Ask HN: Carpal Tunnel Recommendations?

6 points by WoodenChair ↗ HN
I'm having a bit of carpal tunnel. I had it several years ago and I found these exercises which seemed to help a lot: http://www.eatonhand.com/hw/ctexercise.htm

I'm going to do them again, but I'm wondering if HN has any mouse/keyboard/pads/other suggestions. I already have an elevated monitor so I'm good on that front. I'm currently using the standard Apple external keyboard of a couple years ago and a pretty generic Dell mouse.

Edit: Should add that the pain is only in my right wrist/hand (mouse hand) and I think a large degree of it maybe related to the mouse - I spend a lot of time scrolling with my middle finger for example. I'm considering the Apple Magic Trackpad

18 comments

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I had the same issue, and was told by an old school hacker friend to do the following:

- Stop typing for a few days altogether

- Get a Kinesis Advantage keyboard

- Switch to the Dvorak keyboard layout

After a few months, I got rid of the Kinesis keyboard, and everything was back to normal. I never had any issues moving forward, and I attribute a lot of this to the use of Dvorak.

Thanks for the rec. I am considering stopping typing for a few days. How many days did you stop for? Do you feel the Kinesis made a big difference? I feel like a big part of my problem may be the mouse actually - I spend a lot of time scrolling with the middle button and I'm actually only having pain in my right wrist/hand. I'm thinking of getting the Apple magic touchpad.
Have you also tried: - swap to off-hand mouse. - use pageup/pagedown/spacebar for scrolling at times - More/larger monitors, so that you don't have to scroll things or swap between things / re-cat things as often - Plan things with whiteboarding / talking rather than banging out code

These won't eliminate RSI, but they might help alleviate the causes of it.

Thanks yeah, pretty much do all of those.
I like vertical Mice. I've had two and prefer the Evoluent over the Anker. Seemed to help quite a bit when I started "noticing" my mousing wrist.
I use a http://www.goldtouch.com/ergonomic-keyboards/ which forces me to never have my wrists on the table (or on a gel pad). I requires a good posture (elbows almost 90 degrees). With mice I make sure they're big so I can rest my whole hand on them. Apple mice are too low and small in my opinion. Goldtouch also has mice in kind of a 30 degree angle but I never got used to them. I have no recommendation on trackpads. I'm glad you're at least not crouching in front of a small laptop in a cafe.
A few things I can recommend:

(1) Switch to the Colemak keyboard layout -- it significantly reduces the work your fingers have to do.

(2) Vary your mousing devices/behaviors. I love Kensington trackballs, and they're much easier on my wrist than a mouse, but after awhile I get pain in my thumb (because with a trackball you typically use your thumb to left-click rather than your index finger), so I switch back to a mouse for a few weeks. Vertical mice are also nice and I occasionally use one for a change. You can also move your mouse/trackball to the other side of the keyboard and use your non-dominant hand -- it takes a few days to rewire your brain, but it's another good way to change up your mousing behavior.

(3) Consider buying a USB numeric keypad, placing it on the non-dominant side of your keyboard, and using macro software to program the keys for common actions (e.g., scrolling).

I've had similar problems with pain and discomfort when using a mouse. Was using an Evoluent Vertical Mouse for about a year, which helped, until the left clicker started playing up. Replaced this with an Anker vertical mouse which costs a fraction of the price and is just as comfortable. Can't recommend it highly enough!
About 20 years ago I started having pain from carpal tunnel. I enjoy my work, so that was a bummer.

I cured myself within a year mostly by using ice, and I also took aspirin. I am not a doctor: this is just what happened to work for me.

You might also try searching for "anti-inflammatory diets" to help carpal tunnel syndrome, sore knees, etc. My wife and I adjust our diets to help prevent inflamation.

OP Here - What I've decided to try after reading through the comments here and recommendations in other places:

- Take a couple days break from hardcore typing/computer use

- Ordered the Anker vertical mouse and Microsoft Ergonomic 4000 Keyboard from Amazon

- Resume Exercises that worked years ago

- Take anti-inflammatory turmeric laced foods and resume taking some Omega 3 capsules I was taking before

Thanks for all the advice - I hope my typing is back to pain-free soon! Thanks again.

You want to minimize continuous, repetitive use of the same muscles.

* Whenever your hand feels pain, stop typing, and take a break.

* If you have a PC at home and work, you may want to have one type of mouse at work (standard) and another at home (ball and button). Use the mouse with your right hand for half an hour, then switch to your left, then your right. If your right hand uses a mouse and hurts, use your left hand for the mouse half the time! It takes a little adjusting, but it is better than hurting your hand.

* People tell me this gets progressively worse and worse if not dealt with. You're looking to deal with it which is good, so keep on top of it.

What worked for me is:

- moving the mouse to the left (you get used to it in a week); this reduced the pain in my right wrist by half. Most of the pain on the right wrist now comes from using the arrow keys.

- getting a Typematrix 2030; adds spacing between wrists, has softer keys, leads to less movement for Enter key

- switching away from qwerty; this was twice as valuable, because I also finally learned to type properly.

I got Carpal tunnel last year when I was putting in too many hours(60+) for several months. Switching to a Kinesis Advantage Pro keyboard and a RollerMouse Red worked for me. I tried other ergonomic mice (including Evoluent and Anker) and they just shifted the pain. The RollerMouse was the only one that I could use with no pain. I think it is because there is no gripping involved and it allows you to distribute the click force over all your fingers instead of focusing it on just one finger. Moving the mouse from the right hand to the left hand didn't help it just resulted in Carpal tunnel in my left hand.

I also found hanging on my fingers from a pull-up bar and rock climbing helped my hand and fingers heal.

What I normally do is swap between normal mouse and trackball, but I think sustained use of my phone has been bothering me more than recently. I've never been diagnosed with carpal tunnel, but I definitely have some kind of repetitive strain injury.

If it's an RSI and not getting better from breaks, I'd recommend Active Release Technique (http://www.activerelease.com/). I've been going to an ART provider for a knee injury, but since I'm there they also work on my wrist and it's been helping. The 2 places I've been are classified as chiropractors for insurance purposes, since they're chiropractors who also practice ART. This has its pros and cons - you don't need to get a referral to go, but you could be limited on sessions.

Have you read "It's Not Carpal Tunnel Syndrome"?

Even if it is Carpal Tunnel in your case, "It's Not..." is a superb book on RSIs and RSI-like conditions: well worth picking up.