with doctors and other research, I've settled on the following:

  • a good keyboard (I use a kinesis, expensive but worth every penny )
  • a good chair (my leap rules)
  • avoid using the mouse. On days when I spend more time surfing the web than coding I definitely notice a big difference.
  • stretching 3 times a day. Focusing on hands, arms and back.
  • I occasionally wear a brace to bed, apparently I sometimes curl my hands and wrists under me when I sleep which certainly doesn't help.

RSI is certainly something you want to catch early.

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2  
+1 for "avoid the mouse". – Frank Shearar Oct 2 '10 at 17:49
1  
My physio told me to reduce the mouse speed and acceleration to be closer to the actual physical distance that it travels. The benefits are two-fold: (1) the reduced 'down-scaling' that your brain has to do to translate large screen movements to smaller hand movements, and (2) reduces the tension in all the muscles in your hand and wrist as these tend to tighten up when you're trying to accurately move a fast-moving pointer to fairly small buttons and checkboxes, etc. – JBRWilkinson Oct 6 '10 at 23:41

Yes.

Mine was (well still is really) caused by me injuring my right shoulder in an ice skating incident (I fell over :().

Now if I use the mouse with my right hand for any length of time I get various pains up my arm and into my shoulder.

My solution is to use the mouse with my left hand. I don't swap the buttons so a left click is still a left click but I use the middle finger of my left hand rather than the index finger of my right. This seems to do the job and while my fine motor skills aren't quite there yet I can do everything I need to without having to think about it.

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I also switched to mousing with my left hand when I started feeling the early indications of RSI. An added benefit is that it has improved my overall keyboard skills. Since using the mouse with my left hand is awkward I have gone out of my way to learn how to avoid it, such as using Vimperator and Muttator for browsing and email. – ubernerd Sep 13 '10 at 13:01

If you use a mouse, avoid using a mousemat or anything that restricts the area you can move it in. This definitely strains my wrist less.

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A few years ago I started getting a dull pain just beneath my right elbow. I figured it was because of using the mouse, as it increased slightly as I moved the mouse around. I read somewhere that getting an inclined mouse (one where its surface where you hold is not horizontal but near vertical), so I got one. And within a month or two, the pain went away. Never had a problem since.

I also try to use the mouse as little as possible, but I only started with that after the pain had disappeared.

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Get a workplace desk assessment, or something similar in your country/language. Have someone come over to visit you at your working environment to assess your needs such as:

  • Desk height
  • Monitor height
  • Chair support and adjustability
  • Whether you need an angled footrest.
  • Your keyboard - is it the right type for your posture and usage.
  • Your mouse - is it the right type for your posture and usage.

Many companies will organise this for you - it is in their interests as the assessment is ~ £80 but lost days due to work-related illnesses really cost a lot, and some of those illnesses can become chronic and lead to long-term sickness or, more commonly nowadays, law suits.

I have previously had serious RSI problems when doing a lot of work which requires CTRL+this and CTRL+that, either copy-pasting information from one form to another or similar left-ring-finger to left-index-finger rocking action which put strain on my wrist. After a while, I removed the left CTRL, SHIFT and ALT keys, forcing me to use the ones on the right hand side. This helped a lot but a better move was to find a way to automate the repetitive job I was doing and moving to a Microsoft Natural Keyboard, which gave me more room for my big hands.

When doing a lot of mouse work, I developed some serious aches and pains in my right hand and wrist, so I did some research and found the Evoluent Vertical Mouse. I convinced my workplace to buy a couple of them (one for desk, one for 'home working') and this has been an excellent purchase. I think it came with some optional-install software to remind you to take a break when you'd clocked up several "mouse miles".

It wasn't RSI, but last year I developed a problem whereby my left arm and hand would become quite numb, pretty much all of the time. My dexterity dropped as I couldn't feel what I was doing and my productivity and attendance took a nose-dive as the numbness developed into serious pain. It got so bad I went to see the doctor who spent £2000 putting me through a serious of tests including MRI scanning and electro-conductivity testing. A prescription of a course of physiotherapy soon identified a knot in the muscles on the left of my neck. While dicussing the issue with the physio, she identified that the problem was I kept twisting my head 30 degrees to the left and 15 degrees upwards. She deduced that I had two monitors at slightly different heights and angles, which I did and hadn't realised how bad that could be. After physio, and a workplace assessment to make sure no other issues, everything is fine now.

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I've had bad RSI episodes twice in my life, mainly in my mouse hand, to the extent that I have questioned my ability to continue in my career.

In both cases I was able to resume computer work eventually by:

1) Initially taking lots of rest (several weeks).

2) Assessing and optimising my work environment and routine to minimise stress on my body.

3) Using dwell clicking software to reduce mouse clicking (this has a huge effect).

4) Avoiding excessive computer use outside work. No gaming.

5) Taking regular exercise breaks away from the screen (Maybe just a walk round the office, stand up and stretch, hand exercises etc.)

6) Exercise and breathing; doing yoga; attention to posture. Lightness of touch. Economy of action.

7) Planning work to minimise computer contact time (you can do a lot of the design work, reading, and thinking away from the screen - use pen and paper).

8) Limit computer time per day; no all night sessions, no getting carried away.

Why did it come back the second time? I neglected to do too many of the above, for too long. In short, I forgot about RSI and thought it wouldn't come back. I was wrong.

RSI can be beaten, but it does require changes to your lifestyle and work approach.

For people without RSI -- consier doing the above things anyway. Once RSI bites, it's already too late. It never really goes away, but you can adapt to it.

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I had a lot of problems with my wrist when I started my internship, probably because I used a cheap crappy mouse.

Switching to a more ergonomic mouse, where the surface you hold is more vertical, fixed it.

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