I may have Carpal Tunnel Syndrome and I'd appreciate some advice. (Long Post)
Anyway, a couple weeks ago I started getting pain in my wrist while I was typing. I managed to get an appointment with my family doctor for a week later, but because of the pain and my fear of doing more damage, I opted to go to a walk-in clinic I've been to a number of times previously.
The doctor at the clinic seemed to assume it was most likely Carpal Tunnel Syndrome just based on the fact that the pain was in my wrist. He had me flex my wrists (Phalen's Maneuver) and tapped on the underside of my wrist (Tinel's Sign) but neither of these tests really did anything to me - there was no pain or tingling present in either case (NB: When I try Phalen's now, I feel a bit of pressure in the underside of my wrist, but that's it).
The doctor told me to get a wrist brace, and specifically told me to get one made for CTS. He told me that a lot of people flex their wrists into odd positions in the middle of the night, so I should wear the brace when sleeping and when typing. I looked this up later, and there are mentions online about CTS sufferers mangling their wrists like the doctor said, and that this can present as waking up with your hands numb/asleep. I had noticed this a few times recently, so things seem to line up there.
After looking at various models in the drug store and discussing the situation with a girl who worked there, I eventually purchased a relatively expensive model (http://www.amazon.com/M-Brace-Wrist-Splint-Size-Regular/dp/B000X9SUKA). I wore this brace home that day, and have generally worn it when typing since then and always while sleeping.
Things seemed to be improving until I went to my doctor the following week. At my appointment, my doctor did hardly anything to check on my condition, except trying Tinel's again (no symptoms presented during this test this time either). He examined the brace and had me put it on, and he said it was good. The point, he said, was just to limit the range of movement for my wrist, and that the brace did its job just fine. He asked me why I wasn't wearing it when I came in, and I told him that I only really wore it to bed and while on the computer. He told me I should be wearing it all the time, but that I could take it off to sleep (which struck me as horrible advice, given what I had researched). He told me I should wear it all day, and through the night if I wanted, for maybe the next week or 10 days, which I've mostly done. I asked him if that was a bad idea since I had read that leaving the brace on all the time could weaken the muscles, but he said that that only occurred over the long term, and a week wouldn't do any damage.
After wearing the brace all day for several days, I started noticing that the base of my thumb was stiff/sore and the area around my pinky was sort of the same. Everything else felt more or less ok, so I started not wearing the brace through the day, thinking that maybe the brace was constricting my thumb too much. Things have been pretty good for the last couple of days, but there's still lingering... awareness, I guess. I'm aware of a bit of a strain in my wrist/forearm (and there's a tingle in my elbow sometimes) from time to time, but it's mostly alright. In fact, I've typed this entire post without the brace mostly without pain. There is some noticeable strain, but by taking a lot of mini-breaks it's very manageable. I'm also aware that I shouldn't be pushing this hard, but I wasn't really expecting to write quite this much.
Another factor seems to be that I'm typing sitting upright on my smaller couch, with ample room for my rig...
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[ 3.1 ms ] story [ 37.6 ms ] threadSo, I'll try to give you some advice, and hopefully this helps without hurting you.
The very first thing you need to quit doing is:
"I'm typing sitting upright on my smaller couch, with ample room for my right arm (the pained one). Normally, I type lying down on my other couch while watching TV or just relaxing, and my right arm can sometimes get pinned a bit."
What the hell is wrong with you? I'm saying this to kick you in the ass, but in no way is this comfortable or good for your body. You are probably contorting your whole body into all sorts of weird problems, and I'm betting you don't exercise, stretch, take breaks, or do anything physical to maintain your health.
First clue, get a damn desk and a good chair, or invent one. Then, don't sit at it for too long at a time. Take breaks. Setup a rule where you don't code while watching TV. It's just a bad habit and it's actually hurting you.
Next up, your whole body is probably screwed. You need to start doing some stretching at a minimum. Stretching your whole body. You can easily go get a book on how to do it, and you should do it every day, twice a day: when you wake up, and before you go to sleep. If you can take a yoga class then that'd be even better.
You should next make sure you're eating right. Stop eating crap, and in fact, eat out if you can if for no other reason then it gets you away from the computer and walking around. Eat vegetables. Lots of them, and not too much meat. Quit eating junk food, meaning fake food that's crapped out of a machine into a plastic bag. Eat real food.
Finally, for your wrists. As you start fixing up the rest of your body and learning to relax through stretching, you'll probably find a lot of tension in your neck, upper shoulders, and back. It's important to stretch your whole body, but focus on these areas specifically. As you sit and code, keep track of tension in your body and give it a number. Then try to change the number up and then down. You want to start analyzing where you hold tension, and using a number system helps you visualize it.
Once you've got some control over tension, and you've got yourself getting more relaxed, you now need to start working on getting your wrists mobile. Now, your doctor sounds like a retard, but he's a doctor and I'm not, so he wins. However, keeping your wrist in a sling is not going to make it improve, so unless he's giving you exercises that improve it, then you need to find a new doctor.
There's no way in hell I'm going to give you wrist stretches online, even though you need some. You could sue my ass. I will say you should talk to your doctor about getting exercises to work with, and potentially that you should find a free Aikido class and see if they will teach you their wrist exercises. They probably won't let you do them since they also don't want to be sued, but they can teach them to you and then you can ask your doctor.
But, the most importan thing is quit living so unhealthy. I'm not saying become a granola eating hippie, but hell man I work at home and I've got a decent setup and don't kill myself coding for hours without breaks infront of the TV.
Good luck.
I'm using this situation with my wrist as a wake up call. I suppose I never really realized the damage I was doing to myself laying on the couch with my laptop. It started as a necessity when I lived with an asshole and confined myself to my closet of a bedroom where there wasn't room for really anything other than the bed. Slacking off, lying down watching a vid feels pretty comfortable (for the record, are you against lying on a couch in general, or only when that inactivity is coupled with a laptop? I've always thought of lying on the couch as being a good way to decompress, but I can change my ways if it's an overall bad thing) but I definitely see how I let things get out of hand.
I may have a job lined up to start in a couple months (I'm not a rockstar like most people on this site, so this is the best I've been able to do), and I'm bookmarking a few articles and HN comments to setup a proper office when cash allows. For the time being, money is quite the issue. I do have a desk, but as I said my chair is absolute shit. How important are laptop docks? Just sitting up at the desk will, I'm sure, be at least a step in the right direction. Can I get away with a shitty $20 Staples chair for now (as a first step) or is it essential that I dip deep into my reserves and get a $200+ proper office chair?
I'll Google for some introductory stretches for my whole body. I had real stress issues due to being a workaholic and having an asshole boss, so I need to learn stretching/relaxation tecniques as a matter of survival, since at least one of those two problems will persist throughout my career. From the tone of your post, I'm definitely leaning toward trying the massage thing at least once, if for no other reason than to get an initial boost on releasing any pent up tension.
As for the wrist stretches, I've been doing some I found just before I wrote my initial post tonight. I haven't felt any pain so far as I write this post. I guess they help.
These wrist problems seem to be a good kick in the ass to correct a systemic problem. I guess I came to HN looking for what amounts to band-aids for a bullet wound, and your additional ass kick was a good reminder that that's not what I need to be doing. I'll go price some new chairs tomorrow, and I'll take some initial steps towards better overall fitness.
Financially, some bigger measures have to be post-poned, but I can at least start with the things that are in my reach now.
Thanks for the kick in the ass. Seriously.
Edit: Oh, and you're right about the doctor. This isn't even close to the first time I've questioned his treatment (For instance, his office completely failed to fax in an ultrasound request for me last year, though when I called to check up on it they said they'd sent it and were just waiting on the hospital. At my appointment last week, he noticed there was no fax date on the form, so he had to admit it was likely never sent). There's a reason I tend to go to the walk-in clinic before I bother making an appointment with him.
Typing is already pretty weird and unnatural for the body, so you just want to reduce the stress on it as much as possible while you work. Same goes for playing guitar, sewing, drawing, writing, anything that involves lots of tiny motions and focus. It's these activities that tend to turn off your awareness of your body and make it so you don't notice you're hurting it.
Also, definitely take some yoga and focus on meditation. It'll help you a lot, more than you know.
Finally, very few people on here are rock stars. Don't let their blowhard attitude make you think they're so damn awesome because the truth is, human aptitude is a power curve, not a normal curve, and 99% of people doing anything suck because of it.
Myself included.
Edit: And you're welcome. :-)
I have 3 exercises here, which involve the Dyna-flex spinning ball thing and a wrist curl bar. You also need to pay attention to not cock your wrist at funny angles when you're driving, riding your bike, using power tools, etc and don't sleep on your arms.
http://news.ycombinator.com/item?id=1269951
------------------------
http://lifehacker.com/5195481/exercises-that-protect-against...
http://news.ycombinator.com/item?id=104977
http://news.ycombinator.com/item?id=199493
http://news.ycombinator.com/item?id=224604
http://news.ycombinator.com/item?id=427743
(lots of reddit threads too, google those)
That is your major problem, right there - you are still typing a lot! When you're in a hole, stop digging. I had similar problems about your age, made some splints at home to correct some weird posture habits I had developed (eg crooking my pinkie fingers), and I took a break from typing for most of a month. Amazingly, the world continued to revolve without my help :-)
So here's what you do. First, set up an auto-responder on your email: 'Hi, this is me, but I've hurt my wrist and can't type for a few weeks. You can call me on 555-1212 if it's really important, but otherwise I may only be able to send you a one-line reply, if at all. Sorry!'
Next, like Zed says, stop lying on the sofa. this is bad for you in a bunch of ways. Sit up straight - it's uncomfortable at first but once you get used to it it's actually much more sustainable for hours at a time. You can't type, so don't torture yourself by surfing. As you're unemployed but still consider going back to school, how about a few textbooks (cheapie used on amazon, or from the library) to pass the time in a useful manner? You can make notes with a pencil and notebook - not much strain on your wrist when you're doing it at a leisurely pace, and writing is slow enough compared to typing that you'll be a bit more selective about what needs to be noted.
Of course, I am no doctor, and certainly not your doctor. But based on my own experience and that of many others I've spoken to, simple rest is one of the best therapies. You can still perform other tasks, the nature of carpal tunnel and the like stems from spending too long performing a limited set of movements with poor posture. Take it easy, chill out, and you'll find your brain still functions perfectly well without a keyboard.
I know how this sounds since I'm typing this comment, but I've been really afraid to write lately. The problem first presented right as I began taking notes on an Australian CS course available on YouTube/iTunes. I had only been watching and noting for a few days when this hit. At first I thought it was just unused muscles complaining about the sudden workload, but as it persisted I started to realize I was wrong.
Perhaps I'll start up again today, now that my wrist feels a lot better.
As for taking a break, I've been trying, but it's not easy for me. In addition to my usual laziness of browsing reddit all day, my unemployment and severely depleted funds mean cover letters need writing and resumes need tweaking. I think the break is finally doing good though, so a little while longer can't hurt.
For more, start here but the net is full of success stories using Sarno's approach, so do a search... http://en.wikipedia.org/wiki/John_E._Sarno
My last job, by pretty much any measure other than income, was worse for me than being unemployed. Near the end I had been out on multiple stress leaves (I think the total was 5 weeks out, beginning about 9 months prior to my dismissal) and was generally in bad shape. My stress level was so high, in fact, that my boss (the good boss I had for about six months, but before the stress leaves) took me on a detour during our morning coffee run and bought be a bottle of Valerian pills to try to calm me down.
During all of that, I never developed these sorts of symptoms. The only physical effects I can really think of were the insomnia and a case of strep throat during one of the leaves which that same boss said was likely caused by my stress decompression.
Having said that, however, after reading that article this morning, my wrists have felt better than they have in months. I've been attributing that to a) the stretches I found on YouTube this morning, and b) the right-before-bed ibuprofen regimen I described above.
I'll definitely give Sarno's work a second look, but I'm so worried about ruining my life by permanently damaging my wrists that I doubt I can really commit to any approach which requires me to actively ignore signs of potential damage.
I've frequently had RSI pains for about a year now. One solution is to change (somehow) your typing set up. e.g. if you use your right hand to use the mouse, and have pains in your right hand, then change to your left hand. This will give the (damaged and strained) muscles in your right hand a break and they will start to heal. Likewise, change your keyboard. I got a €25 Microsoft Natural Keyboard. When typing on a laptop it's common to rest your wrists on your laptop (before the keyboard). This means you have to bend your wrists upwards. If you do that a lot (like I used to), then you'll get pains along the top of your lower arms. The solution is to not do that as much. I got a new keyboard which means I don't bend my wrists up like that. This means these muscles are not doing as much, and hence aren't being strained, and hence are given a chance to recover.
Install a typing break programme. This is something that will lock your screen every X mins for Y mins, forcing you to take regular breaks from typing. If you're using Linux & Gnome, this is built in as part of the keyboard preferences.
There are other neuropathies that can look like Carpal Tunnel like onset peripheral neuropathy, an entirely different condition.
If it is indeed Carpal Tunnel Syndrome and it's moderate to advanced you might want to consider surgery. They're standard and minimally invasive these days.