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June 28, 2007 | Comments: (0)
Carpal Tunnel Syndrome
It seems I'm not the only open source guy currently suffering from Carpal Tunnel Syndrome. Carpal Tunnel is a Repetitive Strain Injury (RSI) typically caused by too much typing combined with bad ergonomics. Not only do heavy-duty computer users suffer from this, but it also affects musicians quite frequently. In my case, the onset was a combination of too much typing (and why did I agree to a new blog?) bad desk setup and too much guitar playing. Admittedly, I am a novice guitar player but I was spending too many hours learning scales while seated in a cramped office chair on weekends.
So in case anyone else is dealing with RSI, I thought I would share some thoughts and remedies I've learned. Ok, learned would imply I'm following all of this advice, which is not entirely true. But I'm trying to follow it and I'm making progress.
First of all, if you are feeling any pain, tingling or loss of sensation STOP IMMEDIATELY. If your body tells you to stop, pay attention. In fact, you ideally shouldn't do repetitive tasks like typing for more than 15 minutes at a time without getting up and stretching.
The next most important item is about the ergonomics of your desk area. You absolutely need to make sure that you are not bending your wrists upward while typing. Laptop keyboards are not great in this regard. If you have to type at a laptop, use a wrist pad to raise your hands to a neutral position. If you have a detached keyboard, it should be angled downward which means you should never use the rear keyboard feet to raise the back of the keyboard. In fact, you should have a riser at the front of your keyboard. I switched to a Microsoft Natural keyboard years ago, and found this helps somewhat. The newest model, the Microsoft Natural Keyboard 4000 or the wireless version the 7000 are well designed in this regard. In fact, I picked up a new 4000 keyboard for use at home to replace my old Dell branded Natural keyboard and I noticed it had the legs at the rear, which is completely wrong.
You want to make sure that your arms are basically level and that your wrists do not need to bend in uncomfortable ways when you type. I learned to touch type in high school and although I do not usually type completely properly using all 5 fingers, I am trying my best to do so now. It makes a huge difference. If you're of the two finger hunt-and-peck school, consider learning how to type properly so that you are not stretching your hands in unnatural ways. For me, I especially need to make sure I'm not attempting to use the same hand for two simultaneous keystrokes. That is, when you shift, you should be hitting the shift or control key with one hand and the appropriate letter with the other. This takes some retraining if you have bad habits ingrained after many years. The worst is the Alt-Tab combination in Windows. I'm also experimenting with a Kinesis keyboard at work, which is an even more extremely shaped keyboard than the Microsoft Natural keyboard. (It also costs more, but I figure its cheaper than surgery.)
The mouse is a frequent culprit in RSI. You may wish to try just switching hands to see if that helps. Or alternatively using an ergonomic mouse like the Logitech Trackman or Marble Mouse, which is sort of a mouse and trackball combination. I'm also trying out a Kensington trackball.
Carpal Tunnel Syndrome is an inflamation, so taking Ibuprofen (note to self: should that be iBuprofen TM Apple?) will help. Also warming up your arms (before a lot of work) and icing after is a good idea.
I have also found that padded wrist splints such as those by Futuro or Imak can be helpful. You can find them in most drugstores. Plus if you get them in black, grow your hair long and and wear a studded leather jacket, they look kind of heavy metal. These splints can help keep your wrists straight while typing which is important.
When I was in the most pain, I tried using the Dragon Naturally Speaking voice recognition software. It works pretty well, but its not easy to get used to dictating. Its definitely a lot slower than typing.
Oh yeah, and blogging or email from a Treo? That's got to be one of the killers. I can't say I've cured myself of that habit, but I'm trying.
Let me know if you have any ohter ideas that are helpful here. Also, take a look at Wikipedia, the Effective Ergonomics site, as well as these articles for other ideas: Ergonomic Problems with Mice, Cornell's Ergonomic Guidelines for Computer Workstations.
Posted by Zack Urlocker on June 28, 2007 03:22 PM
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Back in 2001 when my e-mail habits went into OT, I began developing that pain in the wrist, just below the cleave of the right palm.
I very much didn't want to be slowed down, so switched to lefty -- took about 2 days and I forgot I was right-handed. Two LONG days.
After about a week, feeling less pain, I went and got a (Logitech) USB trackball device. Shifted back to right and never felt any problems. As far as I can surmise, the difference is in using the fingers instead of the wrist. Still using it today.
Posted by: Sam Hiser at June 28, 2007 05:53 PMYes, CTS really sucks. Other things that help are significant doses of B6, chiropractic adjustment of the wrists, and accupuncture.
If you are taking ibuprofen or another NSAID, keep it up steadily to reduce the inflammation. For OTC ibuprofen, that's 2 pills 4 times a day, or up to 2x more (usually as a prescription dose) if your doctor approves. You'll need to do it for at least 2 weeks for full effect. Consider taking a PPI (proton pump inhibitor) like Prilosec to avoid ulcers from the ibuprofen. If your ears start ringing, cut back the dose.
That said, the best possible therapy would be to lay off the computer, Treo, and guitar completely for about 3 weeks. Beach time?
(This advice comes to you from someone who hasn't really had a vacation for 20 years.)
Posted by: Martin Heller at June 29, 2007 08:30 AMOnce the pain starts, cutting back on typing is crucial. The specialist that I consulted said that it still amazes him how many people continue to type while in pain. There are some exercises that can be done to improve things. One side effect of CTS is that some muscles lose strength.
Posted by: Jose Perez at July 3, 2007 12:56 PM
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