This may help someone out there. I had chronic tennis elbow for years, tried a huge array of options to fix it and failed... until: I found a _vertical_ mouse.
Yup, vertical mouse solves most of my right-side issues. It can't be one of those cool-looking vertical mouses either (e.g. Anker, Evoluent). While those do help, it's not enough for me. I get the most relief from an actual joystick vertical mouse.
Not a vertical mouse, but surprisingly good. Only miss mice when playing around with graphics software. I have it in PS/2 and USB, and they did a hack job with the USB hardware, it's very low resolution. PS/2 connector gives a very smooth and nice trackball experience if anyone is tempted.
Wish there was more competition in ergonomic input devices. Was just searching for a new mouse and couldn't find a vertical mouse with acceptable reviews.
Ended up forgoing the vert. mouse altogether and buying a Logitech MX Master to replace my Logitech G500 (which I've used for many years and is now discontinued) and I'm pretty happy with it so far. I'm even pleased with its gaming performance (probably not OK for highly competitive or pro gamers, but np for me). Mouse was visibly sluggish over Bluetooth but works great over Logitech RF.
Although the MX Master is not billed as an ergonomic device, it fits my hand better than the G500 and I already feel some relief of the slight pain in my right wrist.
I've used a Kinesis Advantage keyboard for about 3 years (and the MS Ergo 4000 for several years before that, in response to pain that developed before I even turned 20) and it's been a godsend. Would like to find a good ergo mouse before I'm forced to.
The DXT Mouse by Kinesis is the absolute best mouse I've ever used. It's ambidextrous so you can switch back and forth to do wear-leveling. It's crazy comfortable. You may have to raise it up on a book or something though next to your keyboard due to the different way you hold it.
I switch back and forth between a DXT mouse and a trackball every couple days so that I'm not always doing the same motions.
I also use auto-click software so that I don't have to click the mouse. I use RSI Guard which has this feature.
The Microsoft Sculpt Ergonomic mouse is semi-vertical (this might depend on how you hold it) and tracks better than the Evoluent mouse I was using before, although the ergonomics are probably not as good. The build quality is also better IMO than the Anker / Sharkk vertical mice popular on Amazon.
Haven't tried the DXT mouse mentioned in the other comment.
I was in pain for a year or more. I got a forearm massage to eliminate the knots. Then I changed my typing style to be more about comfort and less about what the typing instructors wanted. No problems in the 15 years since.
I credit my never having had typing-related stress with being a self-taught typist. My hands rest naturally with wrists straight, unlike "home row" position which would have the wrists bent, and there are several keys which I type with either hand.
(I have had mouse-related grip stress, which I solved by switching to a trackball.)
I got an RSI injury on my left hand and was unable to type normally for a few years. I went so far as to learn Dvorak RH which, even though I got reasonably good at it after a couple of years, was still crappy for programming.
After a very dark period of taking jobs that required less typing (Kafkaesque jobs at mega-corps involving mostly fixing other people's bugs), I'm better now because of:
1) Using an Apple keyboard, which even though it doesn't look ergonomic, the reduced key travel has helped immensely.
2) Using JetBrains' IDEs instead of vim. If you are a bash/vim/tmux (or equivalent) user like I was, try coding in your favorite language in a JetBrains IDE. Automated refactoring and code completion are your friends.
3) Try drinking red wine. The resveratrol in red wine is a natural anti-inflammatory.
Maybe for some? I had been using an "ergonomic" Microsoft keyboard for years, but found that it was the amount of force and distance to depress a key that was causing me problems.
I'm using the Microsoft Sculpt keyboard at work at the moment, which has a similar ergonomic layout but less travel than my old Natural. It's also really nicely made (magnetic stand + battery cover, and fairly sleek design).
However, one fairly significant issue is that the top row uses buttons instead of keys. It doesn't bother me too much, but I can imagine that would mess with some people's workflows. Also the corresponding "ergonomic" mouse was the worst I've ever used. It's like a large ball that forces me to stretch and grip constantly to keep my fingers on the buttons. I replaced it almost immediately.
It is, but I had the same experience as GP FWIW. For me mechanical keyboards are the absolute worst; light touch, short travel, and switching to Dvorak are what saved me.
It's not so much the key travel as the overall 'feel' relative to how your muscles learned to type. Everyone's different and react differently to different keyboards. What's most likely the issue is the not-conscious feedback loop that tells your fingers when to stop pressing. With some keys you type lightly, other types of keyswitches lead you to mash the keys with a high force until you're bottoming out on the pcb. It's that impact that generates high forces.
Does that mean that if I type very hard and I feel there's no hope for me to learn not to bang on the keyboard, the most, well, healthy keyboard for me will be the one with the longest key travel?
I've made a few extensive posts about this here before too. Had 24/7 RSI paint for years. At the worst I couldn't hold a mouse.
Thousands of dollars of ergonomic chairs, keyboards, and so on made it so I could work but still had constant pain.
Started doing pushups (which I had avoided because I thought they made it worse.) Four weeks later I was using a laptop and suddenly it hit me I had been typing for 30 minutes with no pain. Life changing. Zero pain now and I can work 12 hours straight.
Definitely is some combination of the muscles and tendons tightening up in the arms and shoulders. The pain being in a different spot makes in misleading.
I've been saying this for years to my colleagues. Pushups is key to basic overall muscle health. A simple exercise, can be done anywhere, and works your entire body. You'll no longer have lower back pain either. Take a break every hour or so, bang out ten pushups, go get some water. Get back to work. No big deal.
I really don't think one can emphasize the health and life benefits of any sort of full-ish body strength training. I'm a huge proponent of full body movement based barbell training, but exactly like you said, pushups, pullups, that sort of thing makes every aspect of your life better. No one has ever regretted getting even a little bit stronger.
I love rowing for conditioning. It's up there with prowler/sled for puke factor if that's what you're going for, and it's great for general cardio if you don't like uncontrollable body tremors.
I believe that the primary cause of my hand pain is my forward head posture. This can create trigger points in the scalene muscles of the neck which cause sattelite trigger points in my forearms (especially the extensor muscles) and in my upper arms as well. These trigger points then refer pain to the hands. Self-massage using a lacrosse ball has pretty much eliminated my pain and seems to significantly increase bloodflow to my hands.
NOTE: be very gentle the first time you do self massage of the scalenes with your fingers. I went too hard and my scalenes swelled up for 3 days and I experienced the symptoms of thoracic outlet syndrome, ie. I had numbness from my collarbone to my middle and ring finger on my left side. It went away once my neck healed.
It definitely seems circulation related: whenever I use a computer with cold hands, it causes tension and then pain.
I make sure to never use a computer with cold hands. I recently purchased this Far Infrared heating pad to heat my hands. It really does work a ton better than traditional heating pads with resistive coils. https://www.amazon.com/UTK-Infrared-Electric-Therapy-19-Inch...
Also, it is critical to correct the weakness and structural problems in the body. I do yoga, strength training, and swimming and these seem to be helping keep the trigger points from coming back. I am also doing shoulder mobility exercises with a stick and following this guide to correct my forward head posture: http://posturedirect.com/forward-head-posture-correction/
Just under half of the exercises prescribed by my physio are in that last link, and I expect that many of the remainder are coming up in a future appointment.
Got a hand grip exerciser: https://www.amazon.com/dp/B01AJ6HZLG?psc=1 wonder if this just helps with blood flow like suggested. Perhaps then maybe rubbing some warming lotion might help as well.
I use an IBM Model keyboard. It is a larger keyboard so there is less sideways bending at the wrist, but Kinesis keyboard might be better there.
An adjustable standing desk. I try to stand as much as possible, and then adjust the height to keep arms relaxed.
So far feels much better, sometime pain goes away completely, but still not 100%.
In this thread there will be many people with many different degrees of RSI who have solved it using a variety of different solutions. That is because the symptoms can be caused by a variety of different things. The defacto standard high level overview is https://www.amazon.com/Its-Carpal-Tunnel-Syndrome-Profession...
This and the book in the comment previous have both been helpful to me, along with good physiotherapists who understand trigger point release.
I use a split keyboard with a graphics tablet in the middle and a mouse either side of the keyboard - this gives me a good variation of hand position. Right hand mouse is vertical.
I find stretching, weights and cardio to be beneficial. The stretching helps to keep the nerves free from impingement, the cardio keeps a good blood flow, and the weights are rebuilding strength and muscle that atrophied during the year where it was too painful to use my hands & arms.
Thanks everyone in this thread for sharing your techniques - it's always good to hear what other people find effective.
The real solution is we should only work 30 hour weeks. Try telling that to your boss though, it's often hard enough to get an ergonomic pencil.
I had problem with my right hand. Majorly due to mouse usage. I'm not typing much (even being software developer).
I have also tried different physical activities but it's only solving problem temporally.
So my lifehack: switch mouse to left/right hand from time to time (or at work left handed, at home right handed). That's it.
Yes, it's a bit awkward on beginning, but take that as challenge. And it will bring less harm than pills. In couple weeks you won't have problems to use mouse with any hand.
Of course if you're typing a lot and you have problem with both hands due to keyboard usage my solution will not work for you.
I also switch back and forth which hands I use the mouse with. I use the Kinesis DXT mouse which is an ambidextrous vertical mouse. It makes this use-case very easy. switching hands is as easy as pressing a button and moving it.
I also recommend using auto-click software so that you don't have to click the mouse as often. I only click to click-drag, double click, and right click.
I also use the CVim chrome extension to browse with a keyboard.
When I first started getting RSI, it was in the mouse arm, up near the shoulder. I did something similar, but wound up with a mouse on each side of my keyboard. That cleared it up reasonably well, and since then my main mouse has always been on the left.
I think that the combination of a keyboard with a numeric keypad (wiiiide) and a right hand mouse is the main trigger, not the concentrated mouse usage with one hand. If I could find one of the narrow model M keyboards, I'd consider moving back to the other side.
The other things I've done have all centered on being aware of where nerves are near the surface, and never putting pressure there. If you're getting numbness in the thumb and first finger, it's likely carpal tunnel. If it's all over, it's more likely at the elbow.
As already mentioned, everyone's RSI is different so no one solution works for everyone, and if you have RSI, you should try everything until you find something that works for you.
The two biggest wins for me have been a standing desk for posture improvement, and wearing wrist braces at night.
I've dealt with RSI and carpal tunnel syndrome for almost two decades, off and on. Some of my triggers are chairs with arms (I almost can't help but lean on them, making my posture horrible and disrupting blood flow), bad weather (rain and cold), stress, depression (all pain is worse when you're depressed).
My first real recovery came when I got an Aeron and lowered the arms enough to where I couldn't lean on them, switched to a tiling window manager and stopped using the mouse (I am back to normal mouse and window manager these days, but when I feel the twinges of pain, I will sometimes switch back), and fixing the source of some of my stress (money was a stresser back then, and I took a contract job that paid well and got my debts paid off and some savings in the bank, so I could get back to working on the stuff I wanted to work on).
I don't know which of these things was the real cure, though I do know that using a chair with arms I can lean on is the fastest way to bring the pain back.
I suspect it is never "cured", it's just managed. Since figuring out my triggers it's been rare that I've experienced the pain for more than a few hours or days, and taking a walk, massaging my hands and wrists, etc. can usually get me back to work.
Kudos to him. Among other things, I consumed gelatin daily for a year or two to feed the damaged tendons and ligaments, which helped significantly but didn't fully resolve the issue. It is resolved (at least for now), without surgery or drugs.
My pain started coming back this year. One thing that always helps my mouse hand, is to rest my arm on a raised surface (currently a portfolio), but I've used a textbook before. This caused my hand to drop down to touch the mouse, instead of being pushed up, and changed the body part that gets anchored and pivots when moving the mouse from my wrist to my elbow. That really helped a lot.
I still had issues with my left hand, and for me what has helped this time around is a ComfortBead Wrist Rest along the bottom of the keyboard. I'd used it years ago and wasn't convinced, but this time it's clearly and definitely helped a lot.
In the past, I've sometimes gotten some relief by switching which hand is the mouse hand. Every once in awhile I'll let my left hand control the mouse for a bit.
> and changed the body part that gets anchored and pivots when moving the mouse from my wrist to my elbow.
I'm not a doctor, etc.
I set my mouse acceleration pretty high. I have a relatively small mouse, Logitech M325. My forearm, elbow and shoulder don't move at all when I move my mouse.
To move the mouse from one corner to the opposite diagonal, the mouse just moves under my fingers. Most of the time my wrist doesn't move at all.
I've been a programmer, and later jobs that type just as much, since the eighties, and I've never had any kind of RSI. Of course that's me, my body and activity, YMMV etc. But this is worth a shot.
It's also extremely fun to watch a colleague try to drive my mouse and drive off the cliff.
EDIT: Thinking about this a little more. First of all "I've never had any kind of RSI" could just mean that I'm not susceptible to that type of injury.
How I hold my mouse: (works for me)
If I hold my arm up a bit, so that my upper and forearm are something like a V, hand held loosely out and relaxed, then the thumb and index form something like a V, and the fingers are loosely spread out. This puts my thumb about an inch, inch and half below my index.
Now I drop my hand down over my mouse (I don't actually go through this procedure, this just gets you to my position), maintaining that hand configuration roughly. This puts my thumb and pinky just below the bottom edge of the mouse, index on the left button and middle resting lightly on the weel, and ring finger just under the top edge of the mouse on that side. If I pick up the mouse it's held by the thumb and pinky, with a little extra support from the ring finger. To use the right button I move my middle finger over as necessary.
Note that I don't have to move my middle finger forward or back to use the wheel, it's already there. If things get wheely I can lift the middle up a bit. For my hand, this puts the back of the mouse below my highest knuckles.
There are depressions on both sides of the mouse, which look like the natural place to hold it. But if I move my thumb and pinky up into the depression, that pressures my index and middle up. To depress either button or mousewheel it feels like I'm slightly overextending my fingers, and I can feel more effort in my forearm muscles. I also feel effort in my wrist to hold my hand up like that.
When I move the mouse, the outside edge of my pinky and side of my thumb drag on the desk (or couch, at the moment).
If I do lift the mouse up, I just hinge my wrist up a bit, I don't lift my forearm. And my hand hardly moves out of its place, to the point that I sometimes have to clean gummy gunk off my desk, within about the area of a single hand, in one specific place.
So this works for me, I think, because I let all my hand/finger positions and muscles be as natural and lazy as possible. Plus, the mouse fits my hand well, and I've been doing it like this for a long time.
Side note: I hate track pads, and always disable mine, for whatever that's worth.
One useful approach is to use dramatically different mice on different PC's. I find focusing on the one true way, sets you up for RSI in your new setup.
Here's my anecdote. I had painful but not debilitating RSI-like symptoms for a couple of years. For me, fixing this came down to a set of fairly simple things: the Kinesis Advantage keyboard mentioned in the article, setting a timer to force myself to take rest breaks, focusing on posture when working. At least in my case, the issue seems entirely mechanical, and I'm sceptical of psychological and emotional explanations like Sarno's.
It can contribute though. I typed at high speeds for years without issues, it wasn't until I took a stressful job typing all day and my muscles were constantly tense that I got RSI.
I used Sarno's book to cure myself back in 2002 and this approach has been successful ever since. Occasionally I will have some issue (though rarely wrist pain), and I can make it go away quickly by addressing the psychological root cause.
I highly recommend reading his book "The Mindbody Prescription"
Me too. It was a big cognitive leap to accept that the pain could be psychological, but once I'd made it and accepted it it worked. Still get pain from time to time, don't worry about it and instead try and work out what's bugging me that I'm not engaging with, and this nearly always gets rid of whatever it is.
I got RSI some 26 years ago, due to entering a university CS environment where the workstations and terminals had very light action keyboards. I was used to hammering on stiff, long-travel behemoth keyboads, and of course continued that same pounding on the light ones which shocked the tendons, since I was basically tapping my fingers hard against the keyboard base with no shock absorption from the keys.
The fact that I was doing curls with 45 lb dumbbells in the gym didn't help the wrists, either, not to mention playing guitar.
I ended up with pain, tingling and numbness. The university sports med clinic prescribed a NSAID (naproxen). That did provide some relief.
I overcame the RSI by working exclusively through a DEC VT100 terminal (the actual DEC VT100). Its heavy-duty keyboard with stiff action and long key travel didn't irritate my wrists. Eventually I went over to the light-action/short-travel keyboards that are now ubiquitous.
I had carpal tunnel syndrome to where I lost sensation in three of my fingers, and could not grip properly in that hand.
A chiropractor helped me recover. It took three months, a bit more attention to how I sat and leaned and used my computer equipment. But the pain in my neck and upper back went away, the pain in my arms and shoulders went away, and the sensation and strength came back in my hands.
I didn't rush out to get a special keyboard, though my 1984 Model M keyboard is already special, just not in an ergonomic way.
I had a friend who had problems and discovered through research that reversing your mouse buttons does it. The tunnel/tendon used by the middle finger is much better for some reason with the constant clicking.
This resolved it for him, my wife and me as well. I hope it helps someone else.
I have off-and-on pain in my right index finger. (Arthritis is one possibility.) Some of the time, I turn my mouse hand a bit and use the middle finger for the left button.
Try actually reversing them so you always use the middle finger all the time. It takes a little getting used to, and using someone else's computer (or them using yours) is a pain. But I find it takes just a day or two to see big differences.
You also can simply move your mouse to the other side of the computer, and run it with your left hand. (You can reverse the buttons or not, as you prefer.)
I have light wrist pain that is worse some days than others.
What helps me.
1. Heavy deadlifts. This helps grip strength a lot and strengthens my wrists.
2. Posture. I removed the arms from my chair, like SwellJoe mentioned.
3. Posture. Keeping my hand positioned on the keyboard properly. Don't rest the wrists on my laptop.
4. Stretch.
Nerve damage is serious business kids! If you feel it coming on, you need to pay attention and take action. Don't wait until you start randomly feeling needle stabs all day like I did while in the middle of a year long, high pressure, large code volume project. Doc told me to get surgery. I cured it myself the hard way instead. Huge inconvenience for many months. Very happy with that decision today. Here's what worked for me:
* Two keyboards and two mice. One set on my desk. The other keyboard on my lap and the other mouse on a pedestal at my side. I would switch up which keyboard/mouse I was using every 10 minutes or so.
* Typing like I couldn't move my hands. Literally letting them hang limp and moving my arms a lot.
* Pay attention. Take breaks. Notice what feels bad. Notice when you need to change up what you are doing --probably many times an hour. Take off your watch/rings. Watch out for resting your forearm/wrist on anything.
For me tho soluton was switiching to the Dvorak Keybeard.
The reduced travel of my hands has really helped.
All it took to switch was:
1. Practice in KP Typing Tutor 1 hour a day for 3 weeks.
2. Change my computer configuration. (The first week of change was the hardest, I was at 50% my normal speed).
3. Done.
Changing to another keyboard has a price you won't comfortably use other people's computers.
And they won't be able to use yours.
But the benefit of being without pain is so worth it.
Go vertical, kids. For keyboard, I have used a Kinesis Freestyle w/ the Ascent explicitly designed for this purpose but now I just use the Matias Ergo Pro with some tripod parts to keep it vertical https://geekhack.org/index.php?topic=79810.0 (since the pic I have changed a bit but nothing significant, I have these four parts now forming an adjustible, 12" long column: 1/4" to 3/8" male-male spigot, Manfrotto adjustible column, Triopo Short Column, 3/8" female to 1/4" male adapter). The huge advantage of this vs the Kinesis is the super light weight so you can travel with this setup easily. And despite the end result is quite wide it actually collapses into smaller parts so I can just pack them in the same padded tablet bag as the keyboard. Alas, the same bag is now out of production and I honestly have no idea what to recommend. In the same forum you can find other solutions to keep it vertical.
For mouse, Evoulent is good and I have used many generations of it and I can tell you the difference is negligible so you can just go on eBay and buy an older generation for cheap. It is a b!tch to travel with as it is really oddly shaped. Oh well, nothing is perfect.
Never even considered going "vertical" for a keyboard. I wonder if a future laptop utilizing this would have a screen hugged by two keyboard-buns? Future tech sandwich.
I've always wondered why they don't make keyboard halves that attach to arm rests on the typical office chair. So your arms are lowered for more blood flow, and the wrists and elbows in a more natural/neutral position. I'd buy it.
In the meantime, I have a MS "natural" keyboard, and a vertical mouse as well. Those have solved all my RSI/wrist pains.
Going back to flat or compact keyboards and horizontal mice is extremely annoying. Not just the muscle memory gap, but the positioning just feels wrong.
My experience is that vertical keyboards only alleviate some problems and even cause new ones. They do relieve pressure from the ulna and radius being in a twisted position and they obviously relieve pressure from the side of the hands. On the downside, they put strain on the shoulders and neck since the arm is held freely in the air for prolonged time. Vertical keyboards also don't help with issues due to spreading ones pinkies too far for reaching control, shift and enter. For me the Kinesis Advantage was overall a far better relief. None of the measures I tried were however more effective than stretching and upper body strength training.
I had the problem despite of arm rests. Keeping the hands in a lifted position was the problem, moreover even a slightly bad pose caused my hands to bend downwards to reach the keys, which is also suboptimal. Armrests themselves are not optimal for supporting the arm because the surface area is small and hence the pressure is high.
Have you tried the Dvorak keyboard layout? Programmer Dvorak is a much more natural way of finger flow than qwerty and you can see (via statistics) that is reduces the "miles" your fingers "walk"
244 comments
[ 3.0 ms ] story [ 231 ms ] threadTurns out it was a micro-injury thing...
Not a vertical mouse, but surprisingly good. Only miss mice when playing around with graphics software. I have it in PS/2 and USB, and they did a hack job with the USB hardware, it's very low resolution. PS/2 connector gives a very smooth and nice trackball experience if anyone is tempted.
Ended up forgoing the vert. mouse altogether and buying a Logitech MX Master to replace my Logitech G500 (which I've used for many years and is now discontinued) and I'm pretty happy with it so far. I'm even pleased with its gaming performance (probably not OK for highly competitive or pro gamers, but np for me). Mouse was visibly sluggish over Bluetooth but works great over Logitech RF.
Although the MX Master is not billed as an ergonomic device, it fits my hand better than the G500 and I already feel some relief of the slight pain in my right wrist.
I've used a Kinesis Advantage keyboard for about 3 years (and the MS Ergo 4000 for several years before that, in response to pain that developed before I even turned 20) and it's been a godsend. Would like to find a good ergo mouse before I'm forced to.
I switch back and forth between a DXT mouse and a trackball every couple days so that I'm not always doing the same motions.
I also use auto-click software so that I don't have to click the mouse. I use RSI Guard which has this feature.
https://www.amazon.com/Kinesis-Corporation-Wireless-Promotes...
Haven't tried the DXT mouse mentioned in the other comment.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971639/
I do it once a week after I lift weights and it has cleared up my tennis elbow nicely (and helped programmer RSI, I think too!).
(I have had mouse-related grip stress, which I solved by switching to a trackball.)
After a very dark period of taking jobs that required less typing (Kafkaesque jobs at mega-corps involving mostly fixing other people's bugs), I'm better now because of:
1) Using an Apple keyboard, which even though it doesn't look ergonomic, the reduced key travel has helped immensely. 2) Using JetBrains' IDEs instead of vim. If you are a bash/vim/tmux (or equivalent) user like I was, try coding in your favorite language in a JetBrains IDE. Automated refactoring and code completion are your friends. 3) Try drinking red wine. The resveratrol in red wine is a natural anti-inflammatory.
If mousing is the problem, then using vim will help IMO
I thought the conventional wisdom was that Apple keyboards caused RSI?
However, one fairly significant issue is that the top row uses buttons instead of keys. It doesn't bother me too much, but I can imagine that would mess with some people's workflows. Also the corresponding "ergonomic" mouse was the worst I've ever used. It's like a large ball that forces me to stretch and grip constantly to keep my fingers on the buttons. I replaced it almost immediately.
Thousands of dollars of ergonomic chairs, keyboards, and so on made it so I could work but still had constant pain.
Started doing pushups (which I had avoided because I thought they made it worse.) Four weeks later I was using a laptop and suddenly it hit me I had been typing for 30 minutes with no pain. Life changing. Zero pain now and I can work 12 hours straight.
Definitely is some combination of the muscles and tendons tightening up in the arms and shoulders. The pain being in a different spot makes in misleading.
The Trigger Point Therapy Workbook: https://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-T...
I believe that the primary cause of my hand pain is my forward head posture. This can create trigger points in the scalene muscles of the neck which cause sattelite trigger points in my forearms (especially the extensor muscles) and in my upper arms as well. These trigger points then refer pain to the hands. Self-massage using a lacrosse ball has pretty much eliminated my pain and seems to significantly increase bloodflow to my hands.
NOTE: be very gentle the first time you do self massage of the scalenes with your fingers. I went too hard and my scalenes swelled up for 3 days and I experienced the symptoms of thoracic outlet syndrome, ie. I had numbness from my collarbone to my middle and ring finger on my left side. It went away once my neck healed.
It definitely seems circulation related: whenever I use a computer with cold hands, it causes tension and then pain. I make sure to never use a computer with cold hands. I recently purchased this Far Infrared heating pad to heat my hands. It really does work a ton better than traditional heating pads with resistive coils. https://www.amazon.com/UTK-Infrared-Electric-Therapy-19-Inch...
Also, it is critical to correct the weakness and structural problems in the body. I do yoga, strength training, and swimming and these seem to be helping keep the trigger points from coming back. I am also doing shoulder mobility exercises with a stick and following this guide to correct my forward head posture: http://posturedirect.com/forward-head-posture-correction/
I use an IBM Model keyboard. It is a larger keyboard so there is less sideways bending at the wrist, but Kinesis keyboard might be better there.
An adjustable standing desk. I try to stand as much as possible, and then adjust the height to keep arms relaxed.
So far feels much better, sometime pain goes away completely, but still not 100%.
I use a split keyboard with a graphics tablet in the middle and a mouse either side of the keyboard - this gives me a good variation of hand position. Right hand mouse is vertical.
I find stretching, weights and cardio to be beneficial. The stretching helps to keep the nerves free from impingement, the cardio keeps a good blood flow, and the weights are rebuilding strength and muscle that atrophied during the year where it was too painful to use my hands & arms.
Thanks everyone in this thread for sharing your techniques - it's always good to hear what other people find effective.
The real solution is we should only work 30 hour weeks. Try telling that to your boss though, it's often hard enough to get an ergonomic pencil.
Of course if you're typing a lot and you have problem with both hands due to keyboard usage my solution will not work for you.
I also recommend using auto-click software so that you don't have to click the mouse as often. I only click to click-drag, double click, and right click.
I also use the CVim chrome extension to browse with a keyboard.
I think that the combination of a keyboard with a numeric keypad (wiiiide) and a right hand mouse is the main trigger, not the concentrated mouse usage with one hand. If I could find one of the narrow model M keyboards, I'd consider moving back to the other side.
The other things I've done have all centered on being aware of where nerves are near the surface, and never putting pressure there. If you're getting numbness in the thumb and first finger, it's likely carpal tunnel. If it's all over, it's more likely at the elbow.
The two biggest wins for me have been a standing desk for posture improvement, and wearing wrist braces at night.
My first real recovery came when I got an Aeron and lowered the arms enough to where I couldn't lean on them, switched to a tiling window manager and stopped using the mouse (I am back to normal mouse and window manager these days, but when I feel the twinges of pain, I will sometimes switch back), and fixing the source of some of my stress (money was a stresser back then, and I took a contract job that paid well and got my debts paid off and some savings in the bank, so I could get back to working on the stuff I wanted to work on).
I don't know which of these things was the real cure, though I do know that using a chair with arms I can lean on is the fastest way to bring the pain back.
I suspect it is never "cured", it's just managed. Since figuring out my triggers it's been rare that I've experienced the pain for more than a few hours or days, and taking a walk, massaging my hands and wrists, etc. can usually get me back to work.
I still had issues with my left hand, and for me what has helped this time around is a ComfortBead Wrist Rest along the bottom of the keyboard. I'd used it years ago and wasn't convinced, but this time it's clearly and definitely helped a lot.
In the past, I've sometimes gotten some relief by switching which hand is the mouse hand. Every once in awhile I'll let my left hand control the mouse for a bit.
I'm not a doctor, etc.
I set my mouse acceleration pretty high. I have a relatively small mouse, Logitech M325. My forearm, elbow and shoulder don't move at all when I move my mouse.
To move the mouse from one corner to the opposite diagonal, the mouse just moves under my fingers. Most of the time my wrist doesn't move at all.
I've been a programmer, and later jobs that type just as much, since the eighties, and I've never had any kind of RSI. Of course that's me, my body and activity, YMMV etc. But this is worth a shot.
It's also extremely fun to watch a colleague try to drive my mouse and drive off the cliff.
EDIT: Thinking about this a little more. First of all "I've never had any kind of RSI" could just mean that I'm not susceptible to that type of injury.
How I hold my mouse: (works for me)
If I hold my arm up a bit, so that my upper and forearm are something like a V, hand held loosely out and relaxed, then the thumb and index form something like a V, and the fingers are loosely spread out. This puts my thumb about an inch, inch and half below my index.
Now I drop my hand down over my mouse (I don't actually go through this procedure, this just gets you to my position), maintaining that hand configuration roughly. This puts my thumb and pinky just below the bottom edge of the mouse, index on the left button and middle resting lightly on the weel, and ring finger just under the top edge of the mouse on that side. If I pick up the mouse it's held by the thumb and pinky, with a little extra support from the ring finger. To use the right button I move my middle finger over as necessary.
Note that I don't have to move my middle finger forward or back to use the wheel, it's already there. If things get wheely I can lift the middle up a bit. For my hand, this puts the back of the mouse below my highest knuckles.
There are depressions on both sides of the mouse, which look like the natural place to hold it. But if I move my thumb and pinky up into the depression, that pressures my index and middle up. To depress either button or mousewheel it feels like I'm slightly overextending my fingers, and I can feel more effort in my forearm muscles. I also feel effort in my wrist to hold my hand up like that.
When I move the mouse, the outside edge of my pinky and side of my thumb drag on the desk (or couch, at the moment).
If I do lift the mouse up, I just hinge my wrist up a bit, I don't lift my forearm. And my hand hardly moves out of its place, to the point that I sometimes have to clean gummy gunk off my desk, within about the area of a single hand, in one specific place.
So this works for me, I think, because I let all my hand/finger positions and muscles be as natural and lazy as possible. Plus, the mouse fits my hand well, and I've been doing it like this for a long time.
Side note: I hate track pads, and always disable mine, for whatever that's worth.
I know that the fact that I constantly pick at my nails (which I count as a psychological issue) is aggravating the stress on my hands.
I highly recommend reading his book "The Mindbody Prescription"
And here, related to back pain but same root cause as RSI https://m.youtube.com/watch?v=vsR4wydiIBI
The fact that I was doing curls with 45 lb dumbbells in the gym didn't help the wrists, either, not to mention playing guitar.
I ended up with pain, tingling and numbness. The university sports med clinic prescribed a NSAID (naproxen). That did provide some relief.
I overcame the RSI by working exclusively through a DEC VT100 terminal (the actual DEC VT100). Its heavy-duty keyboard with stiff action and long key travel didn't irritate my wrists. Eventually I went over to the light-action/short-travel keyboards that are now ubiquitous.
Haven't had a problem since.
A chiropractor helped me recover. It took three months, a bit more attention to how I sat and leaned and used my computer equipment. But the pain in my neck and upper back went away, the pain in my arms and shoulders went away, and the sensation and strength came back in my hands.
I didn't rush out to get a special keyboard, though my 1984 Model M keyboard is already special, just not in an ergonomic way.
This resolved it for him, my wife and me as well. I hope it helps someone else.
What helps me. 1. Heavy deadlifts. This helps grip strength a lot and strengthens my wrists. 2. Posture. I removed the arms from my chair, like SwellJoe mentioned. 3. Posture. Keeping my hand positioned on the keyboard properly. Don't rest the wrists on my laptop. 4. Stretch.
* Two keyboards and two mice. One set on my desk. The other keyboard on my lap and the other mouse on a pedestal at my side. I would switch up which keyboard/mouse I was using every 10 minutes or so.
* Typing like I couldn't move my hands. Literally letting them hang limp and moving my arms a lot.
* Stretches and massage before, during, after typing. This "Essential Hand Stretches for Guitarists" video helped me a lot https://www.youtube.com/watch?v=TSrfB7JIzxY
* Pay attention. Take breaks. Notice what feels bad. Notice when you need to change up what you are doing --probably many times an hour. Take off your watch/rings. Watch out for resting your forearm/wrist on anything.
All it took to switch was: 1. Practice in KP Typing Tutor 1 hour a day for 3 weeks. 2. Change my computer configuration. (The first week of change was the hardest, I was at 50% my normal speed). 3. Done.
Changing to another keyboard has a price you won't comfortably use other people's computers. And they won't be able to use yours.
But the benefit of being without pain is so worth it.
If you suffer in your hands... make the change.
For mouse, Evoulent is good and I have used many generations of it and I can tell you the difference is negligible so you can just go on eBay and buy an older generation for cheap. It is a b!tch to travel with as it is really oddly shaped. Oh well, nothing is perfect.
In the meantime, I have a MS "natural" keyboard, and a vertical mouse as well. Those have solved all my RSI/wrist pains.
Going back to flat or compact keyboards and horizontal mice is extremely annoying. Not just the muscle memory gap, but the positioning just feels wrong.