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Google Staff MD on Carpal Tunnel & RSI

Posted by CmdrTaco on Wed Apr 26, 2006 08:34 AM
from the wrists-to-sore-to-make-sarcastic-quip dept.
Science
bariswheel writes "Every older and some younger Slashdotters have been subject to that tingling feeling in your wrist after countless hours of hacking, cracking, or playing CS. This Google Blog, posted by the Staff MD addresses this serious symptom that could potentially lead to "compression of the nerve which can cause numbness or tingling and eventually weakness if the nerve is damaged severely." Didn't think hard work would hurt anybody right?"
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  • Livelihood (Score:5, Interesting)

    by eldavojohn (898314) * <my/.username@@@gmail.com> on Wednesday April 26 2006, @08:36AM (#15204131) Homepage Journal
    I use my hands/wrist/forearms for a lot of things. I play bass, program for a living, play piano & enjoy hours of computer games. On top of that, I spent my youth working on a farm doing repetitive chores like picking up rocks or bails of hay.

    I've always been concerned about the state of my wrists especially since they're so vital to my livelihood. But what I've found is that the only time I've experienced fatigue or pain in them is when I haven't used them to intensively work out. I now visit the gym twice a week and I believe that doing proper exercises [myfit.ca] builds strength and endurance in them to overcome what effects poor posture at work might have on them.

    I'm not in any way a doctor but it's been my experience that when I was in college with no time to work out (and no job to force me to use them), I experienced discomfort from programming 12+ hours at the end of semesters. Now, I never even notice a 12+ crunch between work and school.

    I also have a pair of hand grips [ballyfitness.com] at both my office and home where if I'm watching television or waiting for a compile to complete, I'll put in a few repetitions. I just see this as "flossing your teeth" for programmers. It's not something you have to do but you should do it because your hands really are worth a lot to you.

    I don't take this issue lightly after I saw my friend go through it at the young age of 22. He had to wear a sort of headband thing [spectronicsinoz.com] with a reflective dot on it to move his mouse around on his machine. Unbelievably, he even became quite good at play Star Wars Galaxies online with it on.
    • I use my hands/wrist/forearms for a lot of things

      It's a shame I can't think of a sophomoric joke that is clever enough to not be trite.
    • I second this -- exercise strengthens my wrists, arms and shoulders as well. I use Workrave [sourceforge.net] and when it pops up for a break, I just try to lift my desk. It's too heavy, but I keep the tension on the muscles for 30 seconds or so. It doesn't cost any time and nobody notices.

      Except my girlfriend. I have enormous claws now :D

    • I agree that strength and endurance training is important, even for the wrist and forearms, but I don't know if it would help significantly with nerve compression. I practice martial arts fairly seriously and I work on strengthening muscles around joints to prevent breaks and strains. However, if someone torques a joint or puts it at an unusual angle, it still hurts. You can have huge arms like a certain California governor but if you tap the funny bone just right, you still wince in pain.

      Carpal tunnel i
    • Musicians and programmer types know repetitive stress better than anyone I'd say. I found Desktop Yoga [mydailyyoga.com] to be a great set of excercises to start the day and get the wrists / arms / shoulders loose and relaxed. I don't work a desk job but the majority of the excercises can be done sitting down without drawing attention to oneself.
    • I agree 100% about the benefits of wrist and forearm exercises. I started to actually get occasional stabs of pain when using my thumb to turn a faucet or doorknob. My wrists also started to get a constant dull soreness. This all went away completely after doing martial arts (wu shu/kung fu) for a few months (now many years). One of the things that helped the most were the Aikido wrist exercises we would do to get ready to practice wrist locks (Chin Na). Here is a good site about them: Aikido Wrist Exe [aikido-world.com]
    • I'm a pianist. We call those hand grips you are using "unemployment". THROW THEM OUT!!! They will just serve to make your wrists tight.
    • I'm not an MD, but what's likely going on is that you're building some odd muscle or two in that area. Muscles play an important structural role in your body - they're actually holding you together, just like your skeleton does.
      This structural role is often negated in skinny people who lack enough lean mass, as well as people with an excessive body fat ratio.
      So bulk up, people, or you'll be at an increased risk of sprains, back pains, etc.
    • I also recommend buying a mouse like this [3m.com] - it helps to keep your arm in a "natural" position. Unless you're a gamer, you won't matter having one.

      I also recommend buying a wrist brace, even if you don't have RSI. It helps to keep your wrist straight - not keeping it straight is what can inflamate the nerve, AFAIK.
  • I am not a doctor, but what I do is have various input devices, wheel mouse, regular mouse, split keyboard, regular keyboard and every couple of months change my main computer's devices. I don't know if this will actually help but the change feels nice.

  • RSI (Score:2, Informative)

    by sirius sam (963847)
    JWZ has some good information on RSI [jwz.org]

  • Used to have that problem (Score:5, Insightful)

    by DoctorPepper (92269) on Wednesday April 26 2006, @08:44AM (#15204176)
    Then I bought a Microsoft Natural Keyboard. I don't much like MS software, but their hardware is first-rate. I can (and do) sit in front of my computer and write code for hours on end, with no problems. I even bring on with me on contract jobs.

    I have a couple of extra, just in case this one croaks. I haven't noticed the natural keyboard in stores lately.
    • Also, as a not-quite perfect alternative to using a mouse, use of a graphics tablet requires a 90 degree (that's pi/2 radians =] ) turn of the forearm and a natural writing position.

      It might be a good rest/change of position tool for people whose mouse wrists are hurting, and a basic Wacom Graphire doesn't cost the earth either.

      Beware though, if you're a b3ta.com (b3ta wikip. page) [wikipedia.org] user, you'll be coerced into drawing a CDC in no time.
    • I have to agree with this one. The problem I have with the natural is that it's way too wide. It doesn't need that numeric keypad which forces your mouse way over to the right if you're right-handed (which in turn puts more stres on your mouse hand). I have considered cutting the pad off but there is that damn key matrix inside that you can't cut without breaking the whole thing.

      The Naturals wear out after a while though. The keys start to get sticky (especially the wide keys like shift). I have been t

  • It's all about posture. (Score:5, Insightful)

    by Ryvar (122400) on Wednesday April 26 2006, @08:54AM (#15204235) Homepage
    I was starting to get the tingling in the nerves of my right hand recently at 25 - and I've spent nearly every day, at least 12 hours, on the keyboard since highschool. Sometimes I'll go a few months, solid, in front of the screen 16/7. At first I thought it was just age and wear and tear on my wrists, but then I noticed something - the new high-back executive chair I bought sat lower, at its maximum height, than my previous chair.

    So I bought a new chair that sat higher with higher armrests, and haven't had even a whisper of a problem since. I'm convinced the problem is largely one of ergonomics and posture.

    --Ryvar
    • I personally don't think it is the keyboard.
      It was always in the right hand for me.
      I switched to using my left hand for the mouse at work, and my right hand at home, and the problems completely went away.
      Well, unless I do a long session at work or home.
      Then, I just take a bit of a break or do some wrist exercises. I blame mice, not keyboards.
      Although, once I had the problems in times past, it did hurt to use the keyboard (or pretty much anything else).
  • Didn't think hard work would hurt anybody right?

    Each /. post is a painful in this life, but the sacrifice is worth the all good karma that has been spread.

  • Hand Problems (Score:5, Informative)

    by Mobile Unit of the G (862058) on Wednesday April 26 2006, @09:01AM (#15204285)
    Although Carpel Tunnel Syndrome makes the news the most, the most common hand problems that computer users experience is tendonitis. Tendonitis is painful, but it doesn't damage nerves.

    What evidence there is points to the mouse as the source of computer-related hand problems, not the keyboard. I remember hearing a lot about people getting computer-related hand problems in the early 90's, around the time Windows 3.1 came out and the mouse became mainstream.

    I tend to have hand trouble in the spring when I start riding my bike, and that demands a hand position different from anything I do all winter.

    I've had times when my tendonitis was so bad that I thought I'd have to change careers, but I found that push-ups were an effective treatment for me. Push-ups are great because they are a functional exercise that works the whole upper body -- they build up the big muscles in your chest as well as the little muscles in your wrist. I love lifting weights, but you can do push-ups at home without any equipment or gym memberships.

    Note that every motion you do involves a complete 'chain' that leads back to your center of gravity -- if you push a key on a computer, it's only an ounce or two of force, but it's ultimately backed up by your whole mass. Your big muscles help your little muscles do their work and vice versa...

  • You forgot (Score:3, Funny)

    by Immercenary_2000 (863998) on Wednesday April 26 2006, @09:05AM (#15204315)
    "that tingling feeling in your wrist after countless hours of hacking, cracking"

    you forgot to add wacking after all this is /.

  • Sorry, lots of typing != CTS (Score:4, Interesting)

    by TheSkepticalOptimist (898384) on Wednesday April 26 2006, @09:06AM (#15204322)
    I have been programming software for over 10 years, and was avidly using a computer years before that, and I don't have CTS or any tingling sensation after 8, 9, 10+ hour days.

    People that experience CTS because of typing seriously need to figure out what they are doing wrong, and they ARE doing something wrong.

    People I know that have CTS tend to pound on the keyboard, they put so much tension and force in order to hit the keys with their fingers, there is no need to pound on the keyboard. Light quick presses of your fingers is enough to register the key press. If your keyboard forces you to pound on the keys, get a new keyboard. The moment even ONE of my keys because sticky or requires more force to press then normal, I toss it and get a new keyboard, period.

    People that I know who also have CTS tend to try and type as quickly as possible. Their fingers are a flurry of activity for 2 - 5 minutes, and then they have to stop and rub their fingers and wrists because they are sore. I watch them tense up and basically spas out on the keyboard in short intervals. You will find greater productivity and no pain if you learn to type slower, aiming for long sessions of moderate speed typing rather then spazzing out on the keyboard for short stints.

    Put it this way. You move your fingers and wrists in thousands of directions thousands of times a day in with normal activity. Your fingers, hands, and wrists are designed to handle it. Where you get problems is when you strain your tendons and force movement while in a strained position. This is where repetitive STRAIN syndrome occurs.

    By relaxing your fingers, typing with a lighter touch, and slowing your typing speed, you can type for hours, days, weeks and years without pain or any CTS symptoms.

    It work, believe me. With the MS natural keyboard and keeping the above statement in mind, I don't have sore wrists at the end of the day.

    The bottom line is, your company doesn't force you to use the equipment you use. If they won't buy you a natural or other ergonomic keyboard, or a force you to use a keyboard that has sticky or hard to press keys, then buy your own keyboard. Take steps to ensure your work environment is safe. If you don't like your chair, or your desk, get it replaced. Remind any employer that a few hundred dollars to improve the ergonomics of your workstation, or even a few thousand to improve everyone in the office pales in comparison to the millions they will be sued for for not providing a safe working environment that causes you pain or forces you to have to stop working. NO employer should refuse to let you bring in your own keyboard, mouse, even chair, if they do, find other employment.

    I tire of hearing about people getting CTS. They are simply doing it all wrong, but blaming everything else but themselves. If you are using a straight rectangular keyboard that isn't at the proper height, pounding on it with your fingers and strained wrists, and feel you need to type 100 wpm in order to be productive, then its your own damn fault!
    • I can only imagine that these people who experience CTS are overweight and never exercise. I have never had a problem either. Or, of course, we could be lucky and it could be something genetic.
      • I've been hacking/typing since I was 11, that's 24 years now. I have never experienced RSI or CTS or any of that stuff, and I'm overweight ("obese" according to the WHO guidelines, but just moderately overweight according to my quack who still uses the old U.S. guidelines).

        I think most of the problem stems from poor ergonomics at the workstation, i.e. bad keyboard height, improper mouse positioning, etc. 'Course my favorite coding position is with my feet propped up on my desk and the keyboard on my lap or
  • While do-it-yourself solutions (new keyboards/mice, home exercises, wrist splints, etc) are a great first step, if you are still hurting don't be afraid to go to your doctor. They can run tests (e.g. EMG, blood flow studies) that can narrow down the problem and can prescribe physical therapy to help you through exercises specifically for your problem.

    As a long-time RSI sufferer, it is also worth mentioning that even though the symptoms may appear in your wrist/hands, the actual problem could be in your
  • From TFA:

    Shift your gaze from the computer screen to the distance. And don't forget to blink!

    Does this really happen to people? I think (and really hope) that it never happens for me not to be blinking! Has any of you ever noticed that you haven't blinked for a long time?
    • This happens to me. In fact, if I am concentrating hard I find that I forget to breathe as well.
    • I've noticed that when I'm making long, steady mouse movements in Photoshop that I hold my breath. I do the same when taking photographs. I have no idea why I do this but I suspect that I don't blink either.

      Later today I will attempt to walk _and_ chew gum.

      I'll take the appropriate precautions...
  • Anyone have any idea what this is supposed to mean?

    Or, alternatively, can you think of any really funny misinterpretations?
    • What do you mean? Don't you try to type with your mouse, and move your keyboard around every 30 minutes or so?

      Maybe they mean getting a different keyboard, but unless it is quite difference, I don't see what difference it would make.

      Maybe at google they have a range of keyboards that you can swap over every few days, but not here.
  • I can hyperextend my wrists to the point where a normal person's wrist snap. Im sure my extra flexible wrists will help prevent carpal tunnel syndrome. As for figuring out how I had freaky wrists? Trying to break wrists in the martial arts.
    • Wow. Thirty five years in MA and only a couple of strains, here. You must either have been taught how to hold your hands very wrong in relation to your forearms by an incompetent teacher, or you didn't listen to a competent one.
  • If you type a lot, you've got to try using an ergonomic keyboard layout.

    I used to go home from work with a feeling of numbness on the backs of my hands. This scared me enough to try the Dvorak layout. It worked for me; I'm not really any faster than I was with QWERTY, but I'm *way* more comfortable. I tried to design an even better keyboard layout via evolutionary algorithms, but couldn't; Dvorak got it right, at least for my pair of hands.

    Give it a try; you'll thank me later. It's free, too.
  • I had the symptoms associated with carpal tunnel syndrom about an year ago. I had weeks of constant burning, tingling on the bottom of my wrist which was at one point unberable and forcing me to stop working or put my hand in a bowl of cold water just to make it feel a bit better.

    First thing, I stopped supporting my wrist on the edge of the desk, that's REALLY bad and many do that (my brother also does it despite me constantly nagging him about it). Instead I dumped my old CRT and got a TFT, which allowed m

  • From TFA (Score:3, Funny)

    by suv4x4 (956391) on Wednesday April 26 2006, @09:12AM (#15204366)
    From TFA: "Shift your gaze from the computer screen to the distance. And don't forget to blink!"

    Even more important: don't forget to breath! It sounds ridiculous but I caught myself repeatedly forgetting to breath while working on a computer...
  • and I've had it many years, even before I owned a computer. I've been to many physiotherapists, doctors and specialists and the one thing I've learned and been reminded of over and over again is the importance of good posture. The way you sit and stand can and will affect the entire body. Sit up straight, keep the shoulder blades back and the chin tucked in. Don't slouch, and if you're a hangdog like me (head slumps foward as if trying to see the computer monitor better) you'd better stop and correct yourself.

    RSI's are real and frequent and can be very traumatic. Please don't let it happen to you!
  • How can you be an editor of anything and still not know the difference between "to" and "too?"

    I'm serious.
  • Didn't think hard work would hurt anybody right?
    I think that really depends on your job, like soldier or dentist or untrained physiotherapist...

  • If your job requires the constant use of screwdrivers, you know how bad this can be on your wrists. The ergo-style handles might improve your grip, but they don't address the problems of bad wrist geometry and body position that are endemic to their use. But the problem isn't really the handle, it's the length of the shank..

    Go to the tool store, and buy a few of the 'jobber length' screwdrivers - for starters, a #1 & #2 phillips will be fine; they are most commonly used. These drivers have shanks that

  • Weird thing happened to my shoulder recently. I went away for a couple of days skydiving. When I got back, my shoulder was killing me. I saw the doctor, and he sent me for physio which didn't help. Then I went away for another two weeks of driving and skydiving, but my shoulder was fine about 3 days into the trip. Even at the end of the trip it was still fine.

    I got home from the trip and starting processing photos and video, and within 4 hours my shoulder was absolutely killing me.

    I eventually realised that

  • Are some people just immune to this? (Score:3, Interesting)

    by pclminion (145572) on Wednesday April 26 2006, @10:55AM (#15205199)
    Like pretty much everyone here, I spend 8 hours a day on a keyboard. On particularly productive days, I probably hit the keys over 100,000 times. But I've never showed any symptoms of carpal tunnel, or even soreness in my hands, forearms or fingers. I don't take any specific ergonomic precautions other than taking a break when I feel tired.

    Am I heading for disaster, or am I anatomically resistant to the problem?

  • Simple Stretch == No RSI (Score:4, Informative)

    by RonBurk (543988) on Wednesday April 26 2006, @11:14AM (#15205385) Homepage Journal
    I used to get the forearm/wrist pains when I played too much Civ or (more rarely) had too many long coding sessions. While leafing through a book on the science of stretching, I came across this comment that the authors had never failed to remedy RSI in the arms quickly with a particular stretch. Tried it. Works for me. I'm damn lazy, so I don't do the stretch until the pain starts to come. Knocks it down pretty quick.

    You basically hold your hands up in front of you, palms facing you. Then make a tight fist, and rotate each fist to the outside as far as it will go. Fists will tend to pull downward, which is fine. (Looking from above, the right fist rotates counter clockwise while the left first rotates clockwise.) Hold the stretch for about 10-15 seconds. For me, this has been the absolute cheapest, simplest, and laziest way to deal with RSI from typing.

    • Excuse me? You're thinking of claiming WC because you choose to sit with your elbow flattened on a hard surface. No self-responsibility there I suppose, because your boss forces that position on you. If your post was humor, give a clue, else wise get one.

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