Crpl tunnl is a btch

By Shamus
on Nov 12, 2008
Filed under:
Personal

Ow. I’m not sure what the deal is, but my arms are going all carpal on me. This came about very abruptly. Monday I was fine. Tuesday I was flicking my wrists and massaging my forearms. I haven’t changed my workspace, and I haven’t increased my typing output, so I don’t know what’s causing this.

I’m going to forego the posts I’d had slated for today and engage in some premeditated slacking. Just so I don’t send you away empty handed, here is some stuff to read:

Alex reviews Bully.

Kaedrin talks about Anathem, the new Neal Stephenson book. Also good is this post on Blu-Ray, which suggests that Blu-Ray isn’t as important as Sony thinks it is.

Jay Barnson takes another look at the eternally slippery term “RPG”.

Ow again. Kind of sucks when your job, your second job, and your hobby all require lots of typing.

EDIT: I have no idea if this is true carpal tunnel or not. It’s an ache in the backs of my wrists and the front of my forearms which makes typing painful. Addendum: Ouch.

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201737 comments. Hurry up and add yours before it becomes passé.

From the Archives:

  1. DM T. says:

    Get well, Shamus.
    I know how it feels, I suffer from those syndromes myself every now and again. I try to get a short break from coding every hour or two by taking a 10-15 minutes walk outside.
    CRPL TUNNL is indeed a BTCH.

  2. Noah Lesgold says:

    If it persists, talk to your doc, and in the meantime, it would not be a bad idea to invest in a pair of wrist braces. If nothing else they’ll discourage you from using your hands in a way that’ll make things worse.

  3. Kel'Thuzad says:

    Strangely enough, I’ve never had carpal tunnel. Hope it goes away quickly.

  4. Mike says:

    Are you playing anything new? I got tennis elbow from playing too much Call of Duty. It took me a couple of months to recover from that.

  5. Factoid says:

    Best way to relieve pain associated with true carpal tunnel is to do stretching exercises on your wrists. Sit in a chair, feet flat on the floor, put one arm palm up on your leg so your wrist just pivots over the kneecap.

    Make a fist, and push down on it with your other hand for 2-3 seconds, then relax. You should feel the stretch up your forearm.

    Do that 20 times, then flip your arm over and push down in the other direction, you’ll probably want to release the fist so that you get a better stretch in that position. Rinse and repeat with the other arm.

    It does wonders for me when I get that kind of pain, and it takes all of about 5 minutes.

  6. drunkenwimp says:

    Both my brother and my mother had surgery for that, so when it happened to me a couple years ago, my brain blew and I shoved my mouse pad from right to left. Result is once in a while ache in my right shoulder rather than my right wrist.

  7. Shinjin says:

    I’ve posted this in the past, but I’m in a similar situation (work hobby = mucho PC time). My hands/wrists would always get sore until I shelled out for a Kinesis contoured keyboard. I had stumbled across an ad in the back section of some PC magazine.

    No, they aren’t cheap and no, I never did try anything like the MS Natural keyboards. But I’ve been using one of these for ~10 years now and my wrists/hands only have a problem if I need to switch over to a simple 101 keyboard for a week or so (say, for a business trip). Before I worked out of my home I’d bring the keyboard to/from work every day.

    Service has been pretty good when I have needed it. The first one I bought needed one of the PCBs replaced after about 5 years of use. After about 7 years of heavy use, it died though and I’m now on my second one. I picked up the model that can be switched back and forth between QWERTY and Dvorak. Since I use it for work, I was able to get my employer to help defray the costs a little.

    Down sides?

    – For some games it’s not the best. Most decent games allow you to remap keys which is good since WASD movement doesn’t feel too comfortable with the contoured keywells. And in Dvorak mode you need to remap those keys anyway.

    – The function keys are tiny and spaced close together, so for games that make use of them it’s more difficult to hit them by feel with the way that they are grouped together. And with my first model, heavy use of the F-keys eventually led to them getting “gummed up” after ~4 years (which can be usually cured with disassembly and rubbing alcohol). No problems yet after 3 years with my current one.

    – retraining takes a little time. Took me about a month to get up to my old WPM on a 101. Some keys are located in different places and the keypad is a little awkward to use. When I made the Dvorak switch, it took me maybe 2 weeks to transition.

    – hunt and peck typist? No benefit gained.

    Hasn’t done anything for my right index finger, though. Years of mouse-clicking seems to have taken it’s toll…

  8. Joe says:

    Unfortunately, the last time I looked at speech recognition software, it wasn’t so great. And my guess is that it would be absolutely *horrid* for trying to write anything other than text (i.e., code).

    So maybe what we need to work on is a keyboard big enough that you can type on it with your feet. Or elbows. Just to give the wrists a bit of a break.

    Just an idea…

  9. Alexis says:

    Sucks, dunnit.

    There are many causes of hand/wrist/arm pain. If you can figure out which movement is doing it, you can generally move the pain. Diversifying your input devices may help (eg using a console controller + software for CoX). Vertical keyboards like the freestyle ascent don’t require a twisted wrist.

    I hear swimming helps. Watching TV indirectly helps.
    Your employer might help.

    – this post brought to you singlehandedly due to elbow pain.

  10. Brandon says:

    Well, as at least one person has suggested, this is much more likely to be RSI than carpal tunnel syndrome. Still, that doesn’t make it any less painful or restrictive when it hits. I find, for me, that this kind of problem comes on most strongly when I have my keyboard in a bad position and am switching back and forth to the mouse a lot. Try not using the props on the back of the keyboard. A flat keyboard may actually be more ergonomically sound. Also, make sure you have a nice straight wrist when working with the mouse, and minimize the back and forth.

  11. Loneduck3 says:

    Dip your hands in warm oatmeal, keeping them elevated. Feel silly yet? Sorry, don’t mean to make light of your pain, but I’m across the tube, and I really don’t know anything to help.
    Bully always struck me as mundane. GTA without the murder, or car theft, and a crappy main character. IF they were going to make an open sandbox game about school life, the IP to use would be Roald Dahl’s Matilda. Playing as a smart little girl in a school where the headmaster throws kids, holds them by there ears, etc. That is both sufficiently cartoony, and justified mischief. But developers these days would just screw up, so that’s not going to happen.

  12. froogger says:

    I feel your pain. It’s like having broken wings – takes time to heal too.

    I was pained with rsi back in -93 (excessive Doom and Red Alert I suppose) until I got myself a Logitech trackball. Solved the problem in a few weeks and I haven’t been bothered since. It has a superiour feel in FPS games compared to whipping your wrist around on a mousemat. I don’t do alot of coding/typing though, so I haven’t bothered to experiment with ergonomic keyboards.

    Get well soon!

  13. LintMan says:

    A few times that started happening to me, and I realized that someone had adjusted my chair height and I hadn’t noticed.

    Other times that this happens to me, it often seems very game-related. Like I’m playing a game with a more limited and repetitive set of controls, or I let myself hunch over to stare closely at the screen, or I’m so absorbed that I don’t take a break for many hours at a time.

    Anyway, hope you feel better, Shamus.

  14. Aelf'en says:

    I thought I had Carpal Tunnel Syndrome, but had my workstation checked out, and found it was actually all the way up in my shoulder that caused the pain and tingly feelings in my fingers. Reaching for my mouse was aggravating RSI in my shoulder, which caused nerve bundle entrapment in various places in my arm from all the swelling. Turns out I slouch/turtle like crazy too, which is a big part of the problem.

    Work gave me a different chair, a larger flat monitor with an articulated arm so I could bring it closer/higher, forced me onto a keyboard tray and threatened to put a mirror next to me so I could see how horrid my posture was. And I got one of those keyboards with a trackpad in it (like in server rooms) to use in place of a mouse. The pain is gradually lessening every day. Some days though, I swear I’m going to give up using my hands/arms for anything ever again.

  15. Telas says:

    Quick CTS test: holding your arms in front of you, put the backs of your hands together such that your elbow, wrists, and elbow are in a straight line, and your fingers are pointed down. Hold the backs of your hands firmly together, and slowly lower your elbows until you feel slight pressure in the wrist. If you have tingling and burning in the hands after about a minute, you probably have CTS. You can also do the reverse of this test, by putting your palms together (in almost a “praying position”), and raising the elbows until there is slight pressure, then waiting a minute.

    (My wife is a physical terror- therapist.)

  16. evilbob says:

    Long ago when I was in college, after many hours of typing my wrists and hands started to hurt a bit. I switch to the split/ergonomic keyboard types where possible, and the Dvorak keyboard layout. I also switch to using a thumb operated trackball, like the logitech trackman. Don’t get one that you move around with your fingers, you’ll end up worse than where you started.

    It took me about a month to figure out the Dvorak layout, but since then my hands & wrists haven’t bothered me almost 10 years later. You loose a bit of dexterity at first with trackballs, but you never move your arm or wrist while using them so you get the added bonus of being able to cram more garbage on your desk (no mousepad hogging up space).

  17. Nilus says:

    Hey Shamus, Whats the weather like by you? If its cold and rainy you could be seeing signs of Arthritis. From what I have been told its getting more and more common in younger people, especially those in the tech industry. In any event a trip to your doctor probably couldn’t hurt.

  18. Nurgh says:

    I am not a medical doctor, but I have had and recovered from RSI.

    When I was a graduate student, I had very bad RSI. After a half day working in the lab, the pain was bad enough I had to stop. Needless to say this made my thesis work a little slow.
    RSI like I had takes years to build up, and it’s taken years to go away. My hands have improved to the point where I use a normal keyboard at home but I still use a specialized one at work.

    My immediate suggestion: take Ibuprofin at night, before you go to bed. What you’re describing sounds a lot like tendonitis, where the tendon swells within the tendon sheath. When you use your hands, the tendons slide within the sheath, further irritating it. Reducing the swelling lets them heal.
    Don’t take it when you’re going to work. Ibuprofin will also mask pain, which is an important “you should stop” signal. But overnight, yes.

    Listen to your body. I can’t emphasize this enough. It’s hard to learn, but your hands and arms send signals I interpret as a sort of itchy-like discomfort which is really easy to ignore. In the long run, once your RSI goes into remission, listening to your body is what will keep it from coming back.

    Try different keyboards. I tried the Microsoft Natural, but didn’t like the feel. I tried the Kinesis, and couldn’t figure out where I was supposed to put my thumbs when they weren’t in use. I ended up with a Datahand. It’s even more expensive than a Kinesis, but at this point I can type faster on it than on a normal keyboard.

    Look at your posture when working. Knees at right angles, hips at right angles, upper arm vertical, lower arm horizontal. If that means your keyboard is in your lap, so be it.

    Every 30 minutes, take a five minute break. Doesn’t have to be much, just get up and walk around a bit. Doing this helped me immensely. Even now, I listen to music while working and tend to take a break when the CD changes.

    Get someone to show you some gentle stretches for your hands and shoulders. Runners stretch before they begin to run; you type a lot longer than they run and most people don’t bother.

    Finally, look at the non-computing things you do. I discovered that I tended to read a paperback book by holding it open with one hand. That put a whole bunch of strain on that hand; now I hold the book with both hands.

    I could go on, but I’ve put in the most important suggestions and this is already turning into a wall of text.

    I disagree with the person who suggests wrist splints. You’ll lose muscle tone and the muscles are important for preventing damage in the future. If you discover yourself sleeping poorly on your wrists at night, then you might want splints at night.

  19. McNutcase says:

    I don’t have the suggestions so many people have been kind enough to provide, but I do have sympathies. Be well, Shamus.

  20. DaveMc says:

    Telas: “If you have tingling and burning in the hands after about a minute, you probably have CTS.”

    If you have those symptoms, you have the Cardboard Tube Samurai? Huh.

    (Penny Arcade reference, if this is baffling to anyone.)

  21. Nurgh says:

    Oh, one other thing.

    Consider seeing a doctor, to establish that the condition exists. If you don’t get better, you will have documentation a month from now that you’ve had problems for a month.

  22. Nabeshin says:

    Face it man-you’re gettin’ old!
    Like I have room to talk…

  23. Elise says:

    Friends of mine have had great success by learning DVORAK (I learnt because it sounded fun, not because I had RSI problems). Took a few hours to learn where all the keys were, there were a couple of days where typing was painfully slow. Two weeks or so to get back to the speed I was at with QWERTY and I’ve never looked back.

  24. Vacca says:

    I had this exact same problem, many times, when I was younger. Then I got a girlfriend and it went right away. Then I got married and it came back. No idea what causes it but it’s a bitch!

  25. Will says:

    Summary of posts so far:
    Take a break, take a pain reliever, check your ergonomics (a fancy word for posture), talk to a doctor.

    All good advice. It does sound more like muscle pain/tendinitis than carpal tunnel, which typically more of a numb/tingling sensation in the thumb, index, and middle fingers.

    (Insert long disclaimer here which boils down to stating that, even though I am a neurologist, neither you nor anyone else can sue me, and that your coffee is hot and your actual mileage may vary)

  26. Kallahim says:

    One major thing is not to hang your elbow below your wrist when using a mouse or keyboard, not only does it put strain on your wrist but it puts a lot of strain on your shoulder. Make sure your mouse side elbow is resting on a elbow rest that is at the minimum level with your mouse pad, and if dont have wrist rest get them, i use a mouse pad wrist rest and a natural style keyboard. Finally the big thing people miss is if your mouse feet are collected crud, and everyone’s does, the resistance on your mouse gets a lot harder, and you end up using just a little more force each time, then at the end of the day your wrists are a lot sorer than usual. You don’t need a fancy mouse pad, but definitely clean\replace your mouse or pad if there is too much gunk.

  27. Blurr says:

    I definitely recommend switching to Dvorak. It’s a great layout. Typing on QWERTY by comparison is clumsy and uncomfortable.

    Also, nerve pain like the type you described is often actually in another place altogether, so I’d go see a doctor before beginning any sort of treatment, except to lay off the keyboard for a while. ;)

    I can’t offer any other advice, but I do hope you get well soon.

  28. tkech says:

    “I haven’t changed my workspace, and I haven’t increased my typing output, so I don’t know what’s causing this.”
    First time this happened to me was the day after cutting my small son’s hair (using scissors) at home – my theory is that it aggravated what my job was already doing, thus the pain only began at work. So you may have done something Monday that fed the computer problem.

    LintMan above suggested that your workstation may have been altered without your knowledge – I’d check that as well. Vacca: just lmao.

    I will say that my symptoms were identical (wrists and forearms), and when I saw a doctor much much later he said I did not have carpal tunnel because I did not have numbness and tingling in my fingers. He gave me a wrist brace to keep my wrist straight during computer use to prevent deepening the pain and allowing the soreness to heal (not to wear permanently). Finally got a mouse wrist rest – I have not had a problem since, except when my workspace changes and I have to find a new optimum setup. Then I break out the wrist brace until I get everything working again.

  29. Sec says:

    I suggest you go out and install Workrave immediately if you have any kind of pain in your hands/wrists.
    I found that observing the regular microbreaks it suggests really helps.

    For me that makes the pain go away very fast.

  30. DM T. says:

    I’ve been using MS Natural Keyboard for quite a while now and it really REALLY Helps to reduce the occurance percentage throughout the year.

    It takes a while to adjust to, but it’s the number one on my requirements list from my work place.

  31. Alex says:

    I hope one day to write the murder mystery “Carpool Tunnel Syndrome”, about a group of coworkers who are picked off one by one on their commute to work.

  32. Anonymous Botch says:

    I have no idea how you reduce the pain once its there, but there are a number of tried and tested ways of prevention.
    Its all about fitting you as an individual with your workspace. So all the specific remedies suggested are a bit of a red herring. They will work for some people but not all and they can make some worse.
    Here are some tips.

    Adjust your chair and VDU to find the most comfortable position for your work. As a broad guide, your forearms should be approximately horizontal and your eyes the same height as the top of the VDU.

    Make sure you have enough work space to take whatever documents or other equipment you need.

    Try different arrangements of keyboard, screen, mouse and documents to find the best arrangement for you. A document holder may help you avoid awkward neck and eye movements.

    Make sure there is space under your desk to move your legs freely. Move any obstacles such as boxes or equipment.

    Avoid excess pressure from the edge of your seat on the backs of your legs and knees. A footrest may be helpful, particularly for smaller users.

    Adjust your keyboard to get a good keying position. A space in front of the keyboard is sometimes helpful for resting the hands and wrists when not keying.

    Try to keep your wrists straight when keying. Keep a soft touch on the keys and don’t overstretch your fingers. Good keyboard technique is important.
    Reading the screen
    Position the mouse within easy reach, so it can be used with the wrist straight. Sit upright and close to the desk, so you don’t have to work with your mouse arm stretched. Move the keyboard out of the way if it is not being used.

    Support your forearm on the desk, and don’t grip the mouse too tightly.

    Rest your fingers lightly on the buttons and do not press them hard.

    Don’t sit in the same position for long periods. Make sure you change your posture as often as practicable. Some movement is desirable, but avoid repeated stretching to reach things you need (if this happens a lot, rearrange your workstation)

    Frequent short breaks are better than fewer long ones.

    Most of it is pretty obvious, but most people don’t have their workspace set up properly, and because it takes so long for any symptoms to appear, they will never connect the two.

    Hope it helps.

  33. Jeff says:

    My high school computer teacher had carpal tunnel.

    As he demonstrated to me, he squeezed his fist, and tapped the flesh between the thumb and wrist. (Muscles of thenar eminence according to wikipedia.) The nerves there were dead, no feeling. So if it’s getting numb there, you might want to look into it.

  34. Brandon says:

    Blurr, there are no reliable, reputable studies demonstrating a Dvorak keyboard advantage over Querty.

  35. Johannes says:

    Back when I started to experience RSI-like symptoms, I found this suggestion somewhere on the web (also mentioned by Sec, I see): take these so-called ‘micro breaks’ every five minutes (or so). The explanation was that the pain you experience is caused by your muscles put under constant strain. Regular pauses give the muscles time to heal again, or at least rest.

    I absolutely didn’t have the resources necessary to adjust my workspace to a more ‘RSI-friendly’ mode back then, so this was kind of a welcome suggestion. One year ago, when buying a new computer lead me to yet another very intense period of gaming, yet again I found these micro-break-reminder-programs to be quite helpful.

    They can be kind of an annoyance, by the way. But I just keep in mind that it’s for the good of me – since I use my hands quite a lot (besides programming & gaming, I play the piano) I don’t think it would be good for my ‘wellbeing’ to get to suffer from RSI or carpal tunnel.

  36. Jonathan says:

    It’s tennis elbow.

    I get the same thing when working on a lot of papers / doing essay tests in class / taking a lot of notes or after playing a lot of Diablo or something.

    Sometimes taking some ibuprofen can help, but the best thing to do is to type / click less.

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