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Is Carpal Tunnel Syndrome A Hoax? 377

Posted by timothy
from the mysterious-ache-in-the-wrists dept.
ZaMoose writes: "It seems as if all of the hoopla re: repetitive stress injury (RSI) in the high-tech sector might just be group hysteria. Canadian officials are quoted in the following article as saying that many RSI cases have mysteriously 'gone away.'" Hard to deny that extended typing sessions can have painful after-effects, but at issue here is how serious (and permanent) those effects can be. I know plenty of painful typists complete with wrist guards and wincing who probably won't agree that their symptoms aren't genuine.
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Is Carpal Tunnel Syndrome A Hoax?

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  • by Anonymous Coward
    Back in the old days, before keyboards, etc, the most frequent victims of carpal tunnel were miners, eg coal miners. The repetitive motion of flexing the wrist to swing a pick would damage the nerves in the carpal tunnel. So, you have a tough coal miner, back in 1830 or so, with no workers' comp, no health insurance, no disability coverage, twelve kids to feed, etc, and he stops working because of carpal tunnel, and that's a hoax?

    I had a start of carpal tunnel about five years ago from working way too hard and relaxing only by playing a musical instrument that also contributed to the problem. I've slowed down, and the problems have cleared up. But it was real.

    OTOH, this slashdot story is a hoax.

  • Only in one format: the $99 combination wireless keyboard and wireless mouse. I have it. It rox.
  • Hmm. I thought that was a little weird myself. If you somehow interface those prostetics/cybernetics to the nervous system well enough to type like he did, why not stick a USB port or a little wireless transmitter in your hand and skip the finger-splitting step altogether. Those fingers have to be murder to maintain, a simple direct connection seems faster and more efficent.

    Then again, it did look cool.

    Down that path lies madness. On the other hand, the road to hell is paved with melting snowballs.
  • It was very prevalent in the 80's but since people became aware of it and took precautions you might say it never existed unless you lived in the 80's and saw it in person. Not many slashdotters probably remember the 80's.
  • by Jason Earl (1894) on Monday June 11, 2001 @11:33AM (#159807) Homepage Journal

    Even more interesting is the fact that both JWZ and RMS are (or were) both huge Emacs hackers (ever hear of Lucid Emacs).

    Now, I am a huge Emacs fan, but I have seen way too many Emacs users with serious RSI problems to think that this isn't more than coincidental. So next time you need to hit some obscure key chord to get emacs to do something cool remember to take it easy, and don't put your fingers in an uncomfortable position.

  • I've never met anyone who had RSI of any sort who wasn't under a whole lot of stress. I suspect that people who type a lot are more likely to manifest their stress as CTS than people who don't do much with their hands. Media exposure probably also increases the chance, as the article suggests.

    Whether the physical damage is real or not is questionable. Stress could either be manifested as pain or as susceptability to damage, and it could vary among people.

    All in all, I think RSI is better for you than heart disease or chronic fatigue or whatever people will get when they stop getting RSI.
  • Agreed. I used to do a lot of typing back many years ago on the Digital Equipment LK201 keyboard.

    This was the standard keyboard that came with VT340 terminals, DECstations, etc. Wow was it ever a bad keyboard, very mushy plus you had to press hard to register keys. So a days worth of typing was a lot of work.

    My wrists were incredibly screwed up after about two years of that. About that time I got a new machine, switched keyboards, started doing wrist excercises, etc.

    Now my pains have gone away.

    Actually if I recall DEC was sued over that keyboard, but convinced the judge that the pains were imaginary. ;)
  • If you have problems with your wrists, I highly recommend the IBM "clickity" Model M keyboard which shipped with AT and PS/2 systems, if only because it can be found fairly easily at flea markets and thrift stores or ebay for only a couple bucks. To minimize mouse usage, I'm currently using a "TrackPoint II" model, which is standard Model M with the thinkpad nipple on it. Also, learn as many keyboard shortcuts as possible to keep your wrists in the same location.

    It was after using such a keyboard for two weeks that I first began to experience symptoms of CTS. I love 'em too, but I can't use them.

    --

  • by Amphigory (2375) on Monday June 11, 2001 @01:05PM (#159811) Homepage
    No, it's not the keyboard. The misbegotten microsoft keyboard doesn't work any better than any other keyboard (so far as I can tell.)

    It's the posture. The problem comes in when you have a hyper-extension of the wrist, which can be caused by a lot of different things. One especially common one is a seat that's too low. Another is people who slouch before their keyboards, placing their palms and wrists *below* the level of the enter key. Ever see a piano teacher? The wrists must be held straight.

    The keyboard and mouse wrist rests *work* -- not because they pad the joint, but because they make it impossible to hyperextend your wrist.

    --

  • Others have already noted the biases of the interviewee and publisher, but what I want to point out is the disingenuous use of CTS.

    Dr. Shorter is quite correct to note that "most [RSI sufferers] didn't have carpal tunnel syndrome", but a right bastard to then claim "hysteria" as the culprit.

    I do not know Dr. Shorter, but I do know this - most RSI sufferers do not suffer from CTS, but plain old tendonitis or neuritis. Those of you complaining about elbow, shoulder, and wrist pain in the right arm due to mousing are probably (I am not a physician, this is not a medical opinion) suffering from ulnar neuritis (an inflamation of the sheath containing the ulnar nerve - this is the nerve that runs along the outside of your arm, terminating in the ring finger and pinky). This has nothing to do with CTS, other than also being a repetitive strain injury.

    I do agree with the doctor that CTS as an injury is far less common than is commonly believed, and that most people who think they have CTS probably have something else. I don't belive they are hysterical.

    And I think the recent moves against OSHA standards for preventing RSI are driven more by the meatpacking industry wishing to continue to do business as usual (working low-wage meat cutters until they're crippled, then discarding them) than by the white-collar sector, but that's a different rant entirely.

    -Isaac

  • by sphealey (2855) on Monday June 11, 2001 @11:45AM (#159816)
    Yeah, that's what one of my former coworkers, a native of Lithuania, thought too. This guy had survived the Red Army and was (is) one of the hardest workers I have ever met in my life.

    Then one day, after two weeks of 16 hour/day hacking, his wrists froze up and his wife found him lying on the floor screaming in pain.

    Good thing he had that other American excess, health insurance. 6 months of surgery and physical therapy and he can pretty much work 4-5 hours a day now.

    It's a strange kind of malingering that strikes the people who are driven to work the most, hardest.

    sPh
  • Hmm - - BS...

    I had an employee who had suffered from Carpal tunnel syndrome before he was an employee of mine. Sorta funny that he had to have surgery to get some relief??????

    I think someone in Canada has been having more than an extra brewski....
  • by Uruk (4907) on Monday June 11, 2001 @10:30AM (#159820)
    It seems they've proved that malingering is possible. I guess that means that the disease doesn't exist.

  • by rho (6063)
    I use a wristwrest and try to keep my wrists/arms/hands at happy 90 degree angles like in those oh-so-nifty ergo diagrams,

    The wristwrest may be helping to cause some of your problems. The best typing position for your hands is not with your wrists resting on anything, but suspended over the keyboard.

    The same goes for mousing around -- no wrist rest for that either. My RSI problems come more from the mouse than the keyboard, which is why I switched to the Kensington TurboMouse trackballs.

  • I've thought the same thing. I will never trade my IBM Keyboard of Might for some wussie ergonomic POS. I've been hacking for upwards of 12 years, and I haven't had any major problems.

    But on the other hand, I really don't type for long stretches. I'll write a function or two, then I'll compile, then I'll test. If it breaks, I'll have to sift through the debugging information. Then maybe I'll type another line or two to try to fix it. Not a whole lot of continuous typing is going on.

    Basically, I would expect that this whole problem would be much more pronounced among typists, secretaries, admins, etc. who actually type for hours without stopping.
  • by gelfling (6534) on Monday June 11, 2001 @10:41AM (#159824) Homepage Journal
    Take the source for what it's worth. Isn't the newspaper source a decidedly conservative press with an axe to grind against the injured, as well as every other group it sees as a threat?

    After all in this country, the US, we have an adminstration that makes pronouncements on the safe level of arsenic in the water not based on safety but on the cost to do it. And it threw out the Americans with Disabilities Act as it applies to municipal facilities solely on the cost to implement? So maybe it's the same thing here - politicized science that lobbyists trot out as truth?

    Next thing you know they'll dicount mental illness because it's only in your mind.
  • by sacherjj (7595) on Monday June 11, 2001 @10:35AM (#159827) Homepage
    ...is that the computer programming boom has fallen somewhat, so those who have only heard of HTML can no longer get work, so less people are doing less work at the computer causing less RSI?

    Eeh? (Thrown in for the Canadians.)
  • I would like to say that RSI is definitely real, and that it definitely can be made better with heat treatments, better ergonomics, etc. Switching to an ergonomic keyboard has done wonders for my hands, but they still hurt every now and then. Hand massages seem to help, too.
  • by PD (9577) <slashdotlinux@pdrap.org> on Monday June 11, 2001 @12:36PM (#159831) Homepage Journal
    Consider the facts:

    1) People tend to get them at the same time. This is probably because of some kind of "mass hysteria".
    2) All of the people striken with colds have had their colds "go away".

    If carpal tunnel is a hoax, then so is the common cold.
  • So if the folks afflicted with carpel tunnel syndrome didn't get it from using their PCs at work, how did they get it? I suppose they got that numbness from the vibrations transmitted through the steering column on their way to and from work. Yah, that's it. Blame on poor roads and not the crappy furniture that corporations buy that (after how many years of people using PCs at work?) doesn't allow computer users to sit with a comfortable posture.

    If these injuries are declining, one's gotta wonder if they've been disappearing since the use of trackballs became more widespread? I've been using one at home for several years and it seemed to help a great deal. (I still have to use a mouse at work on some systems and heavy use still is a problem.) The good thing about many RSIs, however, is that they do get better. My finger joints seemed to recover when I was on vacation and the most strenuous thing I did with my fingers was trip the shutter on my camera.

    All in all, though, something about this report smells bad. As Deep Throat said: ``Follow the money.'' The article didn't mention just who funded the UofT study and I doubt the regents/board paid for it out of the goodness of their hearts. I know of too many people who have wrist, finger, and back problems that cannot be blamed on anything else but their heavy use of computers at work. Far too many people to attribute it to ``hysteria''. (What an insult that one was.) Companies that employ large numbers of computer users would certainly have an interest in seeing RSIs labeled as mass hysteria. American corporations were quite successful in killing off legislation that would have made workplaces more ergonomic. How many policies were cancelled in the past few months that would have benefitted either people or the environment because it was too expensive for corporations? (My eyes fill with tears just thinking about the horrendous expenses corporations would have to bear -- sniff) Surely some major insurance companies could've banded together to fund this study; they'd just love to claim that RSIs don't exist so they could avoid paying the medical bills of corporate employees.
    --

  • While I agree with you that psychosomatic illnesses are just as real as physiological illnesses in that the suffering is no less acute, the notion the repetetive strain injuries are psychosomatic is, to put it bluntly, a crock of shit. I know several people who are suffering from this and, indeed, suffered a little from it myself before taking longer keyboard breaks and mixing up my duties enough to take myself away from the computer every so often.

    Repetetive strain injuries are real and, if not taken seriously and treated properly, can become absolutely debilitating. Imagine not being able to grip a tennis ball or hold a pencil. I've seen people in that bad of shape, with swollen writsts, etc. and it was not in their heads. In one case I know for a fact that his physician agreed, pointedly ordering him away from the keyboard for several months.

    This article (while not as extreme as the slashdot headline leads one to believe, nevertheless) reminds me of the idiots who were telling Gulf War who were dying from Mustard Gas exposure in Iraq (the ingredients of which were sold to the Iraqis by US companies, with US government approval, from 1985-1989) that their symptoms (passing blood, exhaustion, etc.) were psychosomatic, a result of stress.

    It makes me seriously wonder if the author isn't a shill for insurance companies wanting to get out of covering the medical bills of tens of thousands of programmers now entering their thirties and beginning to reap the physical consiquences of those 80 hour weeks of repetetive typing. It certainly would not be the first time in our (very recent) history something like this has happened.
  • And, as anywone familiar with repetetive stress injuries knows, if you treat it early on (and one aspect of treatment is to STOP THE REPETETIVE ACTIONS CAUSING THE INJURY) yes, the injury will heal itself. But, if it is not treated early, the injury can become very permanent. This should not be a surprise, many physical injuries share similar traits (treat it early and it heals, ignore it and the damage worsens, ultimately becoming irreversable(.
  • [Business] Posted by CptBurrito on Monday, June 11, @04:20PM
    from the mysterious-stories-from-ether dept.


    TheSource writes: "It seems as if all of the hoopla re: economic forces in the background at Slashdot might not just be group hysteria. Andover.Net officials are quoted in the following article as saying that many Slashdot story sources have mysteriously 'gone away.'" Hard to deny that stories of dubious origin can have painful after-effects, but at issue here is how serious (and permanent) those effects can be. I know plenty of sickened readers complete with stomach pains and wincing who probably won't agree that their symptoms aren't genuine.

    ( Read More... | 28 of 115 comments )

  • BTW: If you have tendonitis, a lot of doctors will tell you to take Advil (or a generic version of it). That's because Advil is an anti-inflamitory drug that actually reduces the swelling in your wrist. Since the swolen tendons is what is causign all the friction (which causes more pain and more swelling), reducing it is a Good Thing. Other pain killers will 1: not reduce the swelling, and 2: ease the pain, allowing you to cheerfully type away and hurt yourself more.

    Umm, aspirin has similar anti-inflammatory properties to ibuprofen (Advil). I believe that the painkiller in Aleve is also an anti-inflammatory.

    Acetominaphine (Tylenol) is not a good anti-inflammatory, but it used for most pain relievers because of its perceived safety. I say perceived because acetominaphine does not have any warning signs (like aspirin's ringing in the ears) before fatal overdose, and a fatal overdose will flat out kill your liver. A dead liver is a recipe for a nasty, unpleasant death.

    As for RSI being 'all in your head', I'm willing to believe it, though the article presents insufficient evidence. IMNSHO, that in no way diminishes the seriousness of the disease, or makes the pain less 'real' (since pain is a perception). It just suggests a different method of treatment. We, here in America have a strange disdain of suffering caused by some non-physical source.

  • No, it's not the keyboard. The misbegotten microsoft keyboard doesn't work any better than any other keyboard (so far as I can tell.)

    I'd argue that that the keyboard makes a huge difference, athough I'd agree that the Microsoft ergo doesn't help the real problem one bit.

    I find that if I'm typing on the average "smooshy" feeling keyboard that's almost universal now days for even a couple hours, I start to feel wrist tension. However, I can use a keyboard with positive key action almost indefinately without special pads or keyboard trays or unnatural postures.

    If you have problems with your wrists, I highly recommend the IBM "clickity" Model M keyboard which shipped with AT and PS/2 systems, if only because it can be found fairly easily at flea markets and thrift stores or ebay for only a couple bucks. To minimize mouse usage, I'm currently using a "TrackPoint II" model, which is standard Model M with the thinkpad nipple on it. Also, learn as many keyboard shortcuts as possible to keep your wrists in the same location.
    --
  • It's probably worth noting that RSI's are not confined to "tech" industries either. My wife's father had surgery to both his wrists for carpal tunnel somewhere over a decade ago. His job? Stocker at a grocery store. I don't think he would have put himself through the pain of that surgery for a "hoax" either.
  • As someone who suffers from RSI, i can definately tell you that you are selling yourself short with Aspirin. Ibuprophin is a much better choice. Not only does it relieve pain, but it also reduces swelling, a major helper for carpel tunnel pain. As always consult a doctor, but i take 600mg twice a day, and you can take 600mg up to every 4 hours i believe without ill effects.


    Tis better to be silent and thought a fool, than to open
  • by DHartung (13689) on Monday June 11, 2001 @11:47AM (#159841) Homepage
    Carpal tunnel syndrome isn't a disease of the rich. In fact, it took some time before it was connected with keyboard use. The first instances of diagnosis were of manual laborers, especially farm workers and most particularly slaughterhouse employees. In the US, meat processing is pretty industrialized, and it takes mass numbers of minimum-wage employees chopping away at carcasses to produce the cuts of meat we enjoy in our supermarkets. The production increases have led to people banging a cleaver through meat against a cutting board five times a minute, for eight hours a day.

    Now, granted, Lithuania may have problems just getting enough jobs for people, or building democracy, but don't imagine it's a class thing or limited to developed countries.

    The cynic in me will agree that RSI did not become a "big" problem that people in the US cared about, until higher-paid office workers began to be diagnosed.
    ----
    lake effect [lakefx.nu] weblog
  • by doom (14564) <doom@kzsu.stanford.edu> on Monday June 11, 2001 @03:13PM (#159842) Homepage Journal
    Now, I am a huge Emacs fan, but I have seen way too many Emacs users with serious RSI problems to think that this isn't more than coincidental. So next time you need to hit some obscure key chord to get emacs to do something cool remember to take it easy, and don't put your fingers in an uncomfortable position.
    I'm of the opinion that Emacs plus really lousy keyboards is what does you in (like, what moron decided that control below shift was a good idea?).

    I'm a fan of the Kinesis contoured models, which put all the heavy use keys under your thumbs (Ctrl, Alt, Enter, Space, BS, Delete). Also all keys are programmable, so you can fix any quirk about it that you don't like (e.g. the Caps Lock next to the A can be made to do something useful).

    The Maltrox (sp?) looks interesting too. Possibly better, though more expensive (and the Kinesis ain't cheap to begin with).

    By the way, I've been a heavy keyboard user for decades now, and I didn't feel any ill effects for the first 10 years or so of typing. So you slash kiddies who're feeling smug because your fingers are never sore, remember that you're just getting started...

  • Computer Users Not at Higher Risk of Carpal Tunnel [yahoo.com]

    "'We had expected to find a much higher incidence of carpal tunnel syndrome in the heavy computer users in our study because it is a commonly held belief that computer use causes carpal tunnel syndrome,' said J. Clarke Stevens, a neurologist at the prestigious clinic.... 'The findings are contrary to popular thought but nobody has studied the problem carefully,' Stevens said. 'I'd like computer users to know that prolonged use of a computer does not seem to lead to carpal tunnel.' ... Because the syndrome is a common condition in the population -- one in 10 will develop symptoms -- some computer users will develop it, Stevens said."

    (Edward Shorter -- upon whom another poster cast aspersions, perhaps rightly, perhaps not -- is not mentioned in this story. Stevens, quoted above, is the researcher mentioned in the National Post article.)
  • I suffered from RSI for a while, mainly in my right wrist (not being a touch typist, my typing "style" uses my right hand more than my left). It got so bad at one point, I couldn't hold my mouse. A wrist brace, heat treatments and anti-inflamatories helped, but six years later I still get a twinge when I've been typing too much.

    I think the article contains its own answer to the question it raised: RSI has significantly declined in computer-related injuries mainly because of heightened awareness of ergonomics. I know in my own case, I can go a lot longer because my desk is the right height, my keyboard is at a comfortable height and angle, I chair is more comfortable and holds me at a better posture....

    This whole debate reminds me of Y2K. Everyone perceived it as a huge fiasco in the making (which it was, in 1998), and dumped $millions into fixes, redesigns and contingency plans. Then, when the actual fallout was insignificant, rather than congratulating IT for averting a disaster, people asked "So what was the fuss all about? Why did we spend so much preparing for nothing?" Guess what, folks, if you didn't spend so much, it (probably) wouldn't have been "nothing".

    So in response to a medical condition, let's increase awareness and knowledge about ergonomics, develop solutions, roll it out industry-wide, and perform audits check and maintain compliance. Then, when the condition declines, let's label the whole thing "hysteria".

    Brilliant.

  • I ocasionly get numbness in my hands... usually it happens after I sleep on them for a few hours, but I'm sure it's because of the typing that I do.

    I've been typing for nearly 15 years and I think my carps are suffering for that. However, there are a few things that __I__ accept as my personal responsability:

    1. I chose this lifestyle. I may not have fully understood the risks, but that's my own fault.
    2. It is not the fault of my employer (past, present, or future) for my career choices - if I were working in a factory, I'd wear safety shoes.
    3. While I feel that my carps _are_ squished (which is what cts is), I don't seem to suffer pain from them.

    Carporal(sp) Tunnels, btw, are nerve bundles that run up the arm to the hand. They are divided into two sections - half for your thumb and index finger side and half for the other side. These nerve bundels exist in a tunnel - the carporal(sp) tunnels. The positions that a lot of people take when typing - putting excess weight or pressure on the wrists - can cause the tunnels to collapse. When this happens, nerve signals are interruped from that section of the hand - causeing numbness in part (or whole) of the hand.

    I do not believe it is a "made-up" illness - that some /. users seem to think - rather that it is a valid personal injury that can occur. However, it is my opinion that you are responsable for ensuring that you are taking care of your own body. This may mean that you have to be responsable for your own RSI injuries. If you employer won't let you take a break from typing, go work elsewhere. I'm sure they will reconsider if they realize they will lose your skills.

    That is all.
    ---
    Computer Science: solving today's problems tomorrow.
  • ... because of the danger of RSI, people in general are being a bit more careful, which has led to fewer problems.

    As for myself, I never had Carpal Tunnel Syndrome, but I have developed nasty cases of tendonitis during long coding sessions. However, I've found that if I arrange my workspace in such a way that both of my elbows are resting on the desk when I type, I almost never have any problems.

    Just because I've found a way to minimize chances for reducing future re-occurrances of my tendonitis doesn't mean I didn't have a real problem in the past...

    --

  • I am not just a programmer, but a writer and guitarist,

    Interesting... I have always credited the fact that my wrists have always felt fine with the fact that I am also a guitarist. I play a steel string acoustic in a loose fingerpicking style; to those who aren't guitarists, this translates to stiff strings that are manipulated individually with seperate fingers (no pick, no strumming... well, not what most non-guiatrists would term strumming).

    I have my guitar hanging on the side of the rack holding all my workstation (and development server, MP3 server and A/V equipment). Every couple of hours, I click over to my songbook (maintained as a PDF from chordpro files), and play a few songs. You can generally tell how my coding is going by what I play.

    I've always felt that the alternate hand positions (curled right wrist, tilted left wrist) and complex finger manipulations tends to balance out my typing position. I know that without a guitar, I can feel it when I've been typing all day (actually, heavy all-day mousing seems to hit my wrist harder. Perl can work in NT too, remember... that saved my wrists in the past).

    Okay... the above has rambled damn well enough. I just slept through the afternoon, and it sure shows.

    --
    Evan

  • So is group hysteria, and Carpal Tunnel is probably the *least* common RSI.
    If we had everyone actually coming down with carpal tunnel syndrome, then we'd have a lot of *extremely* unhappy people. The surger is harsh, I believe they do both wrists at once, and you lose the use of your hands during recovery, so you can't even wipe your own ass.

    Ergonomics are as important as ever; I've had debilitating wrist pains from typing before. Granted, I never blamed them on my employer, or carpal tunnel syndrome. I blame myself, for a) not exercising enough and b) not bothering to watch my posture.

  • by dutky (20510) on Monday June 11, 2001 @10:52AM (#159854) Homepage Journal
    I am certain that the pain in my right arm is no hoax or mass delusion, but it doesn't seem to be nearly as debilitating as I have heard other people claim their injuries to be. It also doesn't seem to be due to typing, so much as to use of a mouse or other pointing device in the wrong position.

    In the three years that I have been suffering from this pain (usually just a slight twinge in my wrist and the palm of my hand, but occasionally reaching up to my elbow or even to my shoulder) I have not had to undergo surgery, wear a brace, or even take any kind of pain killer or anti-inflamatory drug. What I have done is obtain a host of assistive ergonomic devices (wrist support pads for keyabord and mouse, and assorted 'ergonomic' keyboards and trackballs) and pay extra attention to the position of my arms and body while I'm working at the computer.

    I've spent several hundred dollars on these accomodations (all of it my own money) and I've been able to reduce the pain from the arm numbing agony I was experiencing in 1999 to slight twinges in the hand and wrist. There may be folks for whom CT, and other RSI's, are real debilitating disorders, but not for me.

    That said, I wouldn't be suprised to find lots of folk exagerating the seriousness of their problems in order to get some concession out of employers in tight labor markets. Similarly, I wouldn't be suprised to find that, with the loosening of the labor market, there has also been a reduction in CT/RSI claims: the sqeaky wheel quiets down when there's less grease to be had, if it knows what's good for it.

  • Yeah, I get that symptom too. I get it when I rest the corner of my elbows on the edge of the table and cut off my ulnar nerve. It's a freaky feeling, non?
  • Ever want to know what carpal tunnel feels like?

    1. Locate a friend and an 8 pound sledge hammer
    2. Place your wrist on an anvil (train tracks work nicely too).
    3. Have your friend bring the sledge hammer up over his head, and swing downwards allowing your wrist to stop the motion of the hammer before it hits the anvil.

    Over the next few days/months, you will experience the exact same feeling that people with carpal tunnel experience. Fun isn't it?
  • Certainly there is some selection bias here; people who are fanatic about an editor are likely to be the people who spend a lot of time typing at editors. Somebody who spends two hours a week typing probably won't care too much if you give them anything nicer than notepad.exe.

    But yeah, emacs people seem to get hit a lot. What's more, in a group of emacs people I know, the RSI diagnosis of choice turned out to be ulnar nerve compression---and we all got the diagnosis before we found out the details of the other people. "Ulnar nerve compression---that's funny, that's what my doctor was thinking...."

  • I just switched the mouse to the LEFT side and I've never had problems since. I was overusing my right arm.

    It took about a week of cursing, but pretty soon everything worked out.

    It's quite fascinating how the body learns and how it can adapt. At first my movements were like watching a 5-year-old play a video game - lots of concentration and emotion, but a pretty low score. Little by little my fine motor skills developed and the mouse cursor ended up where it was supposed to. Now I'm pretty much ambidextrous mouse-wise.

    Another side effect is in FPS games, I use a left-handed mouse, and my right hand uses the cursor keys for movement. This is a little more intuitive for me.
  • You take it with food. Food first; buffered analgesic afterwards. That way it doesn't attack the stomach lining so quick. Best to avoid coffee with it too.

    Simon
  • I've been using computers for almost 20 years, I type horribly, have horrendous posture, etc. Up until recently I've never suffered from RSI at all. However, I'm 29 and I've felt the effects on several occasions in the past few months.

    I have every reason to believe it is a combination of things, including stress which causes it. When people are stressed they tend to stiffen up their muscles, they tend not to relax them and I think this creates the environment for the problem to show up.

    There is also the possibility it may in some cases be caused by another ilness, something similar to the flu and which simply agitates the system causing what would otherwise be ignored and quickly go away to get worse.

    I had to quit playing Black & White because of it. I bet I could start playing it a few days from now (currently dehydrated a bit from a recent flu) and it wouldn't bother me much, if at all.

    When I start feeling any symptoms I tend to change my posture, I change how I do tasks and, I event went so far as to remove my wristwatch. I happen to wear my watch on my right wrist, and I the same hand for the mouse. Sometimes this causes problems; and the watch restricts my movement.

    Decent keyboards, realistic posture, and less stress (I expect I'll have the same job tomorrow I have today.. unlike 5 years ago... etc) are probably the main reason it has disapeared.

  • by hey! (33014) on Monday June 11, 2001 @11:54AM (#159872) Homepage Journal
    but it got better. It must have been a hysterical illusion, along with the 220lb linebacker who hit me.

    Doctors trained with a bias towards intervention tend underestimate the body's capability to heal. I read recently of a meta-analysis study that indicated this is behind the infamous "placebo effect" -- things just get better on their own. This makes total sense to me. Medically trained researchers so underestimate the body's own healing powers that they'd sooner attribute spontaneous recovery to an almost mystical force called the "placebo effect" than thinking of including simple rest and waiting as an experimental group.

    In this case, the researcher is invoking "hysteria" in a similar vein. If somebody's keyboard induced RSI gets better, it must be some kind of insidious psychological phenomenon causing the person to report a non-existent condition. <sacrasm>That's certainly a more reasonable explanation than assuming the patient just got better without some kind of heroic action on the part of the doctor.</sarcasm>

    One of the worst parenting experiences I've ever had was when my daughter's pediatrician wanted to perform an invasive test for a certain condition. I asked him (a) what the prevelance of the condition was in the population; (b) how the symptoms he saw affected this baseline probability and (c) what the statistical properties of the test were (false negatives and positives). He couldn't answer any of this. It was a hunch. I went along, against my instincts, because he browbeat me into it, even though he could not justify the test on objective grounds nor did he have the statistical information necessary to interpret the test (which in the event was negative as I expected).

    The point of this story is that MDs (among which I have several personal friends) practice an art rather than a science. They have to go on what the prevailing standards of practice are and their own instincts much of the time, since they lack the scientific data to make an objective judgement (and in some cases lack the mathematical sophistication, which is somewhat less forgiveable).

    The less than scientific nature of medical practice is what is responsible for fads in diagnosis, not defective personalities in the patients.

  • When I was at school (say about 17) I spent every break in the computer lab, and thought I was enjoying myself, but I wasn't really stretching myself - I was more in the habit of going and tinkering than actually getting on and doing something fun.

    About this time I started getting pain in the back of my hands down over my fingers. I found it hard to hold a pen or type. It was painful, it was real. It wasn't happening 100% of the time - it came and went, but bouts could last all day.

    Then one day, when my hands had been fine all morning, I went to the computer lab for break. At the exact instant I passed through the door of the lab, pain shot down the back of both hands. I stopped, stunned, looked down at my hands and said "You b*st*rds". For the pain to have happened at that point it could only be stress. The pain went and didn't come back until years later - at which point I realised I was stressed out and (while not typing less) took steps to organise myself and remove stress - hey presto the pain went away.

    So it is painful. It is real. It can be crippling. And I am prepared to believe that for many people it's not psychological. But for me - and I'm sure many others - it is.

    Peter.

    (Now 29, very busy Software Engineer, RSI-free).
  • I'd like to see Dr. Shorter tell my wife that the pain is all in her head.

    No, no, she's imagining that it's in her hands, not her head.

    You'd have to surgically remove her hands from his throat.

    Nope, won't help. Phantom Limb Syndrom (or Phantom Limb Phantom Pain Syndrom, in this case) would be a problem.

    On the other hand, what struck me[...]

    So, one hand is in pain, and she's hitting you with the other one?! Time for some serious mariage consuling, here.

    The term is used as shorthand

    Well, if she's already deformed, I guess she was prone to such injury. Hardly a valid sample demographic....

    ;-)

    --
    Aaron Sherman (ajs@ajs.com)
  • It's not that global warming doesn't exist, it's that it isn't a big problem, and that it *is* relative.

    A letter to the editor in the Globe&Mail today brought up my favourite point - the Vikings were farming Greenland successfully in the Middle Ages. It obviously was a lot warmer then than it is now, and that is well before the industrial revolution.

    Nevermind the dinosaurs who roamed Northern Alberta back when the climate was hot and humid.

    I fucking hate environmentalists who don't research things in any more depth than is presented in the Greenpeace pamphlets. (Yes, if it gets warmer, diebacks will occur. In a word, deal.)

    --

  • BTW go read the transcripts of the deposition. When the lawyers for what's her face asked Bill weather or not he had sex with monica there was a long discussion about what they meant by sex. The republicans had drafted this lengthy document about what constituted sex and what didn't and like morons they did not include oral sex as sex. So Bill said he did not have sex with her as was defined in the document and therefore it was not a lie.

    Really I am not kidding go read the transcripts it's very funny the had a chance to crucify him and blew it.

    Also The Bush aldmnistration has laready told more lies and flipped on more issued then Bill did.
    Korea, palestine, global warming, cyanide, ABM, kosovo all those positions Dubya took in the election and right after taking office are now being reversed 180 degrees. He is a bigger waffler then his dad was.
  • Oh here are a few.
    Before the election.
    We will pull out our troops out of kosovo.

    Soon after the election.
    We will let the israelis and the palestenians settle their own disputes.
    We will not bail out Turkey
    We will back out of the Kyoto Treaties (global warming is not real).

    Guess what the troops are staying in kosovo for a long time, turkey got something like 3 billion dollars, the US is now actively trying to broker a treaty in the occupied lands, and Bush is going to Europe to see if he can save face with the kyoto treaty.

    Add to that the following whoppers.
    We did not apologize to china
    It's possible to drill for oil in alaska while preserving nature.
    We will vigorously defend the roadless initiative.

    Oh yea the arsenic thing was pretty funny too.

    I guess none of that is as important as "I did not sleep with monica lewinsky" to the republicans but then again they were obsessed with the size, shape and whereabouts of Bill Clintons cock. I saw Ann Coulter describing Bill Clintons cock on Fox news or MSNBC or one of those other republican media outlets one time and I just about died laughing. She was talking about the shape of his cock and how Paula Jones was going to "kiss it". It was oddly pornographic yet hilarious at the same time.
    I never understood why you guys became so obsessed with the whereabouts of Bill Clintons cock so much, I still don't.
  • so let me get this straight - injuries from silicone breast implants [junkscience.com] are real because people feel they have been hurt, but carpal tunnel syndrome isn't real because geeks feel they have been hurt??

  • I, like most others, use "improper form" when typing. From what I remember of my typing class from hell in 7th grade, "proper form" consisted of raising the wrists/forearms above the level of the keyboard, so that you fingers pushed down from above, rather than "stretching" to the keys.

    This does seem ideal, however, it is tiring - and we are all lazy here. It is tiring holding your arms up at that position. Building a wrist rest to that height wouldn't help matters any, because more pressure would be placed on the carpal region.

    What if, instead of that, the keyboard was angled more sharply at the rear, so that the "pushing" of the keys came back and the "stretching" to the keys was lessoned - a wrist rest could still be used, but the stretching would be minimized - maybe that would help more?

    Worldcom [worldcom.com] - Generation Duh!
  • > I have always had terrible posture when typing at my computer. Considering the way I sit, and the fact that my keyboard is not an ergonomic keyboard, the fact that I do not have RSI leads me to believe that a lot of the problem is somewhat hysterical. Every once in a while, after a long session of typing in a bad position, I will feel some pain. If I simply take a break for a few minutes, or adjust my position, I am fine.

    Ditto here.

    Most frequent problem: pain on the back of my right wrist caused by excessive mouse activity during marathon sessions (2-3 days of 6-12 hours) of real-time-strategy games, which require repetitive and accruate drag-and-drop operations.

    Most effective solution: Stop when it starts to hurt. Duh. I lay off the games for a week. Pain goes away within 24 hours.

    At the orkplace, my posture is atrocious - wrists resting on the desk in front of my non-ergo keyboard. Screen is dead-center at eye-level, 18 inches away from me. Seat is typically tilted backwards by about 5-10 degrees. Feet are resting on a footrest, as opposed to dangling in midair (OK, I do one thing right!). Elbows typically sit on chair arms. 8 hours a day, 10 years, no problems. Lighting? I'm a cave-dweller, yanking out fluorescents on sight. The 21" screen provides most of the light for my workspace. 1280x1024 and small fonts, woo-hoo! More stuff to read on each screenful of information. (OK, I do one other thing right - rather than reading screens in landscape mode, e.g. 80x24, I read in portrait, e.g. 80x80 strips. Eyes scan down the screen, not across. Feels like reading a book.)

    Conclusion: RSI and other ergo problems are real. They are also entirely preventable.

  • Argh, hit "submit" instead of "preview".

    What was important about my atrocious posture at work was that (for me), it's comfortable.

    If it ceases to be comfortable, I change it or rejig my workspace until it is comfortable.

    I'd also like to modify my conclusion somewhat. I'd originally written:
    > Conclusion: RSI and other ergo problems are real. They are also entirely preventable.

    I'd like to add one thing -- RSI is entirely preventable in my office.

    A few posts ago, someone made a comment to the effect that many RSI sufferers were just lookin' for a settlement. While I somewhat sympathize with the sentiment, I'd like to take issue with it.

    While I have no doubt that some RSI sufferers are (I'm using the stereotype for a reason, bear with me) lazy, good-fer-nuthin' civil-servant clerks or other data entry drones just lookin' for a fat disability check or settlement, I'd point out that it's precisely those low-skill, high-stress, Dilbertian-work-environment jobs where the workers are the least likely to be able to fix their ergonomic problems.

    At my office, I'll ask a few cubemates if they hate fluorescents. If enough of us in a given cube-grouping agree they suck, we come to a consensus about which bulbs we can yank without disturbing those who do like lots of light, and we yank the offending bulbs. Likewise, if there's glare from a nearby window making it hard to read the monitor, we block the window. Or we move the gear around the cube so the window's no longer a factor. Presto-changeo, no more eyestrain.

    Doing either of these things at a government workplace would probably be grounds for termination.

    I have a hunch that for RSI, it's the same deal. My posture sux0rz, but I feel more comfortable that way than The Right Way? My employer doesn't care. I get tired and want to walk away from the desk for a while? I will.

    If I worked for the government, I'd probably have the Ergo Police writing me up for violations and forcing me to configure my workspace in a way that would give me an RSI, and my manager writing me up for taking 10.5 minutes, rather than 4.2 minutes, whenever I take a dump.

    The next time you think most RSI complainants are BSing, consider the working environment of the typical RSI complainant.

    If the typical low-level gummint data entry drone is more likely (by virtue of being $STEREOTYPICAL) to exaggerate their symptoms, keep in mind that (by virtue of being supervised by equally-$STEREOTYPICAL managers!) they're also more likely to have the symptoms as a direct result of their employer's poor working environment.

  • > You can also change your diet; the modern Western diet is skewed towards promoting inflammation.

    Blaming the Western Diet for all that ails you sets off my quackometer ;-)

    > I've changed my diet, and my tendonitis has gone down considerably. Typing less would eliminate the problem, but hey...
    > > http://www.drweil.com/database/display/0,1412,72,0 0.html

    You mean this Dr. Andrew Weil [quackwatch.com], as featured on Quackwatch [quackwatch.com].

    Stephen Barret (operator of Quackwatch) on Weil in an interview [quackwatch.com] is particularly caustic:

    Barrett: His advice is an unsortable mixture of sense and nonsense. For example, he says in one of his books that bloodroot, a caustic herb which burns your skin, can kill skin-cancer cells without injuring the surrounding normal cells. That's absurd. It burns everything it touches. It can't tell the difference. On his Web site, which is owned by Time magazine, he has a questionnaire you fill out, and he'll tell you what ten vitamin and herbal products to take. And there's no foundation for such recommendations. Then you click on a link, mid you'll go to an online "store" to buy them. The "Ask Dr. Weil" Web site is brought to you by The Vitamin Shoppe, a company paying over a million dollars for the privilege of placing its link next to Weil's stupid advice.

    Color me skeptical.

    (I don't dispute that your symptoms went away after you changed your diet. I do dispute that this implies a causal relationship between your dietary change and your tendonitis relief.)

    Me? I had RSI in my right hand from wanking far too often. I tried my left hand, but it wasn't the same. So I got a g/f who'd give me head six times a day while I reconditioned the muscles in my right hand by repeatedly lifting 12-oz weights (usually Guinness, but sometimes Murphy's Stout), and the pain went away after a few weeks. Alcohol consumption and blowjobs are the obvious cure for RSI. (Just don't tell her I'm cured!)

  • He's NOT SAYING THE PAIN ISN'T REAL. So get off your high horses and read the damned article.

    He's saying that for some people, the pain, WHICH IS REAL, does not necessarily have an entirely physiological cause. Namely, nothing is wrong in the arm, but they still hurt because they've heard about RSI.

    Is it still debilitating? yes. Should they still be treated? yes. But the point is that the enormous media coverage itself may be causing the problem in many people.

    If so, it's important to discuss this as a possible problem, instead of blindly bashing the author.

    He's right when he says that pain perception is a very complicated issue and the brain has alot of control in what it perceives as pain.

    So can we stop flaming and start thinking for a second?

    -Brad
  • Don't underestimate the power of the mind. It's a well-documented fact that, for instance, people will report feeling hot more often and estimate the temperature in the room to be much higher if accompanied by someone complaining that "it's hot in here!"

    Pain is notoriously subjective, and while tendonitis is a real condition, many people who have heard of the problem and have an unhappy workplace might focus their feelings of dissatisfaction on their hands and wrists even if they don't have tendonitis. I know mine are twinging more as I write this because I'm thinking about it.

    So to say that sometimes disease sufferers are suffering from a psychosomatic rather than a physical condition does not suggest that the disease doesn't exist or that people who report problems are "faking it." Psychosomatic most emphatically does NOT suggest it's being faked (i.e. someone who is pain free is reporting pain to gain sympathy in a court trial) but that its origin is in the mind.

    Mass hysteria is a fascinating subject--witness the fainting spells that would communicate through suggestion in Vienna during Freud's time. Witness the waking dreams accredited to UFO abduction now versus demonic possession in the 1600s versus not at all in Japan. Suggestibility is also a fascinating subject: it is notoriously easy to suggest an alternate version of events to an eyewitness and get them to swear that something happened that didn't happen ("Now, did the man with the green sweater cross the street in front of or behind the car wreck?" when in fact there was no man in a green sweater).

    So someone who studies these phenomena is not, ipso facto, out to prove they don't exist.
  • by Ted V (67691) on Monday June 11, 2001 @10:41AM (#159912) Homepage
    In related news, the moon landing was a hoax, the holocaust never happened, and the American Indians are actually the long lost 12 tribes of Israel.

    People can call anything a hoax and drag up enough circumstancial "evidence" to "prove" their point. More often than not, it's a case of people not wanting to believe the truth, or creating controversy.

    -Ted
  • ... just simple observation.

    Stand up. Put your hands at your sides, so your palms are touching the outside of your thighs. (e.g. as if you were lining up for the drill sergeant.) Notice how your thumb points towards your front, and your pinky points toward your back. This is position #1.

    e.g.

    O (head)
    |
    | (hands resting along your sides, pointing down)
    |
    |
    |_


    Now keeping your elbow beside your body, raise your hands up 90 degrees so your arms form a L and your thumbs are pointing upwards. (Think of shaking someone's hand.) Now rotate your hands inwards so your thumbs are pointing towards each other. And finally, move your hands together so your thumbs are touching. This is position #2.

    Notice the "unnatural" angle your wrists are making in position #2, while the "natural" position of shaking someone's hand doesn't put your wrist in constrained positions.

    RSI is real. I have personally noticed symptons over the last few years. After typing all week, I would get a inflamation in my wrists while driving on the weekend. Hurts like hell, and nothing you can do makes it go away. Fortunately it would only as 30 mins.

    I switched over to M$ natural keyboard, since there is more space between the TGB and YHN keys versus the traditional keyboard. It is certainly not the best ergonomic keyboard, but I notice that if I go back to a normal keyboard, my wrists tend to get sore.

    Interestinly enough I haven't had any symptons of RSI since I started taking Aikido and doing the standard wrist stretches. e.g. Ikkajo, Nikajo, Sankojo, and Kote-gaeshi.

    Disclaimer: Consult a qualified doctor before doing any stretches, etc.

    Cheers
  • > , like writhing on the floor while a udansha gently twists your wrist to just short of the breaking point....

    You could just tap the mat earlier ;-)
  • but probably more complex than just "my keyboard made my wrists hurt" - I know I was typing for 15 years before my tendonitis kicked in and I had to wear a wrist brace for 5 years more. On the other hand I'm pretty sure that the thing that kicked off my pain was not typing - but having kids and all the lifting and bouncing etc involved .... getting a laptop seemed to be the thing that finally fixed it for me - maybe not just because of the less stressfull angle that I hold my wrists at but also because I use a traditional keyboard a bit as well which means I have lots of different ways to work
  • Tried several other trackballs but unfortunately they just didn't quite compare to the one signed with the mark of the beast hehe.

    Seriously though, Microsoft makes outstanding hardware. Maybe it's because I've used them for so long, bu Microsoft mouses (mice?) just *feel* right. When I have to use some custom mouse from Compaq or something, I really notice how crappy other people's designs are.

    I also got me one of them split-down-the-middle Microsoft keyboards (why can't I remember their name?) and DAMN it feels good to have the wrists in straight angles to the keys! There's also this [ypwong.org] cool little proggy that will let you assign any command you want to the round blue shortcut buttons along the top of the keyboard.

    (Even more OT: It seems to me that when Microsoft wants to extend a tentacle into a new market, the pretty much always know how to do it right. Evidence: hardware, the upcoming Windows Messenger in WinXP, the upcoming Xbox, web browsers, etc. The list goes on. Just thinkin' out loud...)


    ---
  • Often, real RSI sufferers are reluctant to seek the help that goes along with a government check. We love our machines too much. I for one, suffer through the aches, stiff joints, numbness, and keep a-typin.

    I've a very rapid typer. Quite fast, in fact. I've been typing since I was 9 years old, and around the age of 21, I started to feel sharp pains in the back of my shoulders, in my elbows, in my wrists, and sometimes even tingling in my finger tips.

    I assumed forever that this sensation was carple tunnel syndrom, and that it would only get worse in time. In fact, it did get worse for a very long time until one day I moved my computer desk and bought a new chair.

    Oddly enough, I didn't ever feel uncomfortable in my previous chair, and my new one never really felt any more or less comfortable. But the pains vanished none the less. I've been pain free now for about 5 years.

    And to think, I was actually considering surgery.


    "Everything you know is wrong. (And stupid.)"
  • by rkent (73434) <rkent@@@post...harvard...edu> on Monday June 11, 2001 @11:53AM (#159920)
    However, for every one true RSI sufferer, there're probably a dozen fakers who smell a big lawsuit/government check, and claim mysterious pains here and there.

    I think I agree about the "faking," but not for the causes you site. Not to dismiss the suffering of people who are genuinely afflicted, but I've noticed a strange pattern of RSI among friends of mine.

    It seems that many of them are conveniently stricken when they want to get out of the computing industry anyway, but can't seem to admit it to themselves. One guy I knew took an early retirement when he was diagnosed with RSI, and another friend was starting to question what he really wanted to do with his life when he "came down" with it. It's like they're subconciously looking for a way out without having a concrete plan of what they'd rather do, and this malaise gives them cause to quit. They do, and bam, symptoms go away. But of course they can't return to work because it would lead to a flare up of symptoms.

    I don't know. Again, I don't mean to dis anyone's particular situation. It's just kind of shady sometimes, from what I've seen.

    ---

  • 1) Repeated repetitive movements cause pain in both my wrists. I tend to avoid the activities that cause the pain, so I have avoided CTS to date.
    2) A friend of mine has this condition, and I am sorry, but seeing her struggle to pick up a fucking cup of coffee is no hoax.

  • That's not Advil, that's Tylenol. The massive liver damage is very specific to acetaminophen. The other drugs bother your liver *far* less; the real problem is that they decrease the secretion of protective mucus in your stomach and can lead to bleeding gastric ulcers (hint: bad).

    And as several other people pointed out, acetaminophen has no anti-inflammatory effect, only anti-pain, so you don't want to take it for RSI anyway.
  • by webword (82711) on Monday June 11, 2001 @10:39AM (#159927) Homepage
    Comment: Repetitive stress injuries are real. Even if they are a matter of "hysteria", the pain is real. If a person thinks they are in pain, then they are actually in pain. Pain is subjective. Perception is reality...

    Resource: The Facts About Repetitive Strain Injuries [webword.com]
  • by webword (82711) on Monday June 11, 2001 @10:48AM (#159928) Homepage
    Edward Shorter is the history of medicine chairman at the University of Toronto that is quoted in the article. Here is a page [ozemail.com.au] that seems like a review of his work on RSI. Mildly useful.

    From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era [pipex.com]

    The Kennedy Family and the Story of Mental Retardation [temple.edu]

    Bedside Manners [nyu.edu]

    So, the point of these links is this: This dude's whole career is based on bashing illness. He seems to think that almost any illness or disease is in the mind.

    The pain in your wrist, elbow, arm, and back is fake. Do you hear me? Fake! Just ask Edward...

  • #611: People on Slashdot assuming they are more intelligent on a particular topic than the "world's leading" authority. A person in this position does not state things at random, duh!
  • It's a well known fact that dealing with repetitively stupid questions on tech support leads to a near constant pain in the ass. In fact, I only have to read a story like this [usatoday.com] and my ass starts hurting in sympathy for all the tech support people who had to deal with questions relating to it.
  • How about if RSI has been an occupational hazard since the 19th century.

    Telegraph operators spent their working lives pounding out dots and dashes on a vertical up and down key. And many developed a condition that was then called "Glass Arm", but is now called RSI.

    In fact there were many designs for ergonomic keys that worked sideways instead vertical, the most popular and effective was the Bug (invented in 1904) which would make a dash when held in one direction and a series of dots when held in the other, requiring far less movement to operate.

    It has been known for over a century that repetative up and down movements of the fingers and wrist, similar to that involved in typing, can cause a longterm painful injury to the wrists.
  • That's a good point- the 'correct' method for touch typing was invented for optimal speed, not because it is at all comfortable for the touch typist. I learned to type by what worked best for me to operate a computer, my style is a strange personal system where the left hand hovers over the number keys, and the right hand over JKL; -- developed perhaps because I once wrote a lot of C and Pascal.

    We've had typewriters since at least 1868, but 'RSI' and 'carpel tunnel' only became news in the last few years... what has changed?

    Perhaps there is something unnatural not just with the 'correct' way of touch typing, but also due to the way the computer keyboard and monitor are placed on the desk and operated as oppposed to the way a typewriter is operated.

  • New poll:

    What typing method do you use?

    1. Touch Typing
    2. 'incorrect' touch typing (personal style)
    3. Hunt 'n' Peck.
    4. I type with one hand on the keyboard only.
    5. Dvorak!

    Have you read the article on Dvorak keyboards in the latest 'The Perl Journal' ?

  • I wouldn't have generated as much interest if it had read "hysteria: a historical chronology"

    Be that good, bad, or indifferent -- It's infotainment -- After all, if you really want scientific information, you'd read a scientific journal.

  • Advil (along with other over-the-counter painkillers) is also well known for causing liver damage, including acute hepatic failure in rare cases. Large doses and alcohol exacerbate this effect.
  • "Although the majority of ibuprofen overdosages are not very serious, acute renal failure, hepatic failure, and hypotension and coma have been described" "Tissue levels of ibuprofen after fatal overdosage of ibuprofen and acetaminophen." Steinmetz JC, Lee CY, Wu AY.

    "In the group of propionic acid derivatives, ibuprofen, pirprofen and naproxen have been implicated in hepatitis of various types" "[Hepatitis due to nonsteroidal anti-inflammatory agents]" Furet Y, Metman EH, Breteau M, Bertrand J.


    "Ninety years ago aspirin was discovered, and within the last forty years phenylbutazone, indomethacin, ibuprofen, the oxicams and many others were discovered. All of these drugs are acidic. They inhibit the prostaglandin synthetase, combine analgesic and anti-inflammatory activity and show side-effects mainly in the GI-tract, liver, bone-marrow, and kidney...Intensive hepatic metabolisation may be related to enhanced hepatic damage...These observations indicate that certain pharmacokinetic characteristics of distinct nonsteroidal anti-inflammatory drugs (NSAIDs) are responsible, at least in part, for well-known side-effects."
    "Towards safer nonsteroidal anti-inflammatory drugs." Brune K, Beck WS.

    This could also be interesting reading:
    "Drug-induced hepatic injury: an analysis of 1100 cases reported to the Danish Committee on Adverse Drug Reactions between 1978 and 1987."
    Friis H, Andreasen PB.
  • Did you read the aritle?

    They did not say it was a hoax, nor did they say anything about malingering, except to point out that this is anything but that.

    What they said is that typing on keyboards does not cause carpel tunnel and there is no aparent PHYSIOLOGICAL cause for "RSI". Rather, that it is a social psycological ailment.

    As was specifically stated, psycological ailments like this are not "malingering" nor is the pain any "less real". Rather that the cause is completely psycological - it is not a permenant crippling disease.

    -Steve
  • The article is not about whether they hurt, it's about whether they are a permanaent injury, or something that magically goes away if people can get away from their keyboards for a while.
  • by zpengo (99887) on Monday June 11, 2001 @11:04AM (#159961) Homepage
    The issue isn't whether repetitive stress injuries are "real" or "painful", it's whether they are permanent injuries. The point of the article is that million-dollar lawsuits may not be in order when the symptoms go away after a while.

    I'm tired of all these Karma whores writing "insightful" and "informative" responses to articles they haven't read.

  • by zpengo (99887) on Monday June 11, 2001 @11:11AM (#159962) Homepage
    Doesn't Alex Chiu [alexchiu.com] have something to combat repetitive stress injuries?
  • by Tom7 (102298)
    I agree with you 100% -- In fact, I think for me it was the mousewheel that did it. Since I shut that off, and started using the keyboard for everything but web browsing, my wrist has gotten a lot better. I second your comment!
  • BTW: If you have tendonitis, a lot of doctors will tell you to take Advil (or a generic version of it). That's because Advil is an anti-inflamitory drug that actually reduces the swelling in your wrist. Since the swolen tendons is what is causign all the friction (which causes more pain and more swelling), reducing it is a Good Thing. Other pain killers will 1: not reduce the swelling, and 2: ease the pain, allowing you to cheerfully type away and hurt yourself more.

    Yep! Advil is an NSAID (Non-Steroidal Anti-Inflammatory Drug). Any NSAID will have the same (or similar) effect.

    However, be warned that NSAIDs are not a magic bullet; constant use of them has been shown to cause stomach ulcers/bleeding [elfstrom.com].

    If you type a lot, get an ergonomic keyboard (the Microsoft Natural Keyboard Pro [microsoft.com] is a great piece of hardware) and a decent chair (I highly recommend the Aeron Chair [hermanmiller.com] if you can afford it -- it's like floating on air, even after sitting it for hours on end!). Your body will thank you!

    --
  • Actually, this is explained by Masamune Shirow in his notes for the manga (upon which the movie is based).

    According to Shirow, the typist in that scene belonged to an older generation that reached maturity before the advent of reliable commercial direct-to-brain electronic interfaces.

    As a result, he was typically uncomfortable with the idea of some "newfangled cyber-doctor" shoving wires into his brain, but was willing to accept older and more proven surgery on his hands to radically increase his data input rate.

    On a side note, Shirow is generally pretty obsessive about documenting the technical concepts in his work. He often includes fairly large appendices containing a wealth of background philosophical, mystical, and technical information - most of it apparently to justify the "look and feel" of his characters and equipment.

    Shirow regularly acknowledges the maintenance costs of high-tech solutions, and suggests that this is the main challenge facing gov't and military purchasers when selecing new hardware.

  • Tendonitis is far more common, in my experience -- I'd like to have seen that discussed in this context.

    Agreed. I was recently diagnosed with DeQuervain's Tenosynovitis [thecentrepc.com], a painful inflamation of the tendons that move the thumb and its tendon sheath. In my case, it started without apparent reason as a general soreness around the bone that sticks out as a bump at the base of the thumb, combined with nasty sharp pains with certain movements of my hand. My first thought was "Carpal Tunnel Syndrome?" since a friend in the IT industry had been diagnosed with this. As you say, CTS is "the flu" of hand injuries.

    A word of warning: After my doctor told me what I had I, naturally I checked the web to find out more about it. Many of the pages (but not this one) describe "Finkelstein's test" [louisville.edu] along the lines of: "form a fist with the thumb inside, then move sharply outwards." DON'T TRY THIS AT HOME! - I did, and was in extreme pain for some time afterwards (and made some rather pointed remarks about Finkelstein's parentage...) I also made the overall problem several times worse that it was and set the healing back at least a week. As the link above explains, this description is wrong and can cause pain even in normal hands. The correct test as described in the link is what my doctor used.

    "Curiosity killed the cat."
  • Besides switching to an ergonomic keyboard, I started practising Aikido (Japanese martial art) a year ago. I've never had major problems since then. Aikido puts a lot of controlled stress on the wrists so my guess is that this helps keeping them elastic. Go find a DoJo in your vicinity at: http://www.aikiweb.com/search/ [aikiweb.com] ;-)
  • I'm a Unix Admin and C/Perl coder/scripter ... I have had various degrees of these types of pains. They way I could remove them is taking three golf balls into the palms of my hands (palms up) and rotate the balls around for a few minutes each day. The pains went away with in weeks and have not had pains for quite some time now.

    Every once in a while if I feel the pains to even start to come back .. i'll get the ol' three golf balls out for a few minutes ....

    Ryan
  • Once you have a genuine RSI injury, you never recover - you live with it. I had wrist, hand and shoulder pain and went through two months of physical therapy, and now work at an ergonomic bi-level table. I'm fine most of the time, but pain can come back if I use my PC improperly (particularly with mousing) or I stop doing certain flexing exercises. A healthy person can do all sorts of "improper" things with their PC use and think RSI is a hoax, but after you sustain an RSI injury it makes all those simple things much more prone to pain. I relish the old days of 6+ hour sessions at the computer, not giving a damn what angle my arm was at, where my wrist was sitting, etc.
  • by www.sorehands.com (142825) on Monday June 11, 2001 @11:22AM (#160003) Homepage
    I don't have breast cancer, so cancer must not exist.

    I spent three weeks in Hoboken, NJ and don't have lung cancer, so lung cancer must not exist.

    They have shown that people with CTS have denervations in the median nerve that are relieved with surgery. I find that to be convincing evidence of a condition.

    You don't need a 1:1 correlation on cause and effect to establish an existence of a condition. Things besides typing cause CTS and other RSIs.

  • by issachar (170323) on Monday June 11, 2001 @10:44AM (#160015) Homepage
    I don't know why I'm saying this, because /. is perpetually misrepresenting the articles it links to, but the article in question DOES NOT say that Carpal Tunnel Syndrome doesn't exist. Rather it says that there does not appear to be a link between keyboard use and carpal tunnel syndrome. (i.e. Office workers using regular keyboards, have the same incidence of carpal tunnel as the rest of society).

    I suppose that if the editors of /. were told that they were not infected with HIV, they would conclude that AIDS is a big hoax...
  • by Golias (176380) on Monday June 11, 2001 @11:09AM (#160022)
    My coach in high school used to make a big deal about the difference between pain and injury. Pain in your wrist is just pain in your wrists (probably from tendonitis; a swelling of the tendons commonly caused by things like bad tennis form, long hours playing the old Pac Man arcade game, or using the torure devices known as the PC keyboard and mouse). Carpal Tunnel Syndrome is damage caused by your swolen tendons constricting around the bundle of nerves that pass through your wrist to your hands. It is an injury. A serious and crippling one.

    If you have pain in your wrist that doesn't go away after a day away from the keyboard, it does not mean you have permanent RSI damage yet. Change your ergonomics and/or work habits, and you may be back to being your old self. Or you could ignore the pain, pop a couple asprin, and end up crippling yourself. Your call.

    BTW: If you have tendonitis, a lot of doctors will tell you to take Advil (or a generic version of it). That's because Advil is an anti-inflamitory drug that actually reduces the swelling in your wrist. Since the swolen tendons is what is causign all the friction (which causes more pain and more swelling), reducing it is a Good Thing. Other pain killers will 1: not reduce the swelling, and 2: ease the pain, allowing you to cheerfully type away and hurt yourself more.

    In spite of articles like this... take care of your hands. Getting along without them would be tough.

  • by sulli (195030) on Monday June 11, 2001 @10:38AM (#160041) Journal
    Yes. I personally know someone who has severe RSI, and I don't think she's bullshitting, as she has told me repeatedly of the pain she experiences. I too have experienced some pain from using crappy keyboards, which I have abandoned in favor of my laptops which are actually easier to use.

    Definitely some people claim RSI to make their jobs easier unfairly, but I can assure you that this shit is real.

    So: Don't overwork your hands, you won't get any new ones!

  • by LionKimbro (200000) on Monday June 11, 2001 @10:54AM (#160050) Homepage

    Sure, my pain "just went away"...

    After I quit working on the Macintosh keyboards, the puck mouse, and the picnic table "desk" that was up way too high.

    Shooting pains are not just imagined. I couldn't write at home because my hand would freak at the slightest exertion of effort. My life is code and paper is my primary resource. I was crippled while working with the Macs. (OS X Server, incidentally, not that the OS matters too much, save with respect to how fast it lets you set your mouse speed.)

    This reminds me of an experience with a coworker. He, a staunch republican, noted just how phony environmentalist concerns were. "A while ago, everyone was complaining about how CFC's would destroy the world by now. But see? Everything is perfectly fine." I said, "Well, yah; That's because you are forbidden to produce CFC's now, save in a few developing countries who's time is almost up." I suspect the same sort of thing going on here. We've learned to work around Carpal Tunnel, so well, that people think it's just a myth.

  • by InsaneCreator (209742) on Monday June 11, 2001 @10:33AM (#160062)
    I'm glad that that pain in my wrist is not for real. I can feel it going away already... If it was not for this article, I would still think I am in pain. :)
  • by update() (217397) on Monday June 11, 2001 @10:49AM (#160068) Homepage
    I'd like to see Dr. Shorter tell my wife that the pain is all in her head. You'd have to surgically remove her hands from his throat.

    On the other hand, what struck me about the article was the emphasis on carpal tunnel syndrome. My impression is that very few people have that. The term is used as shorthand for RSI injuries in general, much as people talk about having "the flu" when they get a cold. Tendonitis is far more common, in my experience -- I'd like to have seen that discussed in this context.

    Unsettling MOTD at my ISP.

  • by thelexx (237096) on Monday June 11, 2001 @11:06AM (#160077)
    This is supported by my experience anyway. It isn't the keyboard which hurts me, it the damned mouse. Switched to an MS Trackball Explorer and have had 80% of my right side arm/wrist/shoulder aches disappear. Tried several other trackballs but unfortunately they just didn't quite compare to the one signed with the mark of the beast hehe. And switching pointer devices is a hell of a lot cheaper than getting a new chair and/or desk that are more ergo perfect. Hope this encourages even one person with pains on their mouse side to try an alternative because it really does help. No more bottles of generic ibuprofen on the desktop!

    LEXX
  • by grovertime (237798) on Monday June 11, 2001 @12:10PM (#160079) Homepage
    If anything you want to use cold. These symptoms are very real and very permanent in many cases like mine. I am not just a programmer, but a writer and guitarist, so my troubles are three-fold. Using heat on an injury that involves inflammation is like putting out a fire with matches.

    1. is this.....is this for REAL? [mikegallay.com]
  • by moksliukas (301561) on Monday June 11, 2001 @10:33AM (#160110)
    Well, i do not know what the fuss was about. It seems that the only people that were worried with this kind of thing came from developed countries, and here in Lithuania noone seems to care. I don't even know if there is a direct translation for RSI in Lithuanian. Maybe it is just because we have other more important problems.
  • by Turq (319326) on Monday June 11, 2001 @10:34AM (#160127) Homepage
    Speaking as a sufferer of carpal tunnel and other repetitive-stress-injuries, aggravated by a genetic predisposition to arthritis, RSIs are -not- a hoax. However, for every one true RSI sufferer, there're probably a dozen fakers who smell a big lawsuit/government check, and claim mysterious pains here and there. These cases up and disappear whenever someone bothers to scruntinize them.. "What? See a doctor? Oh, I, uh, feel much better now. My wrists have healed! It's a miracle!". Often, real RSI sufferers are reluctant to seek the help that goes along with a government check. We love our machines too much. I for one, suffer through the aches, stiff joints, numbness, and keep a-typin. I use a wristwrest and try to keep my wrists/arms/hands at happy 90 degree angles like in those oh-so-nifty ergo diagrams, and I may as well own stock in Bayer for all the asprin I consume. And one day, when the arthritis sets in full force, I hope somebody's perfected cybernetics to the point I can buy new hands from Wal Mart. ;)
  • The National Post [nationalpost.com], the source for this article, is well known as an unashamedly pro-business newspaper. They frequently publish articles which defend existing business practices regardless of their cost - as an example, one of their regular columnists, Terrence Corcoran [nationalpost.com], is famous for his articles denying the existence of global warming.

    In this case, it's likely that the article is intended to reduce the perception of employers' liability for their employees' carpal tunnel injuries, and thereby to dissuade those who are possibly suffering from seeking redress.

  • by glenkim (412499) on Monday June 11, 2001 @10:33AM (#160136) Homepage
    I thought as long as you take breaks from typing every 45 minutes or so with a pr0n break, your wrists should be okay. Or at least one of them.
  • by Wesley Everest (446824) on Monday June 11, 2001 @03:06PM (#160143)
    It looks like Dr. Shorter is basing his information from a dissertation by Dr Yolande Lucire. If you go to Dr. Lucire's webpage [ozemail.com.au] it's clear that Dr. Lucire is just a hired gun for insurance companies and large employers.
    Her doctoral dissertation concerns the current pandemic of Repetitive Strain Injury, RSI, also known as Cumulative Trauma Disorder CTD. This is an epidemic of somatization (hysteria affecting the soma, the body). Somatization is also known as 'functional overlay' or 'functional disorder' by the legal profession.

    Her thesis, Ideology and Aetiology: RSI: an epidemic of craft palsy, examines the origins , the medical philosophies that allowed it to thrive and the issues surrounding those who were afflicted.

    She is frequently called to consult in RSI cases both in Australia and in the United Kingdom.

    Dr Lucire is interested in developing a consultancy practice to the Legal Profession in the United States and Canada as well as her Australian and British work. She would be happy to travel overseas and to review the large numbers of claimants involved in class actions, to conduct appropriate interviews and to provide litigation standard reports.

    She's no different than the "doctors" hired by tobacco companies to testify that there is no evidence to suggest a connection between smoking and lung cancer.
  • by gnurd (455798) on Monday June 11, 2001 @11:08AM (#160157) Homepage
    b (owie) u (ouch) l (ah) l (yikes) s (medic!) h (arg) i (doh) t (uuhhhh)
    ---

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