
Ask HN: Remedies for RSI? - curej
Anyone know of anything that works well for RSI pain?<p>I've tried acupuncture, massage, ice, heat, electric stimulation, ultrasound, laser therapy, break timers, ergonomic devices galore, martial arts, weight lifting, running, swimming, speech recognition software, anti-inflammatories, turmeric, fish oil, vitamins.<p>The only thing I won't do is surgery.<p>It's been five years since my RSI started and it's starting to look like I'm just going to have to suck it up and deal.<p>Is there a miracle cure I don't know about?
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gruseom
Two things I don't see on your list:

1\. I do finger, wrist, and forearm stretches regularly. For me, they prevent
RSI and even get rid of it when it's starting. I don't know if this would help
for chronic pain.

2\. Chronic conditions can sometimes be alleviated by hypnosis. Here the
challenge is finding a skilled practitioner. I know one. I can put you in
touch if you like (email me).

I suppose these are long shots. Good luck.

~~~
curej
I do appreciate the offer but I have some psychological resistance to hypnosis
- my mother has tried to get me to do it also but to no avail :)

The hand/arm stretches help but only up to a point. A lot of the tension I get
seems to arise in the neck and upper back areas. I feel great when I get out
of the gym or after a hot bath but I work in a pretty high pressure
environment where I sometimes can't take breaks for hours at a time. Maybe
that's the real problem. But I was hoping for a workaround.

~~~
gruseom
_A lot of the tension I get seems to arise in the neck and upper back areas._

This reminds me of a third option that I'm surprised I didn't think of
earlier: the Alexander Technique. Tension arising in the neck and upper back
areas is practically their specialty. I got some amazing results working with
a good Alexander teacher.

Incidentally, if your situation is anything like mine (and of course I don't
know), you may need to make some changes in your life in order for the pain to
go away. I'm not talking about techniques, I mean fundamental personal change.
I had a headache for 9 years. No one ever explained it. But it eventually went
away as I addressed some important issues in my life.

~~~
curej
I got kind of a chill when I read this. It hits close to home.

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SwellJoe
When I started having problems about 7 year ago, I did a handful of things,
but the two that made the most difference were:

Better chair (Aeron). Sounds odd, I guess, but being the right height and
having good posture makes a difference. I also dropped the arms way down, so I
simply cannot lean on them no matter how lazy I'm feeling (among many other
pains, my left elbow had a permanent twinge of pain, which still pops up now
and then, but was always-on back then).

Tiling window manager. This assumes UNIX/Linux, but it made a difference when
I almost completely killed the mouse from my life. If typing is more painful
than mousing for you, this might not be the right choice. It helped for me,
though...I immediately was able to work full days again due to this change,
though I don't know if it was therapeutic...it may have just avoided the most
serious pains.

Other things that may or may not have helped, but I did them while recovery
was clearly happening:

Changing positions frequently. Keyboard slanted/flat. Raising and lowering the
chair. Occasionally sitting in a different chair or on a ball or standing.
Getting up and walking about a lot.

Exercises that encouraged blood flow to the affected areas. Cardiovascular
exercise in general, but tennis and such were my focus. You've already tried
swimming...so that's probably in the same league for circulation. I wouldn't
quit doing those things, even though they haven't resolved your problem...I
doubt they're hurting.

I cut back dramatically on playing guitar and piano, since they incurred very
similar sorts of repetitive stress. This one was not pleasant, but now I can
play again without any problems.

~~~
curej
You've obviously struggled with this a lot. A lot of ideas here to think about
- some stuff I knew about but had forgotten - I have to keep churning this
stuff over in my head and making different variations so it's good to think
about what has worked for others. Thanks.

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aj
While not a cure, you should try using a RSI recovery help software which
essentially forces you to take breaks and also tells you of exercises you
should do.

Check out Workrave ( www.workrave.com ) which I personally use and have found
quite useful.

Disclaimer: I am not affiliated to workrave in any form except as a user

~~~
curej
Thanks, yes, I use Workrave and it has helped. But it's not a cure. I also use
MouseTool (also free) so I don't have to click - just dwelling over an area
causes the mouse to click. That's probably the biggest lifesaver I've
encountered. I also use AutoHotKey to eliminate the alt-tab, ctrl-w and alt-f4
combinations which kill my left forearm. Another big help. As is Dragon
NaturallySpeaking whenever I have to compose a long Word document or email.
But, again, not a cure.

Not to be too demanding, but I'm wondering if anyone has found a way to
overcome the problem entirely or if I should only hope for incremental
improvements.

~~~
andrewf
If clicking the mouse is painful, try switching hands. Using your mouse other
handed will feel very clumsy for a few days, and you probably won't ever want
to play a game that way. But it does give your other arm a break.

I switch between left and right once every week or so.

~~~
curej
Because of the auto-clicking software I use - and the fact that I only use
trackpads - typing is more of an issue than clicking.

------
AlanEdge
Surprisingly, lot of RSI problems originate from poor back posture, which
distends the discs through which nerves run down to your wrists.

Wrist exercises may provide short-term relief without actually solving the
root of the problem.

>>Try tweaking how you sit and sleep (90% of your waking hours).

1) Get a used Aeron chair off of Craigslist with lumbar and wrist support (a
$300 chair will lave thousands of dollars in Chiropractor bills).

2) Sleep lying straight with your head resting in the curve of a single foam
pillow (<http://tinyurl.com/87exg3>).

3) Learn and properly practice the McKenzie Tecnique
(<http://tinyurl.com/a8hr2g>), a 30 second means of straightening your entire
spine using just your pointer finger on your chin.

#1-3 are life-changers.

~~~
curej
At my initial evaluation for my RSI problem, the physical therapist said she
thought my typing/mousing was relatively inconsequential in light of my head-
forward position, forward-sloping shoulders and asymmetrical back muscle
development. She believed this had developed from poor posture and slouching
while seated at the computer. I tried to pay attention to it but couldn't seem
to translate my posture-in-my-head to my posture-in-reality. I considered
using some kind of brace to try to hold my posture in check until I get used
to a more upright posture but couldn't find anything that would be
inconspicuous at work. The McKenzie book sounds very promising for my problem
because it seems to address some of these undesirable physical developments
that I have grown into from my computer lifestyle. I have already tried #2
although a lifetime habit of sleeping on my side is hard to kick - even on a
low pillow I manage to turn onto my side. As for #3, I doubt I could manage to
get permission to have one at work which is a pity because I have no problem
paying for one and would like to try it out because so many people have
recommended it. Thank you for pointing me to this book which I assume has
helped you. I look forward to reading it.

~~~
AlanEdge
Interesting. A few thoughts come to mind:

1) You should be covered by worker's comp (by law), in which case a brief to-
the-point conversation with a key decision maker in your company over the
trade-off between them covering thousands of dollars of WC coverage vs.
allowing you to bring your own chair to work is in order.

2) Habits are formed and habits are broken. If you believe you can't change
your sleeping posture, than you're absolutely right. The opposite is also
true.

~~~
curej
You are correct on both counts. I will consider how to approach these issues.
Thank you.

~~~
AlanEdge
Damn- sent you the wrong link. Here's the one for the neck:
[http://www.amazon.com/gp/product/0958269246/ref=s9subs_c2_14...](http://www.amazon.com/gp/product/0958269246/ref=s9subs_c2_14_img1-rfc_g1_si1?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-2&pf_rd_r=1N95JN8E2S15HK0C8YPW&pf_rd_t=101&pf_rd_p=463383371&pf_rd_i=507846)

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johngunderman
There are three things that really helped me when I began developing RSI

1\. Learn and use keyboard shortcuts. The mouse was a major issue for me, so I
started to use the keyboard as much as possible. I installed gnome-do so I
would be able to access all my apps through the keyboard.

2\. When you aren't typing, DO NOT rest your hands on the keyboard. This one
killed me until I finally broke the habit. Resting your hands on the keyboard
causes them undue stress.

3\. Make sure you are elevated above your keyboard at the correct angle. Find
what works for you, but having your arms extend DOWN to the keyboard with a
shallow grade is very important.

Just my $0.02

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trapper
Off the top of my head things you could try:

1\. Go to a paul chek, nasm or shirley sharman practitioner. They will check
out your posture. Ignore anything they say about the one true way [edit - I
mean the research is inconclusive - either may work, but all will claim their
way is correct].

2\. If you already have bad posture you need to correct it. Some good
[alternative] ways:

\- overhead lifting and overhead shrugs

\- heavy front squat holds (just the hold, not the squat)

\- go look at at mike robertson or gray cook for corrective exercises

3\. If you haven't already tried, go to an ART practitioner. It's very sore
but effective for a lot of people.

~~~
curej
I do have very bad posture. Good suggestions - especially the workout
suggestions - my trainer recommended those to me a year ago and I stopped
doing them but it was probably a mistake. Those are changes I can easily make
to my workout. The rest I didn't know about at all. Thanks.

~~~
trapper
Remember the key you are going for in your postural work is time. You spend
50+ hours on the keyboard a week. You need to be able to have a [postural]
buffer large enough so there are no overflows into poor posture, which means a
large work capacity.

Do try ART - (activerelease.com has practitioners probably) - it can work
wonders. The basic algorithm is to identify the parts of the muscle that are
tenser than the rest, bring the muscle into full flexion, then compress the
tense area against the bone while simultaneously moving the muscle into full
extension. This causes a mechanical stress that helps lengthen the tissue. You
can try it on yourself pretty easily which can be useful.

~~~
curej
I've had cross-fiber deep tissue massage (painful). ART sounds similar but
I'll give it a try, thanks.

~~~
trapper
ART is very different - it couples movement with massage to mechanically
stretch out the muscle. It's usually far more effective.

~~~
curej
I did some reading on this. Some practitioners claim they can bring about
recovery of severe RSI in 3-5 visits. Does this sound realistic based on your
experience?

~~~
trapper
Ahh claims of magic :)

It does happen though, but strangely only with certain therapists. There is
one where I live that is renowned for fixing almost any musculoskeletal issue
in one session.

My recommendation would be to find out which one is used by pro sports teams
and go to them.

------
sutro
I used to have very bad RSI, and two things saved me: 1) this book:
[http://www.amazon.com/Repetitive-Strain-Injury-Computer-
User...](http://www.amazon.com/Repetitive-Strain-Injury-Computer-
Users/dp/0471595330/ref=pd_sim_b_3), and 2) this doctor:
<http://www.yelp.com/biz/mehaffy-rick-dc-redwood-city> (only helpful if you
live in the Bay Area). Good luck.

~~~
curej
Interesting to hear that a chiropractor was successful for you. I've heard a
lot of skeptical feedback on using them. The Pascarelli book is good - my
physical therapist recommended it to me and the exercises were helpful
(unfortunately I overdid some of the stretches and had to stop as a result -
but I should probably re-incorporate some of them). Thanks.

------
chris_l
Alexander Technique worked for me. But it is not miracle cure, you have to
work on yourself to make it work. A one line takeaway is that you're probably
doing something too hard as a matter of habit when typing.

~~~
curej
I like it in theory but I find it hard to put into practice. I have very poor
awareness of my body so when others recommend changes I usually feel like I'm
already doing it the way they suggest. It's the same reason I sucked when I
tried to learn swing dancing.

~~~
chris_l
That's why it's necessary to have an AT teacher for a while, to help you
develop awareness of your posture, etc.

