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How I Cured my RSI Pain

99 points by prakash 16y ago

sshumaker 16y ago
I too, encountered crippling RSI pain, and eventually switched to a kinesis keyboard (http://www.kinesis-ergo.com http://www.kinesis-ergo.com). While the keyboards are crazy expensive, and a bit flaky, they completely cured my carpal tunnel. The downside is, I'm now stuck hauling around this weird, non-standard keyboard. :)
- Luc 16y ago
  Same here. Had nasty pains in both wrists and tried a lot of things until I finally purchased a Kinesis (the current model is this one: http://www.kinesis-ergo.com/advantage_pro.htm http://www.kinesis-ergo.com/advantage_pro.htm ) and a Kensington Epert Mouse trackball. I had to learn to type again, but am now faster and completely pain-free for about 6 years.
  - sokoloff 16y ago
    Very similar experience here; bought myself a Kinesis for home and one for work (I'm sure they'd have paid for it, but I couldn't be bothered). It was quite possibly the best $600 I've ever spent. I don't mouse enough to have yet bothered with the trackball, but perhaps I'll get one to try it out. The only downside I've found (other than cost, which is a non-issue IMO) is that you get very used to the keyboard and now when I go to a conference room or someplace else with normal keyboards, I might as well be typing with my elbows.
    - jonstjohn 16y ago
      I keep a kinesis at work and a standard keyboard at home. Now I'm so used to using both that I can type just as fast on either one.
- slug 16y ago
  I've actually never had any serious problems with my wrists, and sometimes I think that starting playing piano as a young kid, along with my guitar today, and with regular trips to the swimming pool and daily bike commute, helps keeping my wrists strong and pain free. I've been using a kinesis freestyle keyboard for about a year, and before that a series of regular chepo 102 keys, but the possibility of having my hands apart a longer distance keeps my wrists more relaxed and overall I get a better body posture. I think most of the problems other people have come from the latter: my elbows are on top of the table, which means my keyboard is farther away than what I see other people using and so I'm in a very relaxed position. The ubiquity of laptop's small keyboards certainly doesn't help either.
- Terretta 16y ago
  I'm partial to the GoldTouch keyboards: http://www.goldtouch.com/p-133-goldtouch-for-mac-adjustable-keyboard-black.aspx http://www.goldtouch.com/p-133-goldtouch-for-mac-adjustable-... Because they're close enough to the regular keyboards, while offering both the split (match natural forearm angle) and the tilt (match natural forearm rotation) to better align natural wrist position. I also like that they ditch the numeric keyboad, so I can put the Kensington ExpertMouse just to the right of the return key and not have to move my hand as far.
- msb 16y ago
  I have to put my vote in for the Kinesis Advantage as well. For anyone reading this that might be on the fence about the cost, you will not be disappointed. I was suffering from excruciating pain in my forearms, wrists and fingers. That pain disappeared almost as soon as I started using the Kinesis. For me, the big difference is having a wide split between home rows. This keeps my arms almost completely parallel and alleviates the forearm pain. The key layout is a little funky at first, but what I have realized is that each individual key is positioned exactly where your fingers naturally curl and extend. The other change I made was to add a trackball. I keep the trackball on the left and my regular mouse on the right and switch up usage as often as I can.
- dagobart 16y ago
  I did the exact opposite--one time I came across a very cheap keyboard with the keys wobbly and floppy. Was a relief to my hands. Since then, as long as I used standalone keyboards I bought cheap keyboards where the situation of my fingertips hitting the key caps was that the caps evaded my fingers a little and required some kind-of adjusting of my finger movements to the individual key once my fingertips hit the key in question. I guess the added movement helped to relax my fingers.
- shard 16y ago
  I switched to an ErgoLogic keyboard (no longer made but looks like this: http://www.emailbattles.com/2006/04/24/other_aadehidhca_ia/ http://www.emailbattles.com/2006/04/24/other_aadehidhca_ia/) which had keypads that can be rotated vertically. My wrists were much happier after that. I detailed my efforts battling a bad case of RSI here: http://blog.chromarati.com/2010/04/rsi-my-problem-child-10-tips-for.html http://blog.chromarati.com/2010/04/rsi-my-problem-child-10-t...
m_eiman 16y ago
It's not actually about "How the technique works", it's more "This book worked for me, but I'm not going to give you even a slight hint about how so go buy the book". Anyone have a link to the actual "How" part?
- paulbaumgart 16y ago
  http://podolsky.everybody.org/rsi/ http://podolsky.everybody.org/rsi/ has a summary. The book is worth reading. It worked for curing similar wrist pain that I suffered starting about 1.5 years ago. I actually managed to cure it just by reading about Dr. Sarno's ideas online, as unlikely as that sounds. I bought the book, after, though, to get more details. I think he takes it too far in terms of the types of ailments to which he ascribes a purely psychological origin. But I was definitely impressed with how effective his explanation/techniques were for wrist pain.
pytxab 16y ago
This article basically describes my experience exactly. If you have been told you have RSI, do NOT ignore this possibility.
kqr2 16y ago
Amazon link to book: http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pain/dp/0446675156 http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pai...
Tichy 16y ago
What has helped me is Yoga.
- mattchew 16y ago
  I used Sarno's methods to get over my RSI. But I could see yoga addressing some of the same underlying issues (anxiety and chronic tension) and solving the problem from a different angle.
usaar333 16y ago
I have tendinitis in my wrists to the point that I need to wear braces whenever I use a computer. I'm pretty skeptical of his claims, though I too agree with what he notes as useless. The only thing that has worked for me has been strengthening my wrists. I do about 600 reps a day (variety of axes and loads) and it has stabilized my RSI. Oh - and I make sure that my keyboard is rather low.
- paulbaumgart 16y ago
  Have you tried it? I'm interested to hear from people who tried following Dr. Sarno's advice but didn't have any success with it. It gives me a better idea for how much certainty I should claim when I advise others to try it. :-)
ErrantX 16y ago
Im still sceptical :) Less, though, than when I opened the article; I have independently noticed my RSI worsens when stressed. Im not sure I buy the mumbo jumbo about the solution as much as I buy the explanation of why stress could affect it. I use a powerball daily which has really helped. Saw the same issues with massage that the article writer had (short term fix) but it feels really great so I stuck with that=. But the powerball seems to really keep it in bay (I think it is the rotational stuff that helps). When really stressed I do pull ups and press ups to stretch the relevant muscles.
- gtani 16y ago
  I think you're talking about the DynaFlex, which helped me quite a bit: http://www.thinkgeek.com/gadgets/electronic/6a4b/ http://www.thinkgeek.com/gadgets/electronic/6a4b/ Also the powerWeb and the wrist roller: http://www.amazon.com/GoFit-GF-WFB-Wrist-Forearm-Blaster/dp/B0007W2FJA/ http://www.amazon.com/GoFit-GF-WFB-Wrist-Forearm-Blaster/dp/... http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx Also, computer time means the smallest mouse i can find with decent action (Logitech, no model number I can find), and switching between Apple and Matias keyboards (short-travel and long, respectively) and carefully setting the tilt angle of the keyboard and height under heels of my hands (rolled up towel)
  - ErrantX 16y ago
    Yeh that seems to be the one; they are just branded powerball over here. Really therapeutic.
- thingie 16y ago
  I have no problem in believing that things like this can help with the pain (a lot). But still, author says that now he is able to type in any uncomfortable position for as long as he wants, and it sounds little scary. "See? I don't feel any pain, it's great." Well, wasn't there some reason for that pain in the first place? Maybe you feel great, but still, are you sure that you aren't permanently hurting your own body? RSI isn't just a state of mind…
Raphael 16y ago
A gripping tale of medical mystery.
mwerty 16y ago
link to book is broken
simonw 16y ago
Chiropractor, Hand Surgeons, Acupuncture, Massage... what's missing here is a physiotherapist. My girlfriend suffered from career threatening RSI (though RSI is actually a pretty useless term, since it works as an umbrella term for dozens of completely different possible problems). We found her a physio but they didn't really help. Then we found her an excellent physio (recommended by numerous friends) who spent 6 months fixing her. She can now type for 7 hours a day, provided she has at least one day a week with no typing at all. That's going from being unable to type for more than 5 minutes without searing pain. We've referred a bunch of other friends to that same physio, all with excellent results. If you're anywhere near Brighton, UK drop me a line and I'll send you her details. If you need to find your own physio, be aware that just like anything you should be ready to shop around for one. Personal recommendations from fellow RSI sufferers are incredibly useful here.
- dasil003 16y ago
  No doubt. I had RSI start to creep up on me when I was 25 and the first thing I did was get a referral from my HMO to a physical therapist. I got some simple exercises with a band, and I was cured entirely for a couple years. These past few years it's come back a little bit, but at worst it's mild discomfort, and I keep it in check with weight lifting and mountain biking. In my case I'm entirely convinced that building wrist strength is the key. What this guy experienced definitely sounds different though, but it's shocking that he never tried one of the most basic solutions.
- jason114 16y ago
  Comment so SimonW I have been having wrist problems for about 6 months now, i live in Worthing and would really appreciate the details on the physio you recommend in brighton Thanks .
lispm 16y ago
sacrifice of a few chickens will also help
- paulbaumgart 16y ago
  Since it seems to be psychosomatic in origin, this sort of RSI is related to the placebo effect. It makes sense to me that it would be possible to overcome it with some sort of placebo. But I think tackling the underlying emotional issues is a better long-term solution.
shin_lao 16y ago
Well it's nothing new that the mind can cause injuries and even diseases: http://en.wikipedia.org/wiki/Psychosomatic_medicine http://en.wikipedia.org/wiki/Psychosomatic_medicine
zefhous 16y ago
Typing in dvorak decreases finger movement significantly. I recommend it.
- tigerthink 16y ago
  Doesn't work with Vim as well though.
  - tome 16y ago
    I'm sure anyone with the thoughtfulness to enjoy reading Hacker News can think of a solution to the Dvorak/Vim integration problem :)
    - snth 16y ago
      For a while I used Qwerty for insert mode and Dvorak for command mode, but eventually I ended up using Dvorak for everything. My particular hand pain didn't show up until years after I took up Dvorak. My problem is mainly with my pinky fingers, and Dvorak actually seemed to be worse than Qwerty for me, so I've switched back to Qwerty.
  - ZeroGravitas 16y ago
    I learned Dvorak and Vim at the same time and never noticed an issue. Maybe if you've already learned Qwerty Vim there's a transition?
    - dylanz 16y ago
      Yeah, it's a brain@#$%. I did it though, and wouldn't look back.
  - dylanz 16y ago
    Vim works great in Dvorak. I switched to Dvorak, and jumped right in to relearning my Vim keystrokes with it. After a few weeks, I was back to normal in Dvorak, in both typing and Vim.
- 16y ago
vai 16y ago
I actually had chronic RSI (CTS) from the age of 16~ due to studying/practicing music (brass/guitar/piano), and a lesser extent computing. I'd tried pretty much everything in that list, as well as an operation on my right wrist. I won't say nothing worked .. because I was able to go from not being able to hold a pen .. to not being able to hold a plate :) I'd actually given up (both therapy, and Music/Software Engineering) due to nothing seemingly working, and by chance started hitting the gym. As a part of my regular workout I integrated some basic wrist exercises (initially, I think it was wrist curls / reverse wrist curls). So fast forward 10+ years and I now have absolutely zero problems. In hindsight I'm sure it was a combination of all the treatments and building significant forearm strength .. but not one Doctor, or Physiotherapist mentioned physical training as part of the path to recovery/prevention.
_debug_ 16y ago
If the author of this article is reading this : can you please provide a timeline of events? Spreadsheet with column A = date, column B = event, column C = number of hours per day of typing at this point. Events include {Started Acupuncture, Started using ergonomic product A, EtherPad acquired}, etc; I wish to exclude these 2 possible reasons for the cure: a) a simple reduction in the number of hours on the keyboard b) the acquisition of your start-up, which may have released a lot of mental stress
- fredoliveira 16y ago
  no wonder your name at HN is _debug_
  - _debug_ 16y ago
    :-))
stretchwithme 16y ago
massage usually only provides a temporary benefit because it releases the tension in the muscles, but does nothing to keep it from returning. The stiffness in muscles is ultimately caused by poor circulation through the muscle. The sarcomeres pump their own blood supply and if the demand is greater than the supply, the sarcomere can run out of energy in its contracted position. This contraction shortens the entire muscles when many sarcomeres are affected. New blood cannot enter the sarcomeres until something pushes out the depleted blood. Massage can do this, but massage will not correct the poor circulation that caused the stiffness to begin with. And that circulation problem is usually caused muscle sheaths that have not been stretched frequently enough. The body's natural collagen deposition essentially gluing it to itself so that it cannot expand or stretch normally. This creates a tight situation when you use the muscle inside of this sheath. The muscle is thicker when contracted and pushes out against this sheath. That creates pressure and blood takes the path of least resistance away from your tight muscle. The tightness inside the muscle must be massaged and then the sheath must be manipulated and stretched. Otherwise, the sheath is too stiff due to the stiff, thick muscle inside it. Further compounding the situation is the way tense muscles effect other muscles and spread the problem. Muscles work together and communicate that a load needs to be moved. A great system when things are healthy, but a permanent source of stress that will thwart efforts just limited to a muscle and its sheath.
pxlpshr 16y ago
I believe it. My dad had chronic lower back pain most of his later life and by no surprise, he also had high anxiety and stress. He read something similar about TMP about 15 years ago after tiring of pain killers, this was around the time he began studying Buddhism to help with stress. Ever since he's been in a lot better shape.
AndrewDucker 16y ago
It doesn't surprise me. I know that I'm more likely to put my back out or pull a muscle when I'm stressed. I hold myself differently, and my movements are also less smooth.
ZeroGravitas 16y ago
I find it interesting that he got great relief from acupuncture, which has been fairly well studied and found to have no benefit beyond a totally untrained person pretending to stick needles into you. Certainly points towards it being psychosomatic.
rabidgnat 16y ago
If you have RSI typing pain and haven't treated it, spend a whole day typing with wrist braces. It convinced me to switch CTRL and CAPS LOCK on my keyboard. I love keyboard shortcuts, and bending my wrist to hit CTRL was causing my left pinkie to go numb. I also have 'evasive action' that works well. When I feel pain typing, I immediately stop and give the offending hand a workout with a stress ball for 5 minutes. Then I massage the tendons in my forearm and then stretch my wrist on all axes. I haven't had significant RSI pain in a few years, and at this point I'm not brave enough to test which part of the routine helps most :D
- viggity 16y ago
  I've had really good luck with switching most of the shortcuts I use to use ALT instead of CTRL. ALT is much easier to reach with your left hand than CTRL.
grrrr 16y ago
I have suffered from RSI repeatedly over the years. I use an ergonomic microsoft keyboard, and this really helps. However what made the biggest difference was when I started using a Logitech Mouseman Marble mouse. The pain in my right arm/wrist vanished. I will never use a normal mouse again.
deleted 16y ago
[deleted]
bensummers 16y ago
Here's my list of things which helped me: Logitech Mouseman Marble, the flat Apple keyboards, regular Pilates, and a conscious effort to sit up straight while typing.
RyanMcGreal 16y ago
The link to "The MindBody Prescription" is broken: http://aaroniba.net/articles/tmp/.. http://aaroniba.net/articles/tmp/...
mikeklaas 16y ago
His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time. After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again. Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal. Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse. For a more medical take, some pieces are conveyed in this article: http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them. If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon. I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.
godDLL 16y ago
[…]You can eliminate the pain by addressing the unconscious stress and becoming consciously aware that the pain is merely a distraction[…] This sounds a whole lot like Dzogchen meditation practices, their way of cleansing the mental palette, achieving "mindfulness". I remember faintly reading a book my one Norbu Chogyal, or a russian translation of said book. I remember it being the only coherent piece of material on meditation that I have ever come across.
mumrah 16y ago
I had very similar symptoms to this guy (pain starting in the wrists and then forearms/elbows). I have adjusted my typing habits and daily routine as follows: * Exercise arms with light weights (~10lbs) * Adjusted chair height * Started using a real keyboard (I think typing on a MBP for extended periods was a big contributor to my RSI) * Drink more water, get better sleep, get some kind of exercise These days, I don't notice any kind of RSI pains. I think generally, RSI (for a typist) is due to combinations of stress, poor posture, lack of general wellness, etc.
- wizard_2 16y ago
  The touch pad on the MBP causes me a lot of pain as well. I started carrying around a Microsoft IntelliMouse Explorer and had the touchpad turn off when a mouse is plugged in. I'm now able to type for long periods of time without killing my wrist or thumb. (It's still hard to break the habit of tapping the pad with my thumb to click.)
  - technomancy 16y ago
    Avoiding mouse use entirely is even better ergonomically. Bonus: it makes you a lot faster.
matt1 16y ago
This was a great article and it sounds very familiar. On and off for the past two years I've experienced similar pain. (see http://news.ycombinator.com/item?id=889067 http://news.ycombinator.com/item?id=889067). The last three weeks have been particularly bad: I've taken time off, I continue to wear wrist braces at work and at night when I program, I've started doing rigorous hand and wrist exercises daily, and while it has helped a little bit, I still experience a lot of pain. It scares the hell out of me because a lot of my future plans depend on me being able to spend a lot of time programming; without my wrists, I'd be lost. What occurred to me reading this article is that about three weeks ago I found out about an incredible opportunity that may drastically change my life. (Stay at my day job or leave and work on a startup full time). I've spent a lot of time dwelling on it, trying to decide what to do. It can't be just a coincidence that my debilitating wrist pain started at about the same time. I'm going to buy the book. I have high hopes. We'll see what happens.
pwk 16y ago
If I had known about this 14 years ago I would have certainly tried it, I tried many things... the ones that I think were helpful for me are: Ice bathes for my arms: I filled a sink with water and ice and submerged my arms up to the elbows; this was obviously useful for short term pain relief, and might have helped reduce inflammation over the longer term. It was important to wait until the arms were warmed up again before going back to typing. Keeping fingernails well trimmed; surprising, but it made a big difference. Massage; I think it was through massage that I started realizing that even though my symptoms were in the wrists the problem was probably more systemic, it's amazing how much pain a good massage can discover in surprising places! Stretching; stretching the wrists felt immediately good, as did standing in a doorway, arms on the door frame, and leaning forward. Working on the hamstrings probably helped longer term. Weight lifting, particularly exercises that strengthened the back; lots of people have mentioned it here, and I credit this for being the biggest long term help.
mattchew 16y ago
I'm another guy who had RSI and eventually got better by using Sarno's methods. Sarno's ideas are a little flakey and a little offputting. But if you have RSI and nothing else seems to help, I recommend swallowing your embarrassment and giving Sarno's approach a real try.
slmbrhrt 16y ago
It may seem small, but adding these lines to my vimrc have entirely broken my habit of scrolling with the arrow keys. map <up> <nop> map <down> <nop> map <left> <nop> map <right> <nop> imap <up> <nop> imap <down> <nop> imap <left> <nop> imap <right> <nop> It may seem irritating at first, but in the end I argue it's worth it.
- spudlyo 16y ago
  That's a good way of training yourself, I weened myself off the left-pinky control key by doing the same thing. I now press it with my left thumb - which is easy on my new Kinesis keyboard. Moving your hands off home row to hit arrow keys also slows you down. It adds about 500ms latency to your workflow every time you do it.
- akkartik 16y ago
  I actually trained myself to use the arrow keys because of my RSI. Moving my hands away from the home row slowed my typing down a touch and alleviates some of the constant pressure on the fingertips. But now that my RSI is manageable as well (two words: wrist breaks) perhaps I should try going back to hjkl.
- kirubakaran 16y ago
  Emacs: (for easy copy-paste into your .emacs) (global-unset-key [left]) (global-unset-key [right]) (global-unset-key [up]) (global-unset-key [down]) (global-unset-key [prior]) (global-unset-key [next]) (global-unset-key [home]) (global-unset-key [end])
jonstjohn 16y ago
I had an interesting experience with pinky finger RSI. After well over a year of pain and experimenting with different keyboards (such as the Kinesis, which I highly recommend), I discovered that part of the problem was resting my elbows on my arm rests. By restricting some of the blood flow to my fingers by pressing on the elbow nerve, I was developing cubital tunnel syndrome. Within a week or so after lowering my arm rests, I felt a ton better. Several months later, pain returns only rarely. I also love my Kinesis keyboard, too. It is well worth the price if you want to continue programming for decades. After discovering what was causing the pain, it helped me recover quickly and prevent it from occurring again. I haven't read many posts on this solution, but want to remind people to examine all aspects of their ergonomic setup, not just the source of the pain (e.g., hand/fingers).
msb 16y ago
Assuming that the techniques the author describes really work, is it any different from taking a pill to relieve the pain? I tend to operate under the assumption that when our bodies present us with pain, then we are doing something to deserve it. Instead of attempting to remove the pain we should be trying to discover what we are doing to cause it. Vacation, chiropractor, surgeons, acupuncture, massage, micro-breaks...but no exercise? A light dumbbell routine and a few walks or runs per week can work wonders on RSI and any other aches and pains we encounter while at the computer. There is a certain "common knowledge" among computer workers that RSI is the result of poor ergonomics. This fails to explain why some people can work for long periods of time under conditions of atrocious ergonomics, but not experience the same pain that I did. In my experience, an increase in RSI and back pain correlate directly with my level of physical activity outside of the work environment. A combination of fitness and ergonomics have absolutely made the difference.
kadavy 16y ago
Unlike him, I find the Mac program AntiRSI to be really helpful - not only for resting my hands, but also my mind: http://tech.inhelsinki.nl/antirsi/ http://tech.inhelsinki.nl/antirsi/
jason114 16y ago
Comment to SimonW I have been having wrist problems for about 6 months now, i live in Worthing and would really appreciate the details on the physio you recommend in brighton Thanks .

99 points by prakash 16y ago

I too, encountered crippling RSI pain, and eventually switched to a kinesis keyboard (http://www.kinesis-ergo.com http://www.kinesis-ergo.com). While the keyboards are crazy expensive, and a bit flaky, they completely cured my carpal tunnel. The downside is, I'm now stuck hauling around this weird, non-standard keyboard. :)

Luc 16y ago
Same here. Had nasty pains in both wrists and tried a lot of things until I finally purchased a Kinesis (the current model is this one: http://www.kinesis-ergo.com/advantage_pro.htm http://www.kinesis-ergo.com/advantage_pro.htm ) and a Kensington Epert Mouse trackball. I had to learn to type again, but am now faster and completely pain-free for about 6 years.
- sokoloff 16y ago
  Very similar experience here; bought myself a Kinesis for home and one for work (I'm sure they'd have paid for it, but I couldn't be bothered). It was quite possibly the best $600 I've ever spent. I don't mouse enough to have yet bothered with the trackball, but perhaps I'll get one to try it out. The only downside I've found (other than cost, which is a non-issue IMO) is that you get very used to the keyboard and now when I go to a conference room or someplace else with normal keyboards, I might as well be typing with my elbows.
  - jonstjohn 16y ago
    I keep a kinesis at work and a standard keyboard at home. Now I'm so used to using both that I can type just as fast on either one.
slug 16y ago
I've actually never had any serious problems with my wrists, and sometimes I think that starting playing piano as a young kid, along with my guitar today, and with regular trips to the swimming pool and daily bike commute, helps keeping my wrists strong and pain free. I've been using a kinesis freestyle keyboard for about a year, and before that a series of regular chepo 102 keys, but the possibility of having my hands apart a longer distance keeps my wrists more relaxed and overall I get a better body posture. I think most of the problems other people have come from the latter: my elbows are on top of the table, which means my keyboard is farther away than what I see other people using and so I'm in a very relaxed position. The ubiquity of laptop's small keyboards certainly doesn't help either.
Terretta 16y ago
I'm partial to the GoldTouch keyboards: http://www.goldtouch.com/p-133-goldtouch-for-mac-adjustable-keyboard-black.aspx http://www.goldtouch.com/p-133-goldtouch-for-mac-adjustable-... Because they're close enough to the regular keyboards, while offering both the split (match natural forearm angle) and the tilt (match natural forearm rotation) to better align natural wrist position. I also like that they ditch the numeric keyboad, so I can put the Kensington ExpertMouse just to the right of the return key and not have to move my hand as far.
msb 16y ago
I have to put my vote in for the Kinesis Advantage as well. For anyone reading this that might be on the fence about the cost, you will not be disappointed. I was suffering from excruciating pain in my forearms, wrists and fingers. That pain disappeared almost as soon as I started using the Kinesis. For me, the big difference is having a wide split between home rows. This keeps my arms almost completely parallel and alleviates the forearm pain. The key layout is a little funky at first, but what I have realized is that each individual key is positioned exactly where your fingers naturally curl and extend. The other change I made was to add a trackball. I keep the trackball on the left and my regular mouse on the right and switch up usage as often as I can.
dagobart 16y ago
I did the exact opposite--one time I came across a very cheap keyboard with the keys wobbly and floppy. Was a relief to my hands. Since then, as long as I used standalone keyboards I bought cheap keyboards where the situation of my fingertips hitting the key caps was that the caps evaded my fingers a little and required some kind-of adjusting of my finger movements to the individual key once my fingertips hit the key in question. I guess the added movement helped to relax my fingers.
shard 16y ago
I switched to an ErgoLogic keyboard (no longer made but looks like this: http://www.emailbattles.com/2006/04/24/other_aadehidhca_ia/ http://www.emailbattles.com/2006/04/24/other_aadehidhca_ia/) which had keypads that can be rotated vertically. My wrists were much happier after that. I detailed my efforts battling a bad case of RSI here: http://blog.chromarati.com/2010/04/rsi-my-problem-child-10-tips-for.html http://blog.chromarati.com/2010/04/rsi-my-problem-child-10-t...

m_eiman 16y ago

It's not actually about "How the technique works", it's more "This book worked for me, but I'm not going to give you even a slight hint about how so go buy the book". Anyone have a link to the actual "How" part?

paulbaumgart 16y ago
http://podolsky.everybody.org/rsi/ http://podolsky.everybody.org/rsi/ has a summary. The book is worth reading. It worked for curing similar wrist pain that I suffered starting about 1.5 years ago. I actually managed to cure it just by reading about Dr. Sarno's ideas online, as unlikely as that sounds. I bought the book, after, though, to get more details. I think he takes it too far in terms of the types of ailments to which he ascribes a purely psychological origin. But I was definitely impressed with how effective his explanation/techniques were for wrist pain.

pytxab 16y ago

This article basically describes my experience exactly. If you have been told you have RSI, do NOT ignore this possibility.

kqr2 16y ago

Amazon link to book: http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pain/dp/0446675156 http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pai...

Tichy 16y ago

What has helped me is Yoga.

mattchew 16y ago
I used Sarno's methods to get over my RSI. But I could see yoga addressing some of the same underlying issues (anxiety and chronic tension) and solving the problem from a different angle.

usaar333 16y ago

I have tendinitis in my wrists to the point that I need to wear braces whenever I use a computer. I'm pretty skeptical of his claims, though I too agree with what he notes as useless. The only thing that has worked for me has been strengthening my wrists. I do about 600 reps a day (variety of axes and loads) and it has stabilized my RSI. Oh - and I make sure that my keyboard is rather low.

paulbaumgart 16y ago
Have you tried it? I'm interested to hear from people who tried following Dr. Sarno's advice but didn't have any success with it. It gives me a better idea for how much certainty I should claim when I advise others to try it. :-)

ErrantX 16y ago

Im still sceptical :) Less, though, than when I opened the article; I have independently noticed my RSI worsens when stressed. Im not sure I buy the mumbo jumbo about the solution as much as I buy the explanation of why stress could affect it. I use a powerball daily which has really helped. Saw the same issues with massage that the article writer had (short term fix) but it feels really great so I stuck with that=. But the powerball seems to really keep it in bay (I think it is the rotational stuff that helps). When really stressed I do pull ups and press ups to stretch the relevant muscles.

gtani 16y ago
I think you're talking about the DynaFlex, which helped me quite a bit: http://www.thinkgeek.com/gadgets/electronic/6a4b/ http://www.thinkgeek.com/gadgets/electronic/6a4b/ Also the powerWeb and the wrist roller: http://www.amazon.com/GoFit-GF-WFB-Wrist-Forearm-Blaster/dp/B0007W2FJA/ http://www.amazon.com/GoFit-GF-WFB-Wrist-Forearm-Blaster/dp/... http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx http://www.fitter1.com/Catalog/Category/35/HandWrist.aspx Also, computer time means the smallest mouse i can find with decent action (Logitech, no model number I can find), and switching between Apple and Matias keyboards (short-travel and long, respectively) and carefully setting the tilt angle of the keyboard and height under heels of my hands (rolled up towel)
- ErrantX 16y ago
  Yeh that seems to be the one; they are just branded powerball over here. Really therapeutic.
thingie 16y ago
I have no problem in believing that things like this can help with the pain (a lot). But still, author says that now he is able to type in any uncomfortable position for as long as he wants, and it sounds little scary. "See? I don't feel any pain, it's great." Well, wasn't there some reason for that pain in the first place? Maybe you feel great, but still, are you sure that you aren't permanently hurting your own body? RSI isn't just a state of mind…

Raphael 16y ago

A gripping tale of medical mystery.

mwerty 16y ago

link to book is broken

simonw 16y ago

Chiropractor, Hand Surgeons, Acupuncture, Massage... what's missing here is a physiotherapist. My girlfriend suffered from career threatening RSI (though RSI is actually a pretty useless term, since it works as an umbrella term for dozens of completely different possible problems). We found her a physio but they didn't really help. Then we found her an excellent physio (recommended by numerous friends) who spent 6 months fixing her. She can now type for 7 hours a day, provided she has at least one day a week with no typing at all. That's going from being unable to type for more than 5 minutes without searing pain. We've referred a bunch of other friends to that same physio, all with excellent results. If you're anywhere near Brighton, UK drop me a line and I'll send you her details. If you need to find your own physio, be aware that just like anything you should be ready to shop around for one. Personal recommendations from fellow RSI sufferers are incredibly useful here.

dasil003 16y ago
No doubt. I had RSI start to creep up on me when I was 25 and the first thing I did was get a referral from my HMO to a physical therapist. I got some simple exercises with a band, and I was cured entirely for a couple years. These past few years it's come back a little bit, but at worst it's mild discomfort, and I keep it in check with weight lifting and mountain biking. In my case I'm entirely convinced that building wrist strength is the key. What this guy experienced definitely sounds different though, but it's shocking that he never tried one of the most basic solutions.
jason114 16y ago
Comment so SimonW I have been having wrist problems for about 6 months now, i live in Worthing and would really appreciate the details on the physio you recommend in brighton Thanks .

lispm 16y ago

sacrifice of a few chickens will also help

paulbaumgart 16y ago
Since it seems to be psychosomatic in origin, this sort of RSI is related to the placebo effect. It makes sense to me that it would be possible to overcome it with some sort of placebo. But I think tackling the underlying emotional issues is a better long-term solution.

shin_lao 16y ago

Well it's nothing new that the mind can cause injuries and even diseases: http://en.wikipedia.org/wiki/Psychosomatic_medicine http://en.wikipedia.org/wiki/Psychosomatic_medicine

zefhous 16y ago

Typing in dvorak decreases finger movement significantly. I recommend it.

tigerthink 16y ago
Doesn't work with Vim as well though.
- tome 16y ago
  I'm sure anyone with the thoughtfulness to enjoy reading Hacker News can think of a solution to the Dvorak/Vim integration problem :)
  - snth 16y ago
    For a while I used Qwerty for insert mode and Dvorak for command mode, but eventually I ended up using Dvorak for everything. My particular hand pain didn't show up until years after I took up Dvorak. My problem is mainly with my pinky fingers, and Dvorak actually seemed to be worse than Qwerty for me, so I've switched back to Qwerty.
- ZeroGravitas 16y ago
  I learned Dvorak and Vim at the same time and never noticed an issue. Maybe if you've already learned Qwerty Vim there's a transition?
  - dylanz 16y ago
    Yeah, it's a brain@#$%. I did it though, and wouldn't look back.
- dylanz 16y ago
  Vim works great in Dvorak. I switched to Dvorak, and jumped right in to relearning my Vim keystrokes with it. After a few weeks, I was back to normal in Dvorak, in both typing and Vim.
16y ago

vai 16y ago

I actually had chronic RSI (CTS) from the age of 16~ due to studying/practicing music (brass/guitar/piano), and a lesser extent computing. I'd tried pretty much everything in that list, as well as an operation on my right wrist. I won't say nothing worked .. because I was able to go from not being able to hold a pen .. to not being able to hold a plate :) I'd actually given up (both therapy, and Music/Software Engineering) due to nothing seemingly working, and by chance started hitting the gym. As a part of my regular workout I integrated some basic wrist exercises (initially, I think it was wrist curls / reverse wrist curls). So fast forward 10+ years and I now have absolutely zero problems. In hindsight I'm sure it was a combination of all the treatments and building significant forearm strength .. but not one Doctor, or Physiotherapist mentioned physical training as part of the path to recovery/prevention.

_debug_ 16y ago

If the author of this article is reading this : can you please provide a timeline of events? Spreadsheet with column A = date, column B = event, column C = number of hours per day of typing at this point. Events include {Started Acupuncture, Started using ergonomic product A, EtherPad acquired}, etc; I wish to exclude these 2 possible reasons for the cure: a) a simple reduction in the number of hours on the keyboard b) the acquisition of your start-up, which may have released a lot of mental stress

fredoliveira 16y ago
no wonder your name at HN is _debug_
- _debug_ 16y ago
  :-))

stretchwithme 16y ago

massage usually only provides a temporary benefit because it releases the tension in the muscles, but does nothing to keep it from returning. The stiffness in muscles is ultimately caused by poor circulation through the muscle. The sarcomeres pump their own blood supply and if the demand is greater than the supply, the sarcomere can run out of energy in its contracted position. This contraction shortens the entire muscles when many sarcomeres are affected. New blood cannot enter the sarcomeres until something pushes out the depleted blood. Massage can do this, but massage will not correct the poor circulation that caused the stiffness to begin with. And that circulation problem is usually caused muscle sheaths that have not been stretched frequently enough. The body's natural collagen deposition essentially gluing it to itself so that it cannot expand or stretch normally. This creates a tight situation when you use the muscle inside of this sheath. The muscle is thicker when contracted and pushes out against this sheath. That creates pressure and blood takes the path of least resistance away from your tight muscle. The tightness inside the muscle must be massaged and then the sheath must be manipulated and stretched. Otherwise, the sheath is too stiff due to the stiff, thick muscle inside it. Further compounding the situation is the way tense muscles effect other muscles and spread the problem. Muscles work together and communicate that a load needs to be moved. A great system when things are healthy, but a permanent source of stress that will thwart efforts just limited to a muscle and its sheath.

pxlpshr 16y ago

I believe it. My dad had chronic lower back pain most of his later life and by no surprise, he also had high anxiety and stress. He read something similar about TMP about 15 years ago after tiring of pain killers, this was around the time he began studying Buddhism to help with stress. Ever since he's been in a lot better shape.

AndrewDucker 16y ago

It doesn't surprise me. I know that I'm more likely to put my back out or pull a muscle when I'm stressed. I hold myself differently, and my movements are also less smooth.

ZeroGravitas 16y ago

I find it interesting that he got great relief from acupuncture, which has been fairly well studied and found to have no benefit beyond a totally untrained person pretending to stick needles into you. Certainly points towards it being psychosomatic.

rabidgnat 16y ago

If you have RSI typing pain and haven't treated it, spend a whole day typing with wrist braces. It convinced me to switch CTRL and CAPS LOCK on my keyboard. I love keyboard shortcuts, and bending my wrist to hit CTRL was causing my left pinkie to go numb. I also have 'evasive action' that works well. When I feel pain typing, I immediately stop and give the offending hand a workout with a stress ball for 5 minutes. Then I massage the tendons in my forearm and then stretch my wrist on all axes. I haven't had significant RSI pain in a few years, and at this point I'm not brave enough to test which part of the routine helps most :D

viggity 16y ago
I've had really good luck with switching most of the shortcuts I use to use ALT instead of CTRL. ALT is much easier to reach with your left hand than CTRL.

grrrr 16y ago

I have suffered from RSI repeatedly over the years. I use an ergonomic microsoft keyboard, and this really helps. However what made the biggest difference was when I started using a Logitech Mouseman Marble mouse. The pain in my right arm/wrist vanished. I will never use a normal mouse again.

deleted 16y ago

[deleted]

bensummers 16y ago

Here's my list of things which helped me: Logitech Mouseman Marble, the flat Apple keyboards, regular Pilates, and a conscious effort to sit up straight while typing.

RyanMcGreal 16y ago

The link to "The MindBody Prescription" is broken: http://aaroniba.net/articles/tmp/.. http://aaroniba.net/articles/tmp/...

mikeklaas 16y ago

His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time. After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again. Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal. Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse. For a more medical take, some pieces are conveyed in this article: http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them. If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon. I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.

godDLL 16y ago

[…]You can eliminate the pain by addressing the unconscious stress and becoming consciously aware that the pain is merely a distraction[…] This sounds a whole lot like Dzogchen meditation practices, their way of cleansing the mental palette, achieving "mindfulness". I remember faintly reading a book my one Norbu Chogyal, or a russian translation of said book. I remember it being the only coherent piece of material on meditation that I have ever come across.

mumrah 16y ago

I had very similar symptoms to this guy (pain starting in the wrists and then forearms/elbows). I have adjusted my typing habits and daily routine as follows: * Exercise arms with light weights (~10lbs) * Adjusted chair height * Started using a real keyboard (I think typing on a MBP for extended periods was a big contributor to my RSI) * Drink more water, get better sleep, get some kind of exercise These days, I don't notice any kind of RSI pains. I think generally, RSI (for a typist) is due to combinations of stress, poor posture, lack of general wellness, etc.

wizard_2 16y ago
The touch pad on the MBP causes me a lot of pain as well. I started carrying around a Microsoft IntelliMouse Explorer and had the touchpad turn off when a mouse is plugged in. I'm now able to type for long periods of time without killing my wrist or thumb. (It's still hard to break the habit of tapping the pad with my thumb to click.)
- technomancy 16y ago
  Avoiding mouse use entirely is even better ergonomically. Bonus: it makes you a lot faster.

matt1 16y ago

This was a great article and it sounds very familiar. On and off for the past two years I've experienced similar pain. (see http://news.ycombinator.com/item?id=889067 http://news.ycombinator.com/item?id=889067). The last three weeks have been particularly bad: I've taken time off, I continue to wear wrist braces at work and at night when I program, I've started doing rigorous hand and wrist exercises daily, and while it has helped a little bit, I still experience a lot of pain. It scares the hell out of me because a lot of my future plans depend on me being able to spend a lot of time programming; without my wrists, I'd be lost. What occurred to me reading this article is that about three weeks ago I found out about an incredible opportunity that may drastically change my life. (Stay at my day job or leave and work on a startup full time). I've spent a lot of time dwelling on it, trying to decide what to do. It can't be just a coincidence that my debilitating wrist pain started at about the same time. I'm going to buy the book. I have high hopes. We'll see what happens.

pwk 16y ago

If I had known about this 14 years ago I would have certainly tried it, I tried many things... the ones that I think were helpful for me are: Ice bathes for my arms: I filled a sink with water and ice and submerged my arms up to the elbows; this was obviously useful for short term pain relief, and might have helped reduce inflammation over the longer term. It was important to wait until the arms were warmed up again before going back to typing. Keeping fingernails well trimmed; surprising, but it made a big difference. Massage; I think it was through massage that I started realizing that even though my symptoms were in the wrists the problem was probably more systemic, it's amazing how much pain a good massage can discover in surprising places! Stretching; stretching the wrists felt immediately good, as did standing in a doorway, arms on the door frame, and leaning forward. Working on the hamstrings probably helped longer term. Weight lifting, particularly exercises that strengthened the back; lots of people have mentioned it here, and I credit this for being the biggest long term help.

mattchew 16y ago

I'm another guy who had RSI and eventually got better by using Sarno's methods. Sarno's ideas are a little flakey and a little offputting. But if you have RSI and nothing else seems to help, I recommend swallowing your embarrassment and giving Sarno's approach a real try.

slmbrhrt 16y ago

It may seem small, but adding these lines to my vimrc have entirely broken my habit of scrolling with the arrow keys. map <up> <nop> map <down> <nop> map <left> <nop> map <right> <nop> imap <up> <nop> imap <down> <nop> imap <left> <nop> imap <right> <nop> It may seem irritating at first, but in the end I argue it's worth it.

spudlyo 16y ago
That's a good way of training yourself, I weened myself off the left-pinky control key by doing the same thing. I now press it with my left thumb - which is easy on my new Kinesis keyboard. Moving your hands off home row to hit arrow keys also slows you down. It adds about 500ms latency to your workflow every time you do it.
akkartik 16y ago
I actually trained myself to use the arrow keys because of my RSI. Moving my hands away from the home row slowed my typing down a touch and alleviates some of the constant pressure on the fingertips. But now that my RSI is manageable as well (two words: wrist breaks) perhaps I should try going back to hjkl.
kirubakaran 16y ago
Emacs: (for easy copy-paste into your .emacs) (global-unset-key [left]) (global-unset-key [right]) (global-unset-key [up]) (global-unset-key [down]) (global-unset-key [prior]) (global-unset-key [next]) (global-unset-key [home]) (global-unset-key [end])

jonstjohn 16y ago

I had an interesting experience with pinky finger RSI. After well over a year of pain and experimenting with different keyboards (such as the Kinesis, which I highly recommend), I discovered that part of the problem was resting my elbows on my arm rests. By restricting some of the blood flow to my fingers by pressing on the elbow nerve, I was developing cubital tunnel syndrome. Within a week or so after lowering my arm rests, I felt a ton better. Several months later, pain returns only rarely. I also love my Kinesis keyboard, too. It is well worth the price if you want to continue programming for decades. After discovering what was causing the pain, it helped me recover quickly and prevent it from occurring again. I haven't read many posts on this solution, but want to remind people to examine all aspects of their ergonomic setup, not just the source of the pain (e.g., hand/fingers).

msb 16y ago

Assuming that the techniques the author describes really work, is it any different from taking a pill to relieve the pain? I tend to operate under the assumption that when our bodies present us with pain, then we are doing something to deserve it. Instead of attempting to remove the pain we should be trying to discover what we are doing to cause it. Vacation, chiropractor, surgeons, acupuncture, massage, micro-breaks...but no exercise? A light dumbbell routine and a few walks or runs per week can work wonders on RSI and any other aches and pains we encounter while at the computer. There is a certain "common knowledge" among computer workers that RSI is the result of poor ergonomics. This fails to explain why some people can work for long periods of time under conditions of atrocious ergonomics, but not experience the same pain that I did. In my experience, an increase in RSI and back pain correlate directly with my level of physical activity outside of the work environment. A combination of fitness and ergonomics have absolutely made the difference.

kadavy 16y ago

Unlike him, I find the Mac program AntiRSI to be really helpful - not only for resting my hands, but also my mind: http://tech.inhelsinki.nl/antirsi/ http://tech.inhelsinki.nl/antirsi/

jason114 16y ago

Comment to SimonW I have been having wrist problems for about 6 months now, i live in Worthing and would really appreciate the details on the physio you recommend in brighton Thanks .