
How I stopped the RSI pain that almost destroyed my programming career - itamarst
https://codewithoutrules.com/2016/11/18/rsi-solution/
======
Someone
RSI is one of those things (ADHD, autism and dyslexia are other examples) that
start as a label some scientist puts on a specific set of symptoms that cannot
(currently) be linked to a specific condition [1], becomes popular and then
get used for a zillion things with more or less the same symptoms (Wikipedia
lists edema, tendinosis, tendinitis, carpal tunnel syndrome, cubital tunnel
syndrome, De Quervain syndrome, thoracic outlet syndrome, intersection
syndrome, epicondylitis, tenosynovitis, radial tunnel syndrome, and focal
dystonia as possible conditions underlying RSI)

Since 'RSI' may have many causes, it is unlikely a single treatment will help
everybody. This article, in particular, looks like anecdata to me.

Having said that, the suggestions others give to sleep and exercise almost
certainly can't hurt and if they may hurt you, you probably already know how
fragile your body is.

Exercise breaks during work have the added benefit of introducing breaks. If I
had to bet, those breaks are more important for RSI-like symptoms than the
exercises themselves.

[1] A disease is a particular abnormal condition, a disorder of a structure or
function, that affects part or all of an organism
([https://en.wikipedia.org/wiki/Disease](https://en.wikipedia.org/wiki/Disease),
via
[https://en.wikipedia.org/wiki/Condition#In_medicine](https://en.wikipedia.org/wiki/Condition#In_medicine))

~~~
niels_olson
Reddit has arrived: a plausibly researched answer that's so far off base it
pains me.

Physician here, and my wife is an occupational therapist. RSI is like saying
you have a cold. Yes, there is a problem, no it's not specific, but it gets us
to the right chapter of the book. Some of the things you list have very
specific causes and treatments that have nothing to do with RSI.

The article would be more like a case report: an interesting, uncommon source
of RSI. Anecdata? Yes, but the interesting data is often the edge cases.

~~~
zwegner
Where, exactly, is your disagreement with the parent post? Nothing you said
seems to contradict it, from what I can tell.

------
overcast
This article is totally missing the basics. Exercise. I promise it will make
ALL the difference. Get yourself a pull-up bar, and if you're feeling extra
fancy, a dip bar.

Push-ups, pull-ups, dips, and sit-ups. Every day. You'll be a coding machine.
At the VERY least, push-ups. Every hour or two, take a break, knock off ten
push-ups, walk around a bit, get some water, get back to work. I'll do this
right at the office, often in the server room.

A good chair helps, but all of this other nonsense is unnecessary. Exercise,
and nutrition is the key to basically everything in life.

As mentioned below. SLEEP.

~~~
e40
I agree that exercise and sleep are keys, but I do believe chronically cold
hands is a serious problem that needed to be remedied.

~~~
SiVal
Just a thought in case it helps someone: a family member of mine always had
cold hands, and a doctor prescribed a special prescription antiperspirant.
Making his hands dry also made them warmer.

~~~
dragonwriter
Sweating is a cooling mechanism, so reducing sweating (ceteris paribus) should
reduce cooling.

------
corysama
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.

* 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](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.

------
cornflake
I had some pretty bad RSI that I thought was going to kill my career also.

Turned out, I managed to eliminate it by completely changing my keyboard
technique to tuck my thumbs underneath my fingers when typing. I'm surprised
no-one ever told me about this before.

The action of tapping the space bar with the corner of your thumbnail instead
of smacking it with a big lateral thumb tap makes all the difference in
reducing strain on your carpal tunnel.

If your arms are at rest beside your body while standing, the 'natural state'
of your fingers and thumbs in this position is the exact same hand posture you
should maintain when typing. If you are instead performing an up-down movement
with an unbent thumb, that can lead to RSI problems.

Learnt about this from: [http://www.kogosowski.com/product/prevent-rsi-
ebook/](http://www.kogosowski.com/product/prevent-rsi-ebook/) * This e-book
was written by a really smart concert pianist and the thumb positioning was
the main take-away for me

------
AJ007
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.

~~~
overcast
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.

~~~
SketchySeaBeast
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.

~~~
akeating
Buying one of these [http://www.concept2.com/indoor-
rowers/model-d](http://www.concept2.com/indoor-rowers/model-d) worked for me.
Full body workout I can do at home.

~~~
SketchySeaBeast
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.

~~~
overcast
I've got the same Concept rower. Rowing is the only exercise that will
completely annihilate you every single time.

------
SwellJoe
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.

------
skriticos2
I was a bit paranoid about this in my mid 20's, so I learned touch-typing the
Dvorak layout (well supported on all major OS's, so no problem using it
everywhere), got myself a decent mechanical keyboard a few years later and I
use vim for editing since forever (fewer key-combos is good against RSI, so
modal wins out here). Most recently I have switched the Ctrl and Caps keys on
my layout, which reduces a lot of stress on my pinky finger. People think I'm
a total geek (which is OK considering I'm in IT), and this works quite well in
my daily business.

Now in my mid-30's I have no problem and enjoy typing very much, so I guess
the best thing to do is start with the precautions before the damage is done.
Of course my conclusion might be very much premature, but I'm carefully
optimistic.

~~~
kzisme
How big of a difference did Dvorak make for you?

While I feel no pain at all I'm pretty paranoid about getting any pain/RSI in
the coming years (recent graduate now working full time)

~~~
emodendroket
While I'm not a Dvorak typist, it seems to me like the benefit from getting
your keyboard at a proper height and maybe doing some hand and wrist
strengthening is going to be bigger than switching keyboard layouts.

~~~
Symbiote
I disagree, and I've used Dvorak for 12 years.

Just using Qwerty for a few sentences feels awful. It doesn't hurt, of course,
it's just a few sentences, usually on someone else's computer. But it's like
using chopsticks to eat oily rice, when you're used to eating potatoes with a
fork.

To everyone:

\- Print this PDF:
[http://www.dvzine.org/type/OneSheetDVmap.pdf](http://www.dvzine.org/type/OneSheetDVmap.pdf)

\- Change your keyboard layout to Dvorak

\- _Don 't look_ at the keyboard, look at the printout to see where the keys
are.

\- Relax :)

(Qwerty: so much is one one hand. "st a few se", "lly on", "oily". Common
things like "ter" and "sed" and "ard". This is the uncomfortable typing.

In Dvorak, the longest sequences on one hand in the above are "12 yea" and the
"ng ch" in "using chopsticks".)

~~~
emodendroket
The longest one-handed QWERTY words are "sweaterdresses" and "stewardesses" as
far as I know.

But anyway, as a programmer, you spend more time hitting key chords and
special characters, which aren't much better in Dvorak and are probably part
of why programmers are so prone to RSI despite in absolute terms not typing
that much compared to, say, a secretary.

~~~
Symbiote
I spend lots of time typing emails, documentation, HN comments, comments
within code, and so on -- this mostly fits the secretary distribution of
keypresses.

Even when I'm writing code, alphabetic characters and normal punctuation are
still by far the most commonly used. It's only the rare punctuation []{};:
that's worse off, and even within code I still type for more S characters than
semicolons.

If this concerns you, there's Programmer Dvorak layout, but I prefer to keep
compatibility with a wider range of computers and use standard Dvorak.

------
cableshaft
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.

~~~
Retric
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.

~~~
WWLink
This works for me. Although my favorite mousees are the low profile ones.

------
nateberkopec
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.

------
pmcollins
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.

~~~
cgvgffyv
> Using an Apple keyboard, which even though it doesn't look ergonomic, the
> reduced key travel has helped immensely.

I thought the conventional wisdom was that Apple keyboards _caused_ RSI?

~~~
cfraenkel
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.

~~~
cgvgffyv
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?

------
westoncb
I had to quit programming for six years because of an RSI. In attempt to get
around it, I even spent a year and half (painfully) writing a new kind of
'higher level' text editor better for use with motion sensors [1]. Now it's
been ten years, and I still don't exactly know what the cause was/is, though
I've got it to a point now where it's at least tolerable.

I think the most confusing factor here is the (potential) mental component to
these injuries. I personally ruled that out as a possibility for the first
five years or so just because it didn't really fit into my understanding of
things that I could experience physical pain via something mental. The idea
was tantamount to calling the pain artificial, which I knew was very much not
the case.

The article (and others here) mention Dr. Sarno. I also read a couple of his
books, and a couple more from others who think in the same basic framework. It
helped. I'm certain there is/was a mental component—but I don't think Sarno et
al's framework is good enough yet (don't get me wrong though—it does work for
some people). Aside from results being imperfect, the fact that much of it is
grounded in Freudian psychology is an obvious defect. I think they've hit on
some techniques that can help, but the theory is bad (which prevents them from
effectively refining the techniques).

My latest idea on what has caused all of this: I had some kind of physical
injury early on (maybe tendonitis), and it eventually resolved itself.
However, I developed this habit of very anxiously monitoring/testing the
wrist/hand pain whenever using mouse and keyboard, which would cause the
muscles to tense to the point of being painful. Unfortunately, my mind failed
to distinguish between the original pain and that caused by tensing, so I
continued operating under the assumption that I had some RSI, and continued
vigorously worrying about it and attempting to solve it.

The only thing I can think of doing now (and which I am actively doing), is
getting better at meditation so I can hopefully one day let go and not worry
and tense up while using mouse/keyboard :/

[1]
[http://westoncb.com/projects/tiledtext](http://westoncb.com/projects/tiledtext)

~~~
adrice727
I started having back issues about five years ago. It got so bad that getting
out of bed in the morning was a struggle. I was diagnosed with a herniated
disc at L4/L5. I tried chiropractic, acupuncture, and massage therapy to no
avail. Then I came across one of Sarno's books. I remembered Howard Stern
singing his praises years ago on his show, so I decided to at least give it a
shot. I was very skeptical, but within the first twenty pages Sarno had
described my situation to a tee. I started following his advice and saw
immediate results. I was back to running and doing yoga within a few days and
a couple weeks later I was back in the gym doing dead lifts. Aside from an
occasional flare up during stressful periods, I haven't had any issues since
then.

However, I don't agree with Sarno's view that the mind uses pain as a
diversion from psychological or emotional issues. I think it uses to pain as a
way to get our attention, to let us know that we need to deal with those
underlying issues.

~~~
westoncb
Your interpretation matches my experience, too. It seems more like the mind
uses pain and anxiety to call attention to the fact that something is wrong,
rather than to distract us.

------
nileshk
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"

~~~
300bps
Same here. More info here:
[http://www.rsi.deas.harvard.edu](http://www.rsi.deas.harvard.edu)

And here, related to back pain but same root cause as RSI
[https://m.youtube.com/watch?v=vsR4wydiIBI](https://m.youtube.com/watch?v=vsR4wydiIBI)

------
tluyben2
(warning, anecdotal) I have been behind a computer full time (>= 8 hrs/day)
(usually including weekend) for over 30 years now, I take breaks for exercise,
cooking & parties and have done for most of that 30 years. I have found, for
myself anyway, that RSI has zippo to do with the amount of typing, mousing or
work I do. I have done years of 12 hr days full on typing and I have gotten
beginning RSI symptoms from a few weeks of stressful meetings with very little
typing in between.

As I was young then and did not want to waste time not being able to lift my
arms or move my wrists, I experimented and found that, again for me, it's just
100% stress. Any exercise (none, too little or too much), working 20 hours or
2 hours are completely unrelated for the onset; if there is a stress factor
(like; our new product is not selling!! back then) I would get symptoms
immediately and they _would_ get worse once started when typing/mousing more
if the stress factor stayed constant.

After that and other health events triggered by (much heavier) stresses, I got
my brain to not stress (took me a lot of years) and that worked. I can just
work forever behind a computer (which I usually don't need anymore, as I found
also that it's completely useless to work many hours / day) without any
effects for the past 13-something years.

------
kazinator
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.

Haven't had a problem since.

------
tom_wilde
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.

Turns out it was a micro-injury thing...

~~~
cookiecaper
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.

~~~
tcoff91
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.

[https://www.amazon.com/Kinesis-Corporation-Wireless-
Promotes...](https://www.amazon.com/Kinesis-Corporation-Wireless-Promotes-
Vertical/dp/B00F0Y3IIW)

------
batter
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.

~~~
tcoff91
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.

------
chx
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](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.

~~~
spacehacker
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.

~~~
chx
Get a better chair with adjustible armrests lifted to desk height so your
elbow is always supported.

~~~
spacehacker
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.

------
wodenokoto
The thing about these pains is that they can come from, and be cured by all
sorts of things.

I once got a terrible pain in my right arm, couldn't click with my fingers,
couldn't move my mouse. After a week I saw a doctor and he said I was tense in
my shoulder, which wasn't causing any pain, and showed me a stretch.

Stretching for 2 days cured me, and I've never had the problem again.

The take-home message isn't that you should stretch, but that the cure for
these things can be almost anything.

------
cortesi
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.

~~~
lutorm
This was the case for me too, although I think there's something to
psychological issues causing tension which definitely can exacerbate the
problem.

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.

------
msluyter
I've found that there are a number of different prescriptions for RSI pain,
and that you have to experiment until you find what works for you. But that's
complicated by the fact that it's hard to run experiments on yourself because
there are so many confounding variables.

In any event, to add to the anecdata, someone below recommends not resting
your arms/wrists on anything and letting your hands float above the keyboard.
I've tried this, and the small muscles in my back that keep the arms lifted
would become sore bundles of fire that eventually would spread pain throughout
my back/neck/arms/wrists.

I found, paradoxically, that totally resting my arms splayed wide on my desk
combined with a Kinesis Freestyle so I can keep my wrists straight (this
wouldn't work with a regular keyboard) is the ideal setup for me.[1]

Not saying this would work for everyone.

[1] I have a standing desk combined with a high chair oriented such that the
desk comes a bit higher on my chest than a sitting desk would, such that I can
just rest my arms on the desk. The keyboard is not elevated and is basically
flat to the desk surface, and is separated and angled such that my wrists are
not bent.

~~~
wingworks
Agreed, this is what works best for me too, the high desk and high chair.

------
cleandreams
I've been a software engineer for nearly 30 years and I was diagnosed with
tendonitis in my first 5 years but I have managed to hold RSI at bay. I pay
attention and if any pain surfaces I take action that day. I do not ever, ever
wait. This is what I do: 1\. short regularly enforced breaks. I use WorkRave
to take a break every 10 minutes for a minute and 6 minutes every hour. I skip
these breaks if I'm fine but use them if I have any soreness. 2\. A keyboard
that allows my hands and wrists to be vertical and can be configured for any
slant. I use a comfort keyboard, not easy to find anymore. 3\. Ice baths. If
my wrists are sore at all I immerse them in an ice bath for 7 minutes each,
morning and evening. This really works. So cold it hurts. 4\. Pressure point
massage therapy. Releases tension in the muscles. It hurts but works. I do
that once in a while.

~~~
Noumenon72
I would pay for a version of WorkRave that worked properly on my Windows 7
work laptop. It would be nice if it prevented me from issuing commands on my
Windows 10 touchscreen too, so I can't just scroll through articles cheating
on my break.

------
analog31
Just as an aside, don't neglect your neck. I have had a couple bouts of pain,
that felt for all the world like it originated in my left wrist. Turned out it
was a pinched nerve in my neck. Physical therapy and a standing desk were the
cure for me. (Of course it might have just cured itself too).

------
mindcrime
I've had a little on-again, off-again RSI trouble over the years. A couple of
years ago, this topic came up on HN, and I picked up a very useful tip.
Somebody shared that they had (heard|learned|observed|whatever) that most of
the damage resulting in RSI happens while you sleep, not while you type. So
they started wearing a wrist brace to bed and it fixed their problem. In my
case, it turned out that wearing the wrist brace to bed also helped
tremendously. Usually if I have an RSI flareup, I make it a point to wear the
brace to bed (and possibly also during the day a bit, but not all the time)
for a few days, and the pain goes away.

All of that said, knock on wood I guess, as I haven't had a serious flareup of
wrist pain in quite some time now. Not sure why, but I'll take it.

------
elorant
While I used a lot of aids, trackballs, special keyboards etc, the one thing
that really made the difference for me was weight lifting exercises for the
wrist.

------
DougN7
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.

~~~
AnimalMuppet
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.

~~~
DougN7
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.

~~~
AnimalMuppet
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.)

------
jcl
The author's experience is consistent with my own... Most incidents of
wrist/hand discomfort that I've experienced have started in cold or drafty
environments. In these cases, I've found fingerless gloves have helped, as
have breaks for walks and warm water rinses.

I'm certain that inadequate blood flow is a major contributor to RSI, and
that's probably one reason that exercise seems to help so much. Unfortunately,
I think, environmental temperature is often overlooked as a source, maybe
because it can affect individuals in so many different ways (e.g.
[https://en.wikipedia.org/wiki/Hunting_reaction](https://en.wikipedia.org/wiki/Hunting_reaction)).

------
tcoff91
I am currently rehabbing hand pain right now and the number 1 thing that is
helping is this book:

The Trigger Point Therapy Workbook: [https://www.amazon.com/Trigger-Point-
Therapy-Workbook-Self-T...](https://www.amazon.com/Trigger-Point-Therapy-
Workbook-Self-Treatment/dp/1572243759)

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...](https://www.amazon.com/UTK-Infrared-Electric-
Therapy-19-Inch/dp/B013S7KGUU/ref=sr_1_3?ie=UTF8&qid=1479497050&sr=8-3&keywords=utk+far+infrared+heating+pad)

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/](http://posturedirect.com/forward-head-posture-correction/)

~~~
dvtv75
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.

------
scottlu2
I had a similar experience: keeping my hands warm while keyboarding made all
the difference.

Before this I was at 20% use for 3 years, tried multiple things, went to
multiple doctors, etc.

I also: wear a pil-o-splint while sleeping so that area of my wrist can relax
at night, make sure my hands are warm and that I've stretched before starting
for the day, and changed my typing posture so that my hands are mostly flat
and wrists don't touch the desk/keyboard while typing.

Finally, I stopped using emacs and the like because of the control key induced
hand/finger stretching. Vim is more RSI friendly in my experience because
there is less stretching required to use it.

------
rdtsc
Got a hand grip exerciser:
[https://www.amazon.com/dp/B01AJ6HZLG?psc=1](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%.

------
bluenose69
My left hand started aching about two years back, mainly when I was in Emacs.
(I have the key to the left of "A" remapped to "CNTRL".) So I switched to Vim,
which involves fewer painful single-hand key "chords". The pain went away
within days, and has not returned. Of course, I'm not happy with the new Mac
keyboards that lack an ESC key, so I am teaching myself CNTRL-[ as an
alternative, and am happy that this splits the keys across two hands, which
causes no pain.

------
elviejo
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.

If you suffer in your hands... make the change.

------
robertcorey
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...](https://www.amazon.com/Its-Carpal-Tunnel-Syndrome-
Professionals/dp/0965510999)

~~~
phes
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.

------
fapjacks
Weightlifting and exercise are the only surefire ways I've found of combating
the kinds of pain I experience as a programmer. I was able to utilize my doc's
recommended steroid injections (and Kratom from Indonesia) in order to get
myself to a point where I was working out every day. Years later, I haven't
had to deal with any of those issues any longer. I am also a much better
programmer for being a generally much healthier person.

~~~
wingworks
Agreed, I have friend who works over 8 hour days often, and is heavily into
gyms too, and he never gets any RSI issues.

------
plainOldText
One of the things I did that made a tremendous impact on reducing the tension
in my joints, was buying a good keyboard.

I don't typically recommend Microsoft products, but their sculpt keyboard is a
product which is cheap[0], stylish and most importantly ergonomic.

[https://www.amazon.com/dp/B00CYX26BC](https://www.amazon.com/dp/B00CYX26BC)

[0] Cheap relative to other ergonomic keyboards.

~~~
TYPE_FASTER
The original Microsoft Natural keyboard saved my career.

Two weeks out of school, I had unendurable pain in both hands. I bought a
Natural keyboard, the pain went away immediately, and only comes back when I
use a laptop keyboard for coding for more than an hour or two.

~~~
dvtv75
The fact that it comes back after an hour or two of laptop keyboard use
strongly suggests that you've not addressed the underlying issues. That's one
of the key things I see cropping up repeatedly here - "I've found something
that helps with my pain, if I stop the problems come back."

I regularly use laptops, standard keyboards, and have no problems. When I had
RSI, it was bad enough that I couldn't hold a fork for almost three months,
and typing was an exercise in agony.

Seek help from a good physiotherapist, but you'll need to do some research to
find a good one.

Also, see if you can find the bad habits you have that promote your injuries.
I have upper body muscle tension and poor posture, and when I first recovered
from my RSI I was having problems all the time with writing, typing,
absolutely everything. It turned out that those problems weren't bad feelings,
my hands and forearms had lost a significant portion of their strength, yet I
was working just the same as I had been beforehand.

------
yesimahuman
A Logitech trackball really helped me. That and avoiding the MacBook trackpad.

I tried a vertical mouse and it helped for a bit then I felt the pain got
worse.

~~~
Crespyl
Growing up, my family computer was set up with a very specific model of
Logitech trackball, the one shaped like a standard mouse with the off-center
ball that rests under your fingers, not your thumb.

It's the only trackball of its kind I've ever seen, every other model is
either a tiny thumb-ball, or an enormous whole-hand deal.

They stopped making them years ago, and now you can only find them from
scalpers on Amazon for upwards of $4-500.

It's frustrating, because I'd love to get back to using a trackball, but every
other model seems less comfortable to me than a normal mouse.

 _Edit_ : It's this one: [https://www.amazon.com/Logitech-Cordless-Optical-
Trackman-US...](https://www.amazon.com/Logitech-Cordless-Optical-Trackman-
USB/dp/B00006B9CR)

------
edwhitesell
I started having indicators of Carpal Tunnel about 10 years ago. I had heard
good things about certain wrist supports while typing, but I'm a
Systems/Network guy; so I frequently do other things than just sitting at my
desk. Wearing a wrist guard was very inconvienent.

So, I started wearing one at night while I slept. It took a couple of months,
but I've never had problems since.

------
muxxa
None of the comments so far seem to have picked up on the mention of caffeine.
For me this was the revelation; paying attention to how a strong cup of coffee
alters my posture and increases tension from my back through to my wrists. I
also notice myself long-pressing shift/ctrl/alt keys in a state which I can
only describe as 'over-determination'. (Funnily enough, a large pot of green
tea delivers a steadier dose of caffeine and doesn't seem to produce these
negative effects)

Not everyone is affected this way and I believe the root cause that caffeine
exacerbates is the particular kind of stress you feel when you want to get
something done already, a typical state of mind to be in running a startup.
Stress and psychological factors feed directly into bad posture and this is
why taking regular breaks only upped my stress levels as now I needed to work
even faster.

Lastly on the level of equipment fixes, ensure your elbows are supported by
arm rests.

------
wallflower
To anyone who has ever had pain or soreness or numbness after a prolonged
coding session and it went away after some rest, pain is the first sign.
Eventually what happens (and what happened to me) is that you need more
recovery time to get back to a baseline normal. And eventually that baseline
normal becomes a combination of symptoms: residual numbness, soreness, or
pain.

Please don't take your ability to "pound" away at the keyboard for granted.
And please don't make jokes about RSI ever. It is not a joke, unless you think
a "punch line" of seriously thinking about having to type a lot as a liability
for your career.

Swimming is quite possibly the best exercise. See
[http://totalimmersion.net](http://totalimmersion.net) for an alternative to
the Red Cross endorsed and rather inefficient "pretend you are a human
paddleboat" method.

Good luck! Ignoring the problem will not make it go away.

~~~
emodendroket
I mostly agree with you but I don't think swimming will necessarily help with
hand and wrist problems.

~~~
wallflower
There is no definite answer. It can and sometimes it can't. Hand and wrist
problems are not always just hand and wrist problems. Sometimes they are a
symptom of improper alignment and/or stress on the shoulder joints. If that is
the case, swimming, a zero-impact (to your joints) activity, through
exercising the full-range of motion of your shoulder and related joints can
help relieve some of that stress/tension that filters down to the hand and
wrist.

------
Gruselbauer
I do pretty much everything wrong in terms of ergonomic working. No wrist
rest, no typing technique, sit however fits the day. The only thing I don't
have in common with the OP is that I'm constantly hot. Sitting in a room with
no heating at 1000m above sea in the Alps right now, wearing a light track
suit and only registering a mild cold. I haven't turned on heating in ages,
actually.

The article does suggest psychosomatic causes more than anything, imho.
Especially people with neither medical training (me included) or prior contact
with that phenomenon (me excluded) often seem to think about this as a
question of willpower, a conscious decision or a few sessions with a
therapist. I beg to differ. If your hands pain you to the point of forcing you
to change careers and there's no physiologically pinpointable reason, I don't
see how the most complex parts of our bodies could not play a leading role.

------
ejcx
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.

------
dkersten
I'll add my own anecdote:

I had an RSI "scare" about ten years ago while I was a student and similar
things worked for me. I started to wear fingerless gloves or other things to
keep my joints warm while typing and I took steps to reduce non-physical
stress. I also took more breaks and made an effort to keep my hands aligned
better. I did the latter two first and by themselves didn't notice any change
but all together, my pain went away.

Now I try to not type with cold hands when possible, try to keep my joints
neutrally positioned and not type for too long at a time. I also used a
mechanical keyboard for a long time (which requires very little pressure to
activate the keys) and learned the Colemak keyboard layout. I haven't had any
relapses although on busy days I can sometimes feel pressure building in my
hands (I then take a break and do some stretches).

------
ijidak
I've had similar problems. And the same thing worked for me. Seeing that it
worked for this person as well, reaffirms that this might be a permanent
solution. Whenever I code without long sleeves, I start to feel pain again. I
haven't tried hand warmers; I might have to try that too. It makes sense
though. Carpal tunnel and other repetitive stress syndromes come down to low
blood flow. I've also used aspirin to beneficial effect, when the carpal
tunnel starts flaring up. And the aspirin helped as well. At the end of the
day it seems like it's all about blood flow. Doctors wanted to do surgery and
I turned it down, and just keeping the blood flowing, by staying warm has
helped quite a bit. (Of course, along with regular breaks too.)

------
AlaShiban
The mobo chair mount has been the most transformative product that
reduced/eliminated RSI for me. For years, I tried to find better tables,
better chairs, better mice/keyboards, postures -

The problem turned out to be in the seams between products, not the individual
pieces.

The mobo mount solves this by throwing away the table component from the
keyboard/mouse equation - solving most posture problems. Try it out.

[https://www.amazon.com/Mobo-Chair-Mount-Keyboard-
System/dp/B...](https://www.amazon.com/Mobo-Chair-Mount-Keyboard-
System/dp/B002YERS32/ref=sr_1_1?s=office-
products&ie=UTF8&qid=1479521391&sr=1-1&keywords=mobo+chair+mount)

------
kylecordes
I arrived here with 167 comments already present, and am very surprised to
find I am the first to offer the following:

A few years ago, I started feeling frequent hand and wrist pain. At the time I
was writing a lot of code and also a lot of text. To attempt to fix it:

1) I learned more keyboard shortcuts and refactoring tools, so that I could
write more code with less finger use.

2) I picked up a voice dictation system, went through the tedious process of
getting comfortable with it, and switched to it for nearly all of my non-
programming work.

Between these two things, I estimate my keyboard use declined by perhaps 75%.
My productivity increased. Pain completely disappeared. Total cost, a few
hundred dollars, including a decent wireless headset.

------
partycoder
After suffering from a severe RSI, involving wrist pain, numb fingers and
months of physical therapy. This is what worked for me:

\- If you are in pain, stop what you are doing. Be it working, stretching or
exercising.

\- Keep your wrists straight using a wrist brace, at day and night, until the
pain goes away. There are soft braces specific for night use. One for day use
that is not invasive is: [https://www.amazon.com/BRACE-RCA-Treatment-Support-
Regular/d...](https://www.amazon.com/BRACE-RCA-Treatment-Support-
Regular/dp/B00PFUPRQ2)

\- You can test your wrist posture by putting a pencil on your wrist. Your
wrist should be straight. I emphasize this because it's one of the most
contributing factors to RSI.

\- Therapy alternatives include: physical therapy, medication, acupuncture. I
did not try the acupuncture personally. Physical therapy was greatly useful,
especially the stretches:
[https://www.youtube.com/watch?v=xAKOpnqvttI](https://www.youtube.com/watch?v=xAKOpnqvttI)

\- Use the right keyboard. A short keyboard helps your elbows, a mechanical
keyboard helps your fingers. Ergonomic keyboards as well as vertical keyboards
did not yield results for me. Even when used under the supervision of an
ergonomist.

\- Exercise does help. Muscles comes in pairs. Typing makes you contract your
muscles more than you extend them, creating a muscle imbalance that
contributes to carpal tunnel syndrome. These products help:
[https://www.amazon.com/PROCIRCLE-Finger-Stretcher-
Resistance...](https://www.amazon.com/PROCIRCLE-Finger-Stretcher-Resistance-
Assorted/dp/B00MA8M454/) , and when you need more:
[https://www.amazon.com/Strengtheners-rehabilitation-
Equipmen...](https://www.amazon.com/Strengtheners-rehabilitation-Equipment-
Rehabilitation-Exercisers/dp/B00G0Y7724/)

Finally, see this as an investment. To be injured for life will put your
career in jeopardy. Invest in your health.

------
emodendroket
I went to an occupational therapist and she gave me a program of exercises and
as long as I do them I can keep my RSI in check. I definitely recommend
occupational therapy if you think you are developing RSI. Of course you should
also make basic ergonomic improvements like getting your keyboard at the right
height (unless you have a keyboard tray it probably isn't); those are helpful
too.

e: Also the Sarno book this guy recommends has always struck me as pseudo-
scientific nonsense. I like Pascarelli and Quilter's _Repetitive Strain
Injury_ and Damany's _It 's Not Carpal Tunnel Syndrome!_

e2: Also if your first impulse is to go buy a wrist brace that is completely
wrong.

------
Mz
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.

------
visarga
I cured chronic back pain that I have been suffering for a decade with Calcium
and Magnesium supplements. They are cheap - 1 dollar for 20 effervescent pills
- and make me feel 10-15 years younger. Another benefit is better sleep (no
more chronic tiredness) and less anxiety.

If you have chronic pain check out Ca and Mg - they are essential for muscles.
My discovery was by chance, I have been going to doctors, gym, yoga and
massage for years with no results. Even run blood tests and they still didn't
catch it. Now, I can tell by the feeling in my body when I need a Calcium.

TL;DR - Calcium is for muscle pain. Magnesium is for better sleep, chronic
tiredness and anxiety.

------
ianaphysicist
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.

~~~
colanderman
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.)

------
TACIXAT
My wrist was aching from twisting to hit the arrow keys and numpad, as I would
keep my arm in the same position and just reach by angling my wrist. I got a
60% mechanical keyboard with a function layer and it is great.

------
sova
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"

------
zackola
I also bike to work every day. I was not having chronic pain, but mild
discomfort and one thing that made a difference was changing my bike
handlebars to more be more upright instead of a flatbar style. These are the
handlebars I ended up with and couldn't be happier. [http://store.velo-
orange.com/index.php/components/handlebars...](http://store.velo-
orange.com/index.php/components/handlebars/vo-left-bank-handlebar-config.html)
They Allow my wrists to stay straight instead of bent back.

------
arrakeen
my pain issue stemmed from my neck which i eventually realized was due to poor
posture/forward head position. i'd highly recommend reading this article [1],
which finally made it click for me. turn off your adblocker since there's a
bug on the page which will hide the content, and ignore the amateurish
presentation. there's some very good information on the site which helped me
finally rid myself of pain

[1]
[http://www.drbookspan.com/NeckPainArticle.html](http://www.drbookspan.com/NeckPainArticle.html)

------
intrasight
About 15 years ago I made the decision to halve my mousing strain by becoming
equally adept at mousing with either hand and either with a mouse or a
trackball. I have both plugged into my computer all the time, and I swap hands
and devices a couple times a month.

A great keyboard is important too. I only use IBM model M's made around 1984.

And as is discussed at length in this thread - exercise! I hit the gym for 2
hours between 5 and 7pm and let almost nothing interfere with that.

I have RSI pain yes - it comes with the job - but it's reached a steady-state
that I can deal with.

------
chipuni
Personal anecdote:

I had crippling pain along my left side. I saw several doctors about it; they
prescribed drugs that helped the immediate pain but didn't solve the
underlying problem.

Then I read on
[https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072780/](https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072780/)
that wearing a wrist brace AT NIGHT helps overcome carpal-tunnel. A good wrist
brace cost me about $20; I've worn it every night since, and the carpal tunnel
has gone away for me.

------
lutorm
I'll put in my constant plug for the Trigger Point Therapy Workbook:
[https://www.amazon.com/Trigger-Point-Therapy-Workbook-
Self-T...](https://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-
Treatment/dp/1608824942)

It was recommended to me by my PT when I had hand pain, and it's helped me not
only with that but back pain, headaches, and plantar fasciitis. Probably a few
more, too. If you ask me, it's the best $16 investment you can imagine.

~~~
tcoff91
Within 2 days of using the techniques in this book my pain started to improve
significantly.

Once you address the trigger points, tools such as the Powerball, captains of
crush grippers, and thick rubber bands can be used to strengthen the flexors
and extensor muscles of the forearms.

~~~
kzisme
Your pain improved or decreased after using the techniques?

------
Uroboric
Only a year or so into my career I started getting pain in my upper right back
from using a mouse. I tried various adjustments to my desk/chair setup but
eventually it got to the point where I couldn't use the mouse with my right
arm anymore without unbearable pain and it would linger when I wasn't working.

I was able to solve the problem completely by starting to use a trackball with
my left arm. I still use a mouse with the right when precision is necessary
but 90% of the time I use the left and trackball.

------
slowmovintarget
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.

------
Benjamin_Dobell
I'm sure tensing up due to cold doesn't help. However, for me an ergonomic
setup (in particular mouse and keyboard) has done wonders. Pain isn't 100%
gone all the time, but it's not crippling agony where I can no longer make a
fist.

The other thing that makes a huge difference to me is sleep. Days I don't
sleep long /well my wrist and fingers hurt more. I don't know if this is due
to giving the body more time to repair or feeling more relaxed (less tense)
throughout the day.

------
mchahn
A very simple way to fix wrist problems is to switch hands for the mouse. I
had carpal tunnel bad enough to stop me from using a mouse at all and then I
tried switching hands. At first my useless left had couldn't click on the side
of a barn. After a week or so I was using my left hand with no problem and
after a month I was as good as with my right.

A year later I happened to be using a mouse with my right hand and I
discovered there was no pain. So I actually fixed my problem.

------
pkamb
My senior year of university I suddenly became unable to click a mouse.
Perfectly fine before, and I loved using mice for normal work and things like
First Person Shooters.

But suddenly the curling "clicking" movement of my index finger stared causing
extreme pain. Still does, to this day, even making that movement in the air.
Typing is fine for some reason.

Transitioned to full-time TrackPoint use (USB ThinkPad keyboard), or TrackPad
on my Macbook when I'm not at my desk.

------
hexsprite
One thing that has improved wrist pain for me is reducing inflammation.
Avoiding sources of inflammation like excess sugar and other high GI index
foods, low quality processed oils, biotoxins, allergens have helped me reduce
my RSI.

Foods and supplements like omega 3, coconut oil, ghee, turmeric, lots of
greens, bone broth and more have helped to keep the inflammation down.

Exercise is also super helpful but may not addressing the root cause of the
problem.

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danieltillett
The thing that I found works wonders in preventing RSI pain is those silicone
gel keyboard wrist rests [1]. Get one (softer the better) and also one for
your mouse. Since using these I have not had any pain.

1\. [http://www.staples.com/Staples-Gel-Wrist-
Rests/product_SS103...](http://www.staples.com/Staples-Gel-Wrist-
Rests/product_SS1033586)

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delbel
I had it pretty bad and thought my career might be over. Then by mistake, I
bought a truck with no power steering, and then started doing push ups first
thing in the morning. Also I spent hundreds of hours making my desktop mouse
free and have dozens of flux-box macro, and various IDE key board sequences
memorized so that I never had to move my hand to the mouse and back.

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udfalkso
I've found the "Time Out" mac app helpful to force myself to take breaks and
stretch/stand/rest-eyes periodically. I disabled the Skip button recently
which has been a bit annoying but valuable.

Also, years ago I started using a trackball mouse instead of a normal mouse
(or the laptop trackpad which is the worst for my wrist). It has helped a ton.

~~~
emodendroket
I used one of those (Workrave specifically) when my symptoms were at their
absolute worst but it just makes it impossible to get things done.

~~~
udfalkso
I did tone down the frequencies some to be more Manageable. Even a 12 second
break every 15 monutes or so does a lot. And it doesn't break the flow much at
all

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tynan
Small anecdote that may help someone:

I finally got RSI. I knew it would happen eventually since I'm on my computer
all the time, so I just accepted it. When the pain in my wrist became too
much, I'd shift positions or take a rest.

Then one day it occurred to me that I had gotten RSI right after getting a new
watch. I loosened the watch by one notch and all symptoms disappeared.

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dmfdmf
Sarno worked for me. Ignore his "rage" theory derived from Freud and just use
his techniques. It worked for my arm and wrist pain. Now, whenever I
experience ANY bodily pain (knee, back, hip, etc.) I assume it is
subconsciously generated and use Sarno's techniques. If that fails then rest +
advil will usually do the trick.

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raverbashing
What helped me: focusing on using the keyboard instead of the mouse and
Powerball exercises. I was never bothered by it again

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ninjakeyboard
I bought a kinesis advantage, learned colemak, and started using a cheap wacom
bamboo tablet w/ my left hand (I'm right handed.)

The latter was the best thing I think. I tried a trackball for a while.
Switching hands entirely and getting used to a tablet where you only move your
arm coupled w/ the kinesis advantage cured my rsi symptoms.

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sandGorgon
This is an article by Aaron Iba (founder of Etherpad and ex-YC partner) -
[http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-
pain.htm...](http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-pain.html)

It changed my life after a year of RSI - validated on multiple people.

------
pfarnsworth
There are many different causes of RSI.

Mine was from my mouse. Two year into my career, my RSI was so debilitating
that I was worried I had to stop programming.

I changed mice, changed how I held my mouse, and 20+ year later have never had
a flare up. I now use a regular mouse, and just pivot my wrist when I use it,
and haven't had a problem since then.

------
dm03514
[https://www.amazon.com/gp/product/1572240393/ref=pd_sim_14_1...](https://www.amazon.com/gp/product/1572240393/ref=pd_sim_14_1?ie=UTF8&psc=1&refRID=YR91QT75TJFKZ76CSCHJ)

Start daily regular stretching fix your finger, wrist, arm, shoulder, back
pain.

------
Chyzwar
In my case weight of mouse is important. Light mouse is much better, cordless
mouses with battery was killing my right hand. I got Mueller Wrist brace and
it helped a lot when away from computer.

The worst thing are stupid standard desks. 75cm height with keyboard on top.
At home I build my own desk with 80cm height and keyboard+mouse shelf.

------
codingdave
RSI is a category of problems, and everyone will have their own specific
flavor of problem. While there is a lot of good advice out there, just ask a
doctor. They can diagnose exactly what is wrong, and filter the advice down to
the problem that you actually have.

------
eikenberry
I never thought of cold causing RSI, but I've never had that problem. Good to
know it might be a cause if it ever comes up again. I did have a bit of RSI
about 10 years ago, but hardware fixed it for me.

Balt split level desk + Kinesis Advantage + Kensington Slim Blade.

------
fillskills
Ok, this home remedy has worked for me and my family - Dip your hands in Hot
water + Mustard oil + salt. A few times and the paid is gone for 1-3 months
based on how frequently you keep up with bad posture (working with laptop in
bed etc).

------
meirelles
I suffered from intense pain on wrist/arm. After starting the gym (weight
lifting + cardio), the problem ended. Zero. I mean, it's been 10 years without
ANY pain. The benefits are many for those who work sitting all day long.

------
jordache
I can not stand keyboards with high pressure threshold on the keys. My
constant Ctrl+C, Ctrl+V, Ctrl+F, etc.. was causing tremendous pain on my pinky
finger, from having to press down on the Ctrl key so many times.

------
homulilly
correction: "-itis" means inflammation, not some random thing.

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latifnanji27
I've had this specific problem and solved it with Dr Sarno's book. It changed
my life. I was able to create a startup (that I longed to do..) and I've never
been happier.

~~~
latifnanji27
And its NOT RSI. It's TMS.

------
cptskippy
I started having really bad wrist pain and numbness in my hands and fingers.
It ended up being the desk height that caused it. Got a lower desk, pain
vanished.

------
srinikoganti
After 6 years of struggle with this career ruining pain, I finally found my
remedy in Homeopathy. Medicine name is "Bellis Perennis". In olden days it was
a popular medicine to treat RSI of Pianists and Stitching workers. I had taken
"Belllis Perennis, 1M potency" 3 times(about 20 small pills each time) in only
one day. That's it. No need of taking it again. If pain doesn't go away in a
week try 1 more day after 1 week. No side effects, since it is Homeopathy.
Since I am not a doctor, Please check with Homeopathy doctor before taking it.
Thanks..

~~~
olivierlacan
Or check a licensed Medical Doctor who understands biology.

1M potency in context: > 30C (diluted 30 times), 200C (diluted 200 times), 1M
(1000 dilutions), and 10M (10,000 dilutions).

> A popular homeopathic treatment for the flu is a 200C dilution of duck
> liver, marketed under the name Oscillococcinum. As there are only about 1080
> atoms in the entire observable universe, a dilution of one molecule in the
> observable universe would be about 40C. Oscillococcinum would thus require
> 10320 more atoms to simply have one molecule in the final substance.

[https://en.wikipedia.org/wiki/Homeopathic_dilutions](https://en.wikipedia.org/wiki/Homeopathic_dilutions)

------
griffinmichl
I bought a Kinesis Advantage, and it 100% completely cured my wrist problems.
Best money I've ever spent.

------
joshribakoff
Switching from a mouse to an apple magic track pad helped my pain a lot. I
recommend giving it a try.

------
utefan001
Highly recommend trying indoor bouldering. Huge help for my RSI. Go easy for
the first 3 weeks.

------
pbrumm
what helped me was being more aware of the position of my hands during sleep.
if I slept with my wrists in a bent position that tended to cause issues
during the day with typing. Keeping them straight while sleeping helped a lot.

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INTPnerd
"As an Emacs user"... Switch to Vim. Problem solved.

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osman84
Did no one notice that OP has affiliate tagged his links to that book, and so
is making money off of anyone who clicks through and buys it?

In the spirit of objectivity, that should be disclosed.

------
RomanPushkin
What hand warmers would you guys recommend?

------
wtcross
Exercise....

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elcct
It looks like it is pretty common for companies to neglect air conditioning.
What's the point in having fancy office if the air makes you dizzy after an
hour and no amount of coffee can make a difference or the temperature. One
days cold as f, another day let's all go naked and drink ice tea...

------
oceanswave
Came here for Star Citizen news. Was disappointed.

~~~
teach
I don't get it.

~~~
Agathos
RSI = Roberts Space Industries

