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Ask HN: Chronic Programming Pain

3 points by hisoka4 ↗ HN
TLDR: how do people deal with wrist pain when programming?

For context: I'm relatively young, and I had a scapholunate ligament injury caused by excesive use of the computer for which I had surgery but pain still stays there. I've read a lot of programmers who, at their 40's, can't even do basic things as in lift objects with one hand. What is the projected situation now that more and more people program and use mobile phones? Are there some dedicated venues or proper studies about this from which I can inform myself?

10 comments

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yawpitch
I don’t know of any authoritative academic work on the topic, but yes lots of (probably most) programmers develop repetitive strain injuries during their careers. The problem is there’s as many injuries as that are permutations of human bodies and their input peripherals. Ergonomic input devices exist to help; for me it was swapping my mouse for a large-diameter trackball that reduced my pain the most, along with lower force mechanical keys and taking more breaks. Some people I’ve known absolutely swear by ergonomic keyboards (notably the Kinesis Advantage) and alternate keyboard layouts (specifically Dvorak), but I couldn’t stand using either long enough for whatever benefits there are to take, so YMMV.
gregjor
Not to minimize the very real pain from RSI, but I don't think "most" programmers develop RSI. I have over 40 years at the keyboard, and then using a mouse, trackball, and now trackpad. I have worked at quite a few places with programmers younger and older. In my experience most groups that I worked with had one or two people -- often the younger people -- who had symptoms of RSI, sometimes severe. But not most of the people I worked with, many of whom had the same number of years, or more, typing and dragging a mouse around as I do.

The only time I ever experienced pain in my wrists came from gaming. When I had young kids they liked to play console games with me. A few hours of that and I'd notice pain in my wrist, probably from gripping the controller too hard (Mortal Kombat and Mario Kart can get intense with a teenage opponent). I suspect heavy gaming does more damage than typing and mousing, unless you have terrible posture, can't touch-type, or grip the mouse/trackball too hard. That might explain why many of the work colleagues who had RSI got it fairly young -- gaming seems more a thing with younger people, and they start gaming as kids whereas I didn't see a video game controller until I got well into my 20s.

My oldest daughter works on a computer all day (mainly Excel) and she developed RSI. Her therapist gave her gloves that keep her wrists straight and told her to pay attention to stress and excessive force in her hands. I guess a light touch helps.

I don't have any actual medical evidence or expertise regarding RSI, just my anecdotal experience.

hisoka4
I played a lot of league of legends in the past and my pain started there, in the hand of the mouse which was as tense as a hand can be, so I could see gaming being a big factor for developing RSI, wish I could go back and tell me!
yawpitch
Admittedly in my experience (primarily VFX industry) pretty much every coder was also gamer.
meghnards
https://www.retrainpain.org/

A physical therapist showed me this site after my own wrist surgery and it changed my life. The realization that spending years with chronic pain in a particular place can sensitize my brain to harmless stimuli, even without any remaining structural damage, has helped a lot.

eimrine
Why not to train your body between the sessions? What you want is effectively some proper studies about men doing wrong things for the sake of learning exactly how much wrongly is this or that behavior. You must to be an expert in these questions tbh if you used to have enough vim to escalate your pain issue into surgery field but amusingly you haven't even consider you have any experience about these kind of issues.

I recommend you to read about healthy men, healthy exercises to your wrists like stretching, music playing and physical exercises. And if you are really young you should try Dvorak, because do not forget since we are living in idiocracy all the good things must be researched by you, not provided to you by default.

GianFabien
For me using the mouse caused me much pain. The fine positioning and operating the buttons were required conflicting muscle groups to cooperate. My solution is to have a trackball for the right hand and a mouse with the optical window taped up for the left hand. Thus positioning and clicking / operating the wheel no longer require conflicting muscles to act.

For me it was a revelation to actually slow down and watch out which micro-motion lead to which source of pain. Once I could sense the twitches, etc I could change my environment to better suit my physiology.

kmos17
Strength training/weight lifting, basic yoga stretches like sun salutation and squats/lunges to strengthen the back have helped a lot. Long uninterrupted work session still can bring back my pain, but of all the remedies/treatments I have tried the only thing that works are physical exercise focused on core/back strength.
navjack27
Some people are genetically more predisposed to developing wrist issues but a significant amount of it can be mitigated by proper ergonomics and posture. Your wrist should be flat on a table and it shouldn't be tilted up or down or left or right. Make sure your desk is long enough that you can put your whole forearm on your desk on a big mouse mat that covers the desk space where your mouse will travel and under your keyboard. Same idea when typing. Your feet should be flat on the ground or up on a foot rest. Your monitor should be level with your eyes so you're not looking up or down at it. The lumbar of your chair should be up in your lumbar.

I'm in my mid-thirties and I've been using computers since I was three and I don't have any issues at all.

But there are a lot of people out there simply "holding it wrong" when it comes to using the devices they use. There isn't a universal way to do things but there is a general as long as you're not straining yourself to do the things that you're doing and you're not putting your ligaments and muscles in strained positions then you're not going to end up with much or any damage. Keep everything neutral as possible. Like right now as I'm posting this I'm lying in bed I just woke up. I'm using voice typing and I'm holding my phone braced up against my chest and I'm keeping the line of my pointer finger in a straight line from my forearm and my wrist has no bend in it for both of my hands and I'm just holding the phone with my thumb and my fingers. Keeping my wrist at a natural flat state so there's no bend in it that is pulling the ligaments either direction. Just being more aware of things like that in your day-to-day life can mitigate or I don't want to say reverse but who knows.

Oh and since a lot of people are suggesting training and strengths and all this other stuff. I've never done a lick of it absolutely none I'm not fat I'm not out of shape per se but I've only recently started to do anything that even seems like exercise so your mile may vary there.

solardev
It's different for everyone, but one thing I've found that's been tremendously helpful for me (in 30+ years of programming and heavy W-A-S-D gaming) has been the use of ergonomic devices (keyboards, mice) and workspaces (desk height, position, chair, posture, etc.).

In particular, ergo keyboards allow me to type comfortably for hours on end, day after day, year after year, at very fast speeds and without any injuries so far. Before I switched, I would get all sorts of finger and hand cramps monthly.

I personally like the Microsoft Sculpt Business keyboard the most, but that's currently discontinued (soon to be re-released under the Incase brand). There are many other brands & models, both with soft laptop-style keys and harder mechanical keys.

I particularly like the Microsoft one because it doesn't have an attached numpad, which means your mousing hand can fit comfortably next to the keyboard instead of stretched out unnaturally far away. (The numpad is wireless and can be placed anywhere, for the rare times you need it).

There are also many types of mice, from wrist mice to vertical mice to trackballs to simply flat mice (like Magic Mouse). I found alternating between the Magic Mouse and a trackpad to help with mousing pain. You can also use webcam-based eye tracking if you prefer, or like foot pedals for scrolling.