8 ms·

How I Cured my RSI Pain (2010)

106 points by vsbuffalo 13y ago

zmitri 13y ago
For what it's worth, I read this recommendation a year or so a go and it helped a lot despite my initial skepticism. It's mostly a mindful awareness thing.
skore 13y ago
"Relax" to ease pain stemming from tension. Who would've thought.
- pawrvx 13y ago
  It's actually hard to impossible to relax when you don't know the source of the tension. Finding that tension within a network of hundreds of billions of neurons can be like finding a single sand on the beach. Worse, as time goes on you tend to compensate instead of resolving the root cause, leading to an increasingly complex web which you have to untangle first before being able to reach the root cause. Most people die before any of the above is accomplished.
  - jakebellacera 13y ago
    This is why I think that the methods taught in this book seem to work for some people. When you're stressed beyond all means and don't deal with it mentally, the tension you give yourself causes physical harm. Sort of like how stress can cause you to grind your teeth at night. Dealing with your problems and just simply relaxing can help tremendously.
- mattm 13y ago
  When you're deep inside a problem of many years, sometimes the simple solutions get easily overlooked.
zwegner 13y ago
I'm another person cured of RSI by the same approach. Initially, when learning of TMS, the RSI got worse (progressing from just constant pain to feelings of numbness and nerve damage). Certainly worth a look if you have RSI--clearly if people can be cured more or less overnight by just reading, there's SOME mental component, whether or not Dr. Sarno's explanations of the mechanisms of TMS are correct.
- typpo 13y ago
  Me too. I spent about a year after college in constant pain from carpal tunnel and sciatica. Even basic actions like opening a door were extremely painful. I blew a lot of money on ergonomic equipment, PT, steroidal treatments, and was strongly considering surgery until I treated my chronic pain as TMS. My desk setup has not changed at all but I've been completely pain free for about a year now. It was eye-opening to realize that such severe pain, which inhibited simple daily activities, could be entirely psychosomatic. The nocebo effect[1] is a well-documented phenomenon that is closely related. When you expect an autonomic symptom, you are much more likely to experience it. [1] http://www.nytimes.com/2012/08/12/opinion/sunday/beware-the-nocebo-effect.html http://www.nytimes.com/2012/08/12/opinion/sunday/beware-the-...
plainOldText 13y ago
Thank you for sharing. It's always great to learn about effective strategies to deal with/cure RSI; especially when so many said cures are failing. Already ordered the book, and I hope I won't be disappointed :)
leashless 13y ago
Two words: music physiotherapists. Musicians get RSI-type problems a lot, and when it's career-ending for a concert pianist, people really pay attention. Plus there's several hundred years of accumulated experience dealing with these problems. I still have fluid around my tendons 20 years later, my RSI was so bad - visible roundness in my forearms - and I haven't had a day of pain in a decade. It took six sessions, and they only worked on my neck. Highly recommended.
- collyw 13y ago
  The Alexander technique is also popular amongst musicians, and there seems to be a lot of overlap with the principles described here.
wam 13y ago
I've been seeing this book pop up all over the place for the past year or so. It seems to be the go-to recommendation from friends to other friends who are frustrated at not finding relief from chronic pain after trying many other treatments. I haven't read the book. All I can say is that the results, from my perspective, have been mixed. Some people who have tried it and not seen their pain alleviated blame themselves for not getting to the root of their stress. I haven't heard of anyone's pain disappearing in 2 weeks. I've heard people recommend it for all kinds of pain, not just muscle and back pain. Claims about its efficacy seem to have broadened over time. The book is set at a very good "it can't hurt to try" price point, and the word of mouth marketing makes it very appealing to people who feel desperate. I am a random person. My experiences are anecdotal.
xenophanes 13y ago
Never read the book, but psychology changes helped my RSI issues tremendously. > if you are unconsciously worried about something (including worried about your wrists hurting while you type), then this can cause your wrists to hurt while you type. This. If you're scared of RSI and scared of typing, that can itself cause problems.
- president 13y ago
  > including worried about your wrists hurting while you type This is the thing that fixed my problem. After trying so many different "methods" and "tricks", I read about this approach on an HN thread a few years ago. I was skeptical in the beginning but now I'm just dumbfounded how effective it was.
- deleted 13y ago
  [deleted]
  - xenophanes 13y ago
    In short, I relaxed and stopped being scared of it. FWIW I also took more breaks, got a better chair and posture, stretched regularly, and especially importantly: became a lot more aware of signs of incoming pain and would take breaks before it started hurting not after. (But lately I'm fine and rarely need any breaks. After some success I stopped being scared.) I think it's completely reasonable that your thoughts have a lot of effect on your body. I don't see anything unscientific about that. Both consciously and unconsciously your brain can move your legs, for example. And a lot of other important stuff. As a comparison, consider running or some other sport. There's often minor aches and pains involved even if you never get anything people would call an "injury". If you had a bad attitude to them and interpreted them as a dangerous injury, I think they could bother you a huge amount. But if you aren't scared of them at all because you have a good understanding of which ones are danger signs and which are nothing to worry about, then the same pains can be no problem. I think novices often make mistakes in both directions. Being overly worried about minor pains is common -- many people quickly give up on running. And trying to ignore major pains is also common and gets people injured. I think both types of mistakes happen (a lot) with RSI and typing too. If you get get your psychology so you don't mind non-dangerous minor pains, but do things about any real problems, then that's good. If you stray to either direction of getting this correct you can cause problems. Sometimes both issues happen. First you get some real pain. You take some breaks and it soon heals and you're OK but now you're scared and start interpreting non-dangerous minor sensations as scary pain. And if you keep going down that path it can escalate. And also if you try to push through while scared of every minor sensation, and type anyway, you're in no condition to understand whether there's anything dangerous going on that needs a break, some stretching, or more. So it's psychologically unpleasant plus you might hurt yourself again. I think it's really valuable to build up more awareness and understanding of your hands/wrists, and have the right way of thinking about the topic. EDIT: i think he deleted while i was writing my post. but basically he just asked for information about the things i talk about.
deleted 13y ago
[deleted]
fabvanso 13y ago
This does not work at all. The causes behind RSI are physical and real.
- AsymetricCom 13y ago
  Then why is there any discussion at all? We already know the solution right? No.
- logn 13y ago
  Somewhere is the many paragraphs of typing he did for this article, he mentions that perhaps fixing the psychological component improves the physical condition. His idea is that mental stress over RSI restricts bloodflow to the parts of the hands/arms that need blood. While I don't buy into this article's theory, I do think that the mind is tightly coupled to the body and that people who draw too many distinctions between the two are misguided. That said, I still seek out good ergonomics personally and think RSI, at least for me, is due to me typing for 12 hours a day. I never worried about RSI until I had pain in my hands the went on for weeks. We can debate until the cows come home about whether the mental stress caused the hand pain or whether the ergonomics caused it--in the end it's the same pain and same RSI and just semantics. If wearing wrist pads eliminates the pain or if telling yourself to not worry makes the pain go away--the physical and mental result is the same. For me, wristpads worked. But I know from experience that stress on the mind and stress on the body is basically the same in many regards.
- jthol 13y ago
  Psychology can play a component though. If you are tense your muscles start off tighter and are easier to fatigue. You are also more likely to be hunched over your keyboard resulting in worse posture. I'm skeptical about the book and the miracle cure side of it but, i don't think psychology can be completely ruled out.
- flatline 13y ago
  Pain is not terribly well understood. I mean, we generally know how nerve impulses convey a signal to the CNS, but how the brain chooses to interpret those signals as "pain" is still something of a mystery. There is an area of research called neuromatrix theory that started out trying to explain phantom limbs, but has possible applications to chronic pain as well. From the little I've read about it, the idea is that the brain can start interpreting normal sensations as painful, or can create sensations that are not there. While this is an actual area if research, unlike Sarno's books, there are some interesting similarities.
Apes 13y ago
Please be careful with this article. It is not remotely skeptical, and seems to be highly biased in the favor of Dr. Sarno's book. Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag. There is not a large amount of unbiased information about Dr Sarno's methods that I could find quickly, but from what is available TMS appears to be a form of alternative medicine that has no basis in science, and instead relies on pseudoscience and the placebo effect. Rather than the pain relief being due to TMS, there is probably a more likely cause behind the result. Perhaps stretching exercises or pain medicine was involved. Or perhaps even just the placebo effect itself. Please read this article for more information. It even contains a brief mention of Dr. Sarno. http://www.sciencebasedmedicine.org/why-do-people-turn-to-alternative-medicine/ http://www.sciencebasedmedicine.org/why-do-people-turn-to-al...
- sillysaurus 13y ago
  Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag. Trying something to check whether it works is orthogonal to being skeptical about it. In fact, it's the heart of science.
  - akiselev 13y ago
    Making very specific predictions via a hypothesis and gathering specific, and plentiful, data that test your predictions is the heart of science. Anecdotes (on which all alternative medicine is based on) do not make good science and "trying something to check whether it works" with a sample size of one is the worst way to do medicine.
    - sillysaurus 13y ago
      Actually, the scientific method is the heart of science, and the method is to check a hypothesis. When the goal is to fix yourself, the only relevant sample size is yourself. And when the problem may be psychological, then placebo effect may fix it, because you believe you've fixed it.
lunix 13y ago
Claims to be sceptical but then: "The first medical specialist I consulted was a chiropractor" Chiropractic was founded by magnetic healer, D.D. Palmer. Magnetic healing is also a pseudoscience but less people take it seriously.
- lunix 13y ago
  He also promotes this book: http://www.amazon.com/4-Hour-Body-Uncommon-Incredible-Superhuman/dp/030746363X http://www.amazon.com/4-Hour-Body-Uncommon-Incredible-Superh... If you look at the reviews you'll get a better understanding.
  - emmelaich 13y ago
    Indeed, it doesn't look good. I don't know how you can be skeptical but then also try chiropractic and acupuncture (without trying a lot of other stuff) The wikipedia talk page is interesting. Here's my personal story about how I conquered my RSI: stopped using Emacs. It helped that I moved from a developer to a sysadmin role. When I do occasionally use Emacs, it's with viper mode.
    - dvdkhlng 13y ago
      After reading multiple comments criticising Emacs for wearing down the hands, there's some more stuff (apart from viper-mode) that makes Emacs use less damaging: * ergo-emacs key bindings (http://ergoemacs.org/features.html http://ergoemacs.org/features.html) * partial-completion-mode * auto-completion (e.g. binding dabbrev-expand to an easy reachable key/combo) * put window/buffer navigation onto easier reachable keys (for me F7, F11 work well) * Make buffer switching smarter by using ido-switch-buffer and ido-find-file instead of the normal switch-buffer and find-file functions (see documentation for ido-mode) * desktop-save-mode so you don't have to repeatedly re-open files after restarting emacs * Using auto-generated boilerplate when creating new files (see Emacs manual for define-auto-insert and friends) * using a Kinesis Advantage keyboard helps with emacs key combos as Ctrl/Alt can be reached via the thumbs without moving the hands. ...
bluesmoon 13y ago
I don't know what's more impressive... the results, or that the top comment on the article is by Jeffrey Friedl. I've communicated with Friedl a bit at Y!, and if he says you changed his life, I believe him.
jongraehl 13y ago
The book helped me try to stress out less about some frightening RSI I had years ago. The speculative mechanical explanation for the "stress -> pain", something like: stress means less oxygenated blood to extremities, was never convincing - more like a dumbo's feather for those skeptical of general mind-body woo. Coincidentally, I got better. That was probably just rest and time, but I'm grateful that the book helped me not worry so much.
bluemetal 13y ago
To anyone suffering significant hand, arm, neck & shoulder pain, I suggest you consider asking your doctor about Thoracic Outlet Syndrome. (https://en.wikipedia.org/wiki/Thoracic_outlet_syndrome https://en.wikipedia.org/wiki/Thoracic_outlet_syndrome) I was diagnosed with bilateral arterial T.O.S. last year after reading about it in a comment on HN. I very recently had corrective surgery on my right side and I hope to have my left side done soon. I was diagnosed when an ultrasound showed full occlusion of my subclavian arteries whenever I lifted my arms (but only when sitting or standing upright, like at my desk, which was not a standard discovery). If anyone has any questions feel free to message me.
bmcleod 13y ago
I suspect what's happening with all the people who this works for is that given there are some people who have a psychological component to their pain and some who have a mostly physical component. Even if there are far fewer suffering from the psychological version, they are the ones who physical treatment will fail for. So they will be the ones that get as far as trying the pseudosciencey approach to dealing with the pain. So the mind body approach will have a high success rate amongst the people trying it even if it would be a terrible initial remedy to try.
- jwr 13y ago
  I am amazed at the shallow thinking of many in this thread who dismiss the story as "quackery". I'd encourage anyone who speaks of a "pseudosciencey approach" to do some careful thinking and propose an approach that would let us measure the effects our minds have on our bodies. So far most people sweep this effect under the rug calling it the "placebo effect" (a catch-all phrase for everything we do not understand). That's not an answer. Notice: we live in the XXI century, and yet we treat our bodies as though our heads were detached and completely independent. Medicine as we know it is based on pills, syringes, vials and knives. Anything else is the "placebo effect" or in the (decidedly non-scientific) domain of psychologists and psychiatrists. I'd call that hiding our head in the sand (double-entendre intended). We do all this while readily accepting that we can sweat, or get diarrhea from nervousness. If people accept that the mind can (subconsciously) control sweating, why can't they accept that it can (subconsciously) control the narrowing of blood vessels? Most people dismiss psychosomatic effects without understanding what they are. Psychosomatic pain isn't any less real. The physical changes are there, they just might not be exactly the changes you are looking for (e.g. no inflammation). And they are caused by the mind, which is why we call them "psychosomatic". But they are not hallucinations, or misfiring neurons in your nervous system. I am all for scientific approach to medicine. But that includes not shutting your eyes to an entire huge branch of it that we simply do not understand — the connection between the mind and the body. Also, many people don't understand the mechanism behind all this. It's not that Sarno is a magic-voodoo healer. All he does is show you the mechanism — which is very often enough: the mind, once exposed to its own tricks, starts working differently. This is why just reading his books and thinking about them causes changes in so many people (either the pain is gone, or the symptoms shift and change). Source: myself. I got rid of joint pain after 8 years of fruitless doctor visits. It is now almost completely under control: if it happens, I can tell why it happened and control it. As a bonus, it turned out that my frequent throat infections and the allergies are gone, too. Don't dismiss psychosomatic effects. Sure, go see a doctor first, but if multiple doctors are unable to find a cause of your pain, at least read one of Sarno's books and think (critically!) about it.
huhtenberg 13y ago
Me too, not the RSI though. I am generally as skeptical as it gets, but I read the book, then spent some time contemplating how it applied to my situation and - poof - a debilitating hip joint pain I had a mispleasure experiencing every few months was gone. I went through an MRI and a bone scan prior to that and all I got back was that everything was A-OK. Frankly, I was stunned that thinking about the problem was the remedy. You can basically talk to your body, say "stop that" and it will comply. Really weird.
smrtinsert 13y ago
I'm not selling this dvd, but even the 5 or so videos here really helped. http://www.youtube.com/user/HealthyTyping http://www.youtube.com/user/HealthyTyping. It is very practical, showing how tendons are strained in positions that seem like they should be pain free. Since then I don't use arm rests so I can keep my elbows in, and dont curl my fingers. The pain went away almost over one weekend.
domdip 13y ago
Pain treatment is one of the few areas where a placebo actually 'works' (in the sense that it leads to better outcomes than non-treatment). See Pollo et al, "Response expectancies in placebo analgesia and their clinical relevance." So even if it's full of nonsense, it's not surprising that the book could work (and not just anecdotally). The question is whether this book is any better than a placebo, and anecdotes can't answer that. (I also wonder if it's any better than any other book that would help you cope with psychological stress.)
eli 13y ago
I guess whatever works for you. Personally, I was having problems in my dominant hand and switching from a mouse to a Wacom tablet with a pen made a colossal improvement.
- rafski 13y ago
  My wrist pain is gone ever since I moved on to Wacom.
tosseraccount 13y ago
Learning and using macros helps a lot. Don't keep pounding the same sequence of keys. If, for instance, you use vim, check out the map feature ... http://vimdoc.sourceforge.net/htmldoc/map.html http://vimdoc.sourceforge.net/htmldoc/map.html
MichaelGG 13y ago
This book is NOT "rigorously scientific". The guy comes off as a bit of a nut, and wastes paragraphs defending Freud (seriously, wtf?). That said, he might be right that there's a psychological component to RSI, even if his explanations and theories are incorrect. After all, fall and winter come even though Demeter isn't actually crying for Persephone. This book helped my RSI by convincing me enough that it might be psychological, even though I tossed the book in disgust after a few chapters. For a few years my pain seemed to have gone away completely, although it's back somewhat now.
cupcake-unicorn 13y ago
Maybe I'm missing something here, but from his very brief description of the methods used, I thought that there was at least some "method" or "logic" to it. But then I brought up: https://en.wikipedia.org/wiki/Tension_myositis_syndrome https://en.wikipedia.org/wiki/Tension_myositis_syndrome Which seems to indicate that the "treatment" is something much more vague like...journaling, support groups, therapy...? Pardon the stereotype, but I'm imagining some old women's knitting group or something...or all the stuff about "repressed anger" "childhood abuse", etc....if that were the case, wouldn't women's circles, group therapy, individual therapy, anger management classes, spontaneously start curing people of their pain? I don't see anything specific about this method. Maybe I'm missing something very basic? Distraction and getting your mind off of it is a well known way to deal with pain. I didn't think that was new.
evmar 13y ago
I'm another person that was helped by this. I was also pretty skeptical entering it, and I hate that I am embarrassed to tell my RSI-suffering friends about it when I know that it has helped many people (including others of my RSI-suffering friends). To those talking about how it's pseudoscience, all I have to say is that there are at least some people, including the author of the post, who have tried many other options and found that this approach helps. As far as I'm concerned, I'd be happy to sit in a crystal pyramid or any other sort of quackery if it genuinely improved the problem. (And in reading the book, the author does have some reasoning as to why it works. I think it's at least indisputable that there are physical consequences to many mental ailments like stress, so it doesn't seem like such a reach to me to try treating the mental issue to improve the physical symptoms.)
wallflower 13y ago
The cycle is like this: 1. Pound away at the keyboard indiscriminately for years, no pain 2. Pound away, start to get pain but it goes away after some off time (could be as little as a night) 3. Pound away, get pain but it goes away after extended rest time 4. Pound away, the pain never really goes away, it just subsides. It is much like the straw the breaks the camel's back, the frog in a boiling point of water - what you take for granted (the ability to input your thoughts into a machine) might not always be toll-free. If you get pain, stop. Don't be macho or in denial. Go out and do some whole body exercise like swimming (http://totalimmersion.net http://totalimmersion.net rocks) -Someone who has residual pain of 3 on a scale of 10, with spikes going higher. I've become very efficient and have long ago since started diversifying out of programming.
vsbuffalo 13y ago
I am unsure this book's claims are correct, and I still remain skeptical. But one epiphany I had in dealing with my recent RSI is that it does make me worry — quite a bit in fact. Programming is not only how I make a living, and also a hobby and my future life as a grad student. Having it all be at risk because of RSI makes me incredibly stressed. Previously when I've had RSI, it's gone away after a week or so. Now I'm the most stressed I've ever been about it because it just hasn't gone away. I don't think it's so odd to suspect that there is a psychological component (and now that I am aware of it I am addressing this it from angle more). There's an unlimited positive pain feedback cycle, which could explain the persistence. I could see some sort of process where RSI's origination is physical (overuse, definitely was in my case) but its lingering is a function of stress. This article also made me realize that it is silly for skeptics to use the placebo effect (a purely psychological effect) to attack pseudoscience healing crap, but then dismiss psychological explanations for pain. If the mind can limit pain through the placebo effect, why is it so suspicious the brain can cause or continue pain?
verisimilidude 13y ago
I won't begrudge anyone who finds comfort in this "mindbody" stuff. If your pain is gone, good for you. But I really really hope you folks won't take away the wrong lesson and assume that all RSI is mental. It's not. Overcoming my own physical pain was tough, but I eventually conquered it. Here's what worked for me. * I learned to type Dvorak. Since learning how to type on a C64 at the age of 3, my typing form has always been terrible. If nothing else, Dvorak taught me how to put my fingers in the right places. * I picked up a split-in-two-halves keyboard. The right half of the keyboard is rotated counter-clockwise to address the extreme ulnar deviation in my right forearm (following an old injury). * It's also nice, with these broad shoulders, to spread out the two keyboard halves. This helps a lot with my neck and shoulders. * I tented that keyboard to ease pronation in my wrists. I started at about 70 degrees (almost fully vertical) and eased down to 15 degrees over time. * I grabbed a vertical mouse to match my vertical-ish keyboard. * I stopped leaning my head toward the screen. Huge help for my neck. * I started using a sit-stand desk. This is a great way to "take a break" without actually taking a break. Some other important observations. * Being in good physical shape reduces all my RSI problems/risks across the board. When I'm fit, I can type in any awkward position for days without pain. When I'm fat, I get RSI just thinking about my keyboard. Being fit at the moment, all my new equipment and good computing habits are making me far more productive. * Good sleep and good food also help. Sometimes I lose focus and slip back into bad habits when I'm in a cheesesteak coma, for example. It may be possible to fix your RSI physically if you pay really close attention to what your body is telling you, and earnestly experiment with possible solutions. Some big organizations in SV have ergo labs where you can go test out equipment for free. Use that resource if you can. Do what you must, but don't discount the physical solutions.
- nzealand 13y ago
  What vertical mouse did you use? I ended up settling on a rollermouse along with the split keyboard.
  - verisimilidude 13y ago
    I'm using a left-handed Evoluent VerticalMouse 2. They skipped the leftie in the third generation, but it's back for the newer VerticalMouse 4. I may need to check that out. http://www.evoluent.com/ http://www.evoluent.com/ My keyboard is the Kinesis Freestyle (with VIP attachment). To get the 70 degree tenting when I started, I welded together my own stand from old door hinges. http://www.kinesis-ergo.com/freestyle2.htm http://www.kinesis-ergo.com/freestyle2.htm How do you like the rollermouse? It's a bit weird for me given how far apart I like to splay my keyboard, but I've always admired the general idea.
throwit1979 13y ago
While we're discussing anecdotal cures for RSI, I'll disclose mine: deadlifting. That's it. Consistent, heavy deadlifting has kept it away for years. I have no medical explanation.
snth 13y ago
I was also very, very skeptical about this. But I have to say, it worked for me. I read this book in desperation after learning Dvorak, getting a fancy Kinesis keyboard, and getting expensive physical therapy (massaging of my forearms, hand strengthening exercises) to no effect. I repeat, no effect. I don't know what else to say. It still sounds like bullshit to me, but it worked when all of the other methods did not.
- dvdkhlng 13y ago
  When talking about physical therapy, did you ever consider referred pain patterns [1], like neck/shoulder muscle tension causing pain in the wrist/fingers? I found the Trigger Point Therapy Workbook [2] quite enlightening in that regard. Maybe you should think about doing some weightlifting or jogging instead of trying to strengthen your hands :) [1] https://en.wikipedia.org/wiki/Referred_pain https://en.wikipedia.org/wiki/Referred_pain [2] http://www.triggerpointbook.com/ http://www.triggerpointbook.com/
- jdahlin 13y ago
  I was in a similiar situation a few years back, had to stop working due to the pain. Went to a loads of doctors, tried medication, fancy keyboards, changing chairs, improving postures, raising monitors, switching mouse arm etc. It all helped a little, but nothing solved it. 12-18 months of gym/pilates helped in the end, after gaining strength in my hands, wrists and arms I was able to go back to full time working again, without feeling pain.
mr_donk 13y ago
My experience was almost identical to the author's. As improbable as it sounds, reading the book and following it's advice completely eliminated my RSI pain after 3 years of dr visits (steroid cream), physiotherapy (tens, ims, massage, art, etc), and every ergonomic input device I could get my hands on failed to help. My RSI was starting to bother me even when I wasn't at a keyboard, to the point where it hurt to drive. I'm the last person I would have ever expected to use some "new age" treatment, yet as soon as I started to read the book, my pain lessened and was 100% gone within a month. I strongly agree with the author's premise about emotions playing a role in this, and in my case the onset of RSI corresponded with a very stressful time in my life. Maybe this won't be the case for you, but it certainly was for me. I can once again type on a normal keyboard all day with no pain. 2 years ago I would have never believed this possible. If you're in a similar situation, you should give it a shot. It costs nearly nothing, and has helped many people (read the book's reviews on Amazon).
robomartin 13y ago
Many years ago I suffered nearly life-changing RSI pain. It happened in the middle of an extreme project where I found myself coding and running CAD for 16 to 18 hours a day, seven days a week for months. The first good decision I made was to stop all work. Next, I sought medical opinion. I was horrified to learn medical professionals were all over the place. I got recommendations spanning from surgery to vitamins. I concluded that I'd do my own research and come to my own independent conclusions. I focused on two areas: understanding the physiology or mechanics of the damage and taking a deep dive into ergonomics. I came out convinced that the root cause was poor ergonomics. I had not caused enough damage to require surgery. I set out to test out various ergonomic products. Nearly all of them sucked. Gimmicky crap. The ultimate solution was to design my own desk. The goal was to promote a fully relaxed posture with proper alignment and support. The standard 29 to 30 inch high desk was designed in the dark ages for writing. Placing a keyboard or laptop on it throws your entire body out of alignment. Your fingers, hand, wrist, arms and shoulders end-up operating in tension as opposed to from a neutral stance. My desk featured a dropped (about three inches) front section for the keyboard and thumb-operated trackball. I ditched the mouse as it caused too much tension. I found a thumb-operated trackball to flow naturally and comfortably. A dropped keyboard shelf wasn't enough. The front edge got a solid piece of wood, 2x2 inches in cross-section with generously rounded edges. This created a forearm support across the entire width of the keyboard shelf. The net effect was that my hands very naturally drooped onto the keyboard and trackball. My shoulders were not unnaturally pushed up or pulled down. I played with monitor height and settled for looking slightly down at the monitors (24 inch). I tend to alternate between sliding down in the chair and sitting up, which means that at times I am looking straight at the screens. The end result was that all pain was gone and I could get back to work. I also took regular breaks every two to four hours based on flow.
- stiff 13y ago
  I second this, the only time I ever had wrist pain for prolonged amount of time was from having the desk too high. Ergonomics is not about buying different five different mices, but about making sure the position of your body is such that it can work effectively. There is a good basic description here: http://www.ergonomics.com.au/pages/400_useful_info/420_how_to_sit.htm http://www.ergonomics.com.au/pages/400_useful_info/420_how_t... I don't think you have to go as far as to design your own desk (although the effect is probably great). Just avoid "computer desks" like the black plague and go for a simple large table top on regulated table legs - the keyboard drawer is the worst invention ever in terms of ergonomics.
efnx 13y ago
verisimilidude touched on a couple of these points already but apart from training your mind to not worry about pain you can also train it to type in Dvorak. I went even a little further and bought a $30 datahand keyboard (a really, really good price) but even with that dvorak'd wacky thing it only took me about 3 weeks of typing to get proficient and pain free. A good chair goes a long way as well.
asdf333 13y ago
I have to say it does not help your case that the your link to the book on amazon is an affiliate link....
stafrer 13y ago
how did this bullshit article make it to the front page?
jimgardener 13y ago
these links(http://en.wikipedia.org/wiki/Myofascial_pain_syndrome http://en.wikipedia.org/wiki/Myofascial_pain_syndrome and http://en.wikipedia.org/wiki/Myofascial_release http://en.wikipedia.org/wiki/Myofascial_release) seem related to the above problem ..In fact, couple of my programmer friends (been coding for 17 yrs) had this posture related problem and massage therapy more or less cured them
johannesg 13y ago
I like this article about Dr. Sarno's theories: http://www.bettermovement.org/2011/a-skeptical-look-at-the-theories-of-dr-john-sarno/ http://www.bettermovement.org/2011/a-skeptical-look-at-the-t.... In summary: his treatment probably works, but his theories explaining chronic pain are most likely incorrect.
mrexroad 13y ago
i was hoping that my rsi pain was either bad ergonomics or just mental, then last week i got the results from a 2nd MRI of my wrist: - torn TFCC - positive variance of distal ulna as well as an intraosseous cyst it's going to suck to get this fixed (especially the bone saw + plate + screws part), but the pain is pretty bad these days and the success rate is pretty high for what needs to be done. it's hard to bring myself to the keyboard when it's not absolutely necessary these days.

106 points by vsbuffalo 13y ago

For what it's worth, I read this recommendation a year or so a go and it helped a lot despite my initial skepticism. It's mostly a mindful awareness thing.

skore 13y ago

"Relax" to ease pain stemming from tension. Who would've thought.

pawrvx 13y ago
It's actually hard to impossible to relax when you don't know the source of the tension. Finding that tension within a network of hundreds of billions of neurons can be like finding a single sand on the beach. Worse, as time goes on you tend to compensate instead of resolving the root cause, leading to an increasingly complex web which you have to untangle first before being able to reach the root cause. Most people die before any of the above is accomplished.
- jakebellacera 13y ago
  This is why I think that the methods taught in this book seem to work for some people. When you're stressed beyond all means and don't deal with it mentally, the tension you give yourself causes physical harm. Sort of like how stress can cause you to grind your teeth at night. Dealing with your problems and just simply relaxing can help tremendously.
mattm 13y ago
When you're deep inside a problem of many years, sometimes the simple solutions get easily overlooked.

zwegner 13y ago

I'm another person cured of RSI by the same approach. Initially, when learning of TMS, the RSI got worse (progressing from just constant pain to feelings of numbness and nerve damage). Certainly worth a look if you have RSI--clearly if people can be cured more or less overnight by just reading, there's SOME mental component, whether or not Dr. Sarno's explanations of the mechanisms of TMS are correct.

typpo 13y ago
Me too. I spent about a year after college in constant pain from carpal tunnel and sciatica. Even basic actions like opening a door were extremely painful. I blew a lot of money on ergonomic equipment, PT, steroidal treatments, and was strongly considering surgery until I treated my chronic pain as TMS. My desk setup has not changed at all but I've been completely pain free for about a year now. It was eye-opening to realize that such severe pain, which inhibited simple daily activities, could be entirely psychosomatic. The nocebo effect[1] is a well-documented phenomenon that is closely related. When you expect an autonomic symptom, you are much more likely to experience it. [1] http://www.nytimes.com/2012/08/12/opinion/sunday/beware-the-nocebo-effect.html http://www.nytimes.com/2012/08/12/opinion/sunday/beware-the-...

plainOldText 13y ago

Thank you for sharing. It's always great to learn about effective strategies to deal with/cure RSI; especially when so many said cures are failing. Already ordered the book, and I hope I won't be disappointed :)

leashless 13y ago

Two words: music physiotherapists. Musicians get RSI-type problems a lot, and when it's career-ending for a concert pianist, people really pay attention. Plus there's several hundred years of accumulated experience dealing with these problems. I still have fluid around my tendons 20 years later, my RSI was so bad - visible roundness in my forearms - and I haven't had a day of pain in a decade. It took six sessions, and they only worked on my neck. Highly recommended.

collyw 13y ago
The Alexander technique is also popular amongst musicians, and there seems to be a lot of overlap with the principles described here.

wam 13y ago

I've been seeing this book pop up all over the place for the past year or so. It seems to be the go-to recommendation from friends to other friends who are frustrated at not finding relief from chronic pain after trying many other treatments. I haven't read the book. All I can say is that the results, from my perspective, have been mixed. Some people who have tried it and not seen their pain alleviated blame themselves for not getting to the root of their stress. I haven't heard of anyone's pain disappearing in 2 weeks. I've heard people recommend it for all kinds of pain, not just muscle and back pain. Claims about its efficacy seem to have broadened over time. The book is set at a very good "it can't hurt to try" price point, and the word of mouth marketing makes it very appealing to people who feel desperate. I am a random person. My experiences are anecdotal.

xenophanes 13y ago

Never read the book, but psychology changes helped my RSI issues tremendously. > if you are unconsciously worried about something (including worried about your wrists hurting while you type), then this can cause your wrists to hurt while you type. This. If you're scared of RSI and scared of typing, that can itself cause problems.

president 13y ago
> including worried about your wrists hurting while you type This is the thing that fixed my problem. After trying so many different "methods" and "tricks", I read about this approach on an HN thread a few years ago. I was skeptical in the beginning but now I'm just dumbfounded how effective it was.
deleted 13y ago
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- xenophanes 13y ago
  In short, I relaxed and stopped being scared of it. FWIW I also took more breaks, got a better chair and posture, stretched regularly, and especially importantly: became a lot more aware of signs of incoming pain and would take breaks before it started hurting not after. (But lately I'm fine and rarely need any breaks. After some success I stopped being scared.) I think it's completely reasonable that your thoughts have a lot of effect on your body. I don't see anything unscientific about that. Both consciously and unconsciously your brain can move your legs, for example. And a lot of other important stuff. As a comparison, consider running or some other sport. There's often minor aches and pains involved even if you never get anything people would call an "injury". If you had a bad attitude to them and interpreted them as a dangerous injury, I think they could bother you a huge amount. But if you aren't scared of them at all because you have a good understanding of which ones are danger signs and which are nothing to worry about, then the same pains can be no problem. I think novices often make mistakes in both directions. Being overly worried about minor pains is common -- many people quickly give up on running. And trying to ignore major pains is also common and gets people injured. I think both types of mistakes happen (a lot) with RSI and typing too. If you get get your psychology so you don't mind non-dangerous minor pains, but do things about any real problems, then that's good. If you stray to either direction of getting this correct you can cause problems. Sometimes both issues happen. First you get some real pain. You take some breaks and it soon heals and you're OK but now you're scared and start interpreting non-dangerous minor sensations as scary pain. And if you keep going down that path it can escalate. And also if you try to push through while scared of every minor sensation, and type anyway, you're in no condition to understand whether there's anything dangerous going on that needs a break, some stretching, or more. So it's psychologically unpleasant plus you might hurt yourself again. I think it's really valuable to build up more awareness and understanding of your hands/wrists, and have the right way of thinking about the topic. EDIT: i think he deleted while i was writing my post. but basically he just asked for information about the things i talk about.

deleted 13y ago

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fabvanso 13y ago

This does not work at all. The causes behind RSI are physical and real.

AsymetricCom 13y ago
Then why is there any discussion at all? We already know the solution right? No.
logn 13y ago
Somewhere is the many paragraphs of typing he did for this article, he mentions that perhaps fixing the psychological component improves the physical condition. His idea is that mental stress over RSI restricts bloodflow to the parts of the hands/arms that need blood. While I don't buy into this article's theory, I do think that the mind is tightly coupled to the body and that people who draw too many distinctions between the two are misguided. That said, I still seek out good ergonomics personally and think RSI, at least for me, is due to me typing for 12 hours a day. I never worried about RSI until I had pain in my hands the went on for weeks. We can debate until the cows come home about whether the mental stress caused the hand pain or whether the ergonomics caused it--in the end it's the same pain and same RSI and just semantics. If wearing wrist pads eliminates the pain or if telling yourself to not worry makes the pain go away--the physical and mental result is the same. For me, wristpads worked. But I know from experience that stress on the mind and stress on the body is basically the same in many regards.
jthol 13y ago
Psychology can play a component though. If you are tense your muscles start off tighter and are easier to fatigue. You are also more likely to be hunched over your keyboard resulting in worse posture. I'm skeptical about the book and the miracle cure side of it but, i don't think psychology can be completely ruled out.
flatline 13y ago
Pain is not terribly well understood. I mean, we generally know how nerve impulses convey a signal to the CNS, but how the brain chooses to interpret those signals as "pain" is still something of a mystery. There is an area of research called neuromatrix theory that started out trying to explain phantom limbs, but has possible applications to chronic pain as well. From the little I've read about it, the idea is that the brain can start interpreting normal sensations as painful, or can create sensations that are not there. While this is an actual area if research, unlike Sarno's books, there are some interesting similarities.

Apes 13y ago

Please be careful with this article. It is not remotely skeptical, and seems to be highly biased in the favor of Dr. Sarno's book. Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag. There is not a large amount of unbiased information about Dr Sarno's methods that I could find quickly, but from what is available TMS appears to be a form of alternative medicine that has no basis in science, and instead relies on pseudoscience and the placebo effect. Rather than the pain relief being due to TMS, there is probably a more likely cause behind the result. Perhaps stretching exercises or pain medicine was involved. Or perhaps even just the placebo effect itself. Please read this article for more information. It even contains a brief mention of Dr. Sarno. http://www.sciencebasedmedicine.org/why-do-people-turn-to-alternative-medicine/ http://www.sciencebasedmedicine.org/why-do-people-turn-to-al...

sillysaurus 13y ago
Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag. Trying something to check whether it works is orthogonal to being skeptical about it. In fact, it's the heart of science.
- akiselev 13y ago
  Making very specific predictions via a hypothesis and gathering specific, and plentiful, data that test your predictions is the heart of science. Anecdotes (on which all alternative medicine is based on) do not make good science and "trying something to check whether it works" with a sample size of one is the worst way to do medicine.
  - sillysaurus 13y ago
    Actually, the scientific method is the heart of science, and the method is to check a hypothesis. When the goal is to fix yourself, the only relevant sample size is yourself. And when the problem may be psychological, then placebo effect may fix it, because you believe you've fixed it.

lunix 13y ago

Claims to be sceptical but then: "The first medical specialist I consulted was a chiropractor" Chiropractic was founded by magnetic healer, D.D. Palmer. Magnetic healing is also a pseudoscience but less people take it seriously.

lunix 13y ago
He also promotes this book: http://www.amazon.com/4-Hour-Body-Uncommon-Incredible-Superhuman/dp/030746363X http://www.amazon.com/4-Hour-Body-Uncommon-Incredible-Superh... If you look at the reviews you'll get a better understanding.
- emmelaich 13y ago
  Indeed, it doesn't look good. I don't know how you can be skeptical but then also try chiropractic and acupuncture (without trying a lot of other stuff) The wikipedia talk page is interesting. Here's my personal story about how I conquered my RSI: stopped using Emacs. It helped that I moved from a developer to a sysadmin role. When I do occasionally use Emacs, it's with viper mode.
  - dvdkhlng 13y ago
    After reading multiple comments criticising Emacs for wearing down the hands, there's some more stuff (apart from viper-mode) that makes Emacs use less damaging: * ergo-emacs key bindings (http://ergoemacs.org/features.html http://ergoemacs.org/features.html) * partial-completion-mode * auto-completion (e.g. binding dabbrev-expand to an easy reachable key/combo) * put window/buffer navigation onto easier reachable keys (for me F7, F11 work well) * Make buffer switching smarter by using ido-switch-buffer and ido-find-file instead of the normal switch-buffer and find-file functions (see documentation for ido-mode) * desktop-save-mode so you don't have to repeatedly re-open files after restarting emacs * Using auto-generated boilerplate when creating new files (see Emacs manual for define-auto-insert and friends) * using a Kinesis Advantage keyboard helps with emacs key combos as Ctrl/Alt can be reached via the thumbs without moving the hands. ...

bluesmoon 13y ago

I don't know what's more impressive... the results, or that the top comment on the article is by Jeffrey Friedl. I've communicated with Friedl a bit at Y!, and if he says you changed his life, I believe him.

jongraehl 13y ago

The book helped me try to stress out less about some frightening RSI I had years ago. The speculative mechanical explanation for the "stress -> pain", something like: stress means less oxygenated blood to extremities, was never convincing - more like a dumbo's feather for those skeptical of general mind-body woo. Coincidentally, I got better. That was probably just rest and time, but I'm grateful that the book helped me not worry so much.

bluemetal 13y ago

To anyone suffering significant hand, arm, neck & shoulder pain, I suggest you consider asking your doctor about Thoracic Outlet Syndrome. (https://en.wikipedia.org/wiki/Thoracic_outlet_syndrome https://en.wikipedia.org/wiki/Thoracic_outlet_syndrome) I was diagnosed with bilateral arterial T.O.S. last year after reading about it in a comment on HN. I very recently had corrective surgery on my right side and I hope to have my left side done soon. I was diagnosed when an ultrasound showed full occlusion of my subclavian arteries whenever I lifted my arms (but only when sitting or standing upright, like at my desk, which was not a standard discovery). If anyone has any questions feel free to message me.

bmcleod 13y ago

I suspect what's happening with all the people who this works for is that given there are some people who have a psychological component to their pain and some who have a mostly physical component. Even if there are far fewer suffering from the psychological version, they are the ones who physical treatment will fail for. So they will be the ones that get as far as trying the pseudosciencey approach to dealing with the pain. So the mind body approach will have a high success rate amongst the people trying it even if it would be a terrible initial remedy to try.

jwr 13y ago
I am amazed at the shallow thinking of many in this thread who dismiss the story as "quackery". I'd encourage anyone who speaks of a "pseudosciencey approach" to do some careful thinking and propose an approach that would let us measure the effects our minds have on our bodies. So far most people sweep this effect under the rug calling it the "placebo effect" (a catch-all phrase for everything we do not understand). That's not an answer. Notice: we live in the XXI century, and yet we treat our bodies as though our heads were detached and completely independent. Medicine as we know it is based on pills, syringes, vials and knives. Anything else is the "placebo effect" or in the (decidedly non-scientific) domain of psychologists and psychiatrists. I'd call that hiding our head in the sand (double-entendre intended). We do all this while readily accepting that we can sweat, or get diarrhea from nervousness. If people accept that the mind can (subconsciously) control sweating, why can't they accept that it can (subconsciously) control the narrowing of blood vessels? Most people dismiss psychosomatic effects without understanding what they are. Psychosomatic pain isn't any less real. The physical changes are there, they just might not be exactly the changes you are looking for (e.g. no inflammation). And they are caused by the mind, which is why we call them "psychosomatic". But they are not hallucinations, or misfiring neurons in your nervous system. I am all for scientific approach to medicine. But that includes not shutting your eyes to an entire huge branch of it that we simply do not understand — the connection between the mind and the body. Also, many people don't understand the mechanism behind all this. It's not that Sarno is a magic-voodoo healer. All he does is show you the mechanism — which is very often enough: the mind, once exposed to its own tricks, starts working differently. This is why just reading his books and thinking about them causes changes in so many people (either the pain is gone, or the symptoms shift and change). Source: myself. I got rid of joint pain after 8 years of fruitless doctor visits. It is now almost completely under control: if it happens, I can tell why it happened and control it. As a bonus, it turned out that my frequent throat infections and the allergies are gone, too. Don't dismiss psychosomatic effects. Sure, go see a doctor first, but if multiple doctors are unable to find a cause of your pain, at least read one of Sarno's books and think (critically!) about it.

huhtenberg 13y ago

Me too, not the RSI though. I am generally as skeptical as it gets, but I read the book, then spent some time contemplating how it applied to my situation and - poof - a debilitating hip joint pain I had a mispleasure experiencing every few months was gone. I went through an MRI and a bone scan prior to that and all I got back was that everything was A-OK. Frankly, I was stunned that thinking about the problem was the remedy. You can basically talk to your body, say "stop that" and it will comply. Really weird.

smrtinsert 13y ago

I'm not selling this dvd, but even the 5 or so videos here really helped. http://www.youtube.com/user/HealthyTyping http://www.youtube.com/user/HealthyTyping. It is very practical, showing how tendons are strained in positions that seem like they should be pain free. Since then I don't use arm rests so I can keep my elbows in, and dont curl my fingers. The pain went away almost over one weekend.

domdip 13y ago

Pain treatment is one of the few areas where a placebo actually 'works' (in the sense that it leads to better outcomes than non-treatment). See Pollo et al, "Response expectancies in placebo analgesia and their clinical relevance." So even if it's full of nonsense, it's not surprising that the book could work (and not just anecdotally). The question is whether this book is any better than a placebo, and anecdotes can't answer that. (I also wonder if it's any better than any other book that would help you cope with psychological stress.)

eli 13y ago

I guess whatever works for you. Personally, I was having problems in my dominant hand and switching from a mouse to a Wacom tablet with a pen made a colossal improvement.

rafski 13y ago
My wrist pain is gone ever since I moved on to Wacom.

tosseraccount 13y ago

Learning and using macros helps a lot. Don't keep pounding the same sequence of keys. If, for instance, you use vim, check out the map feature ... http://vimdoc.sourceforge.net/htmldoc/map.html http://vimdoc.sourceforge.net/htmldoc/map.html

MichaelGG 13y ago

This book is NOT "rigorously scientific". The guy comes off as a bit of a nut, and wastes paragraphs defending Freud (seriously, wtf?). That said, he might be right that there's a psychological component to RSI, even if his explanations and theories are incorrect. After all, fall and winter come even though Demeter isn't actually crying for Persephone. This book helped my RSI by convincing me enough that it might be psychological, even though I tossed the book in disgust after a few chapters. For a few years my pain seemed to have gone away completely, although it's back somewhat now.

cupcake-unicorn 13y ago

Maybe I'm missing something here, but from his very brief description of the methods used, I thought that there was at least some "method" or "logic" to it. But then I brought up: https://en.wikipedia.org/wiki/Tension_myositis_syndrome https://en.wikipedia.org/wiki/Tension_myositis_syndrome Which seems to indicate that the "treatment" is something much more vague like...journaling, support groups, therapy...? Pardon the stereotype, but I'm imagining some old women's knitting group or something...or all the stuff about "repressed anger" "childhood abuse", etc....if that were the case, wouldn't women's circles, group therapy, individual therapy, anger management classes, spontaneously start curing people of their pain? I don't see anything specific about this method. Maybe I'm missing something very basic? Distraction and getting your mind off of it is a well known way to deal with pain. I didn't think that was new.

evmar 13y ago

I'm another person that was helped by this. I was also pretty skeptical entering it, and I hate that I am embarrassed to tell my RSI-suffering friends about it when I know that it has helped many people (including others of my RSI-suffering friends). To those talking about how it's pseudoscience, all I have to say is that there are at least some people, including the author of the post, who have tried many other options and found that this approach helps. As far as I'm concerned, I'd be happy to sit in a crystal pyramid or any other sort of quackery if it genuinely improved the problem. (And in reading the book, the author does have some reasoning as to why it works. I think it's at least indisputable that there are physical consequences to many mental ailments like stress, so it doesn't seem like such a reach to me to try treating the mental issue to improve the physical symptoms.)

wallflower 13y ago

The cycle is like this: 1. Pound away at the keyboard indiscriminately for years, no pain 2. Pound away, start to get pain but it goes away after some off time (could be as little as a night) 3. Pound away, get pain but it goes away after extended rest time 4. Pound away, the pain never really goes away, it just subsides. It is much like the straw the breaks the camel's back, the frog in a boiling point of water - what you take for granted (the ability to input your thoughts into a machine) might not always be toll-free. If you get pain, stop. Don't be macho or in denial. Go out and do some whole body exercise like swimming (http://totalimmersion.net http://totalimmersion.net rocks) -Someone who has residual pain of 3 on a scale of 10, with spikes going higher. I've become very efficient and have long ago since started diversifying out of programming.

vsbuffalo 13y ago

I am unsure this book's claims are correct, and I still remain skeptical. But one epiphany I had in dealing with my recent RSI is that it does make me worry — quite a bit in fact. Programming is not only how I make a living, and also a hobby and my future life as a grad student. Having it all be at risk because of RSI makes me incredibly stressed. Previously when I've had RSI, it's gone away after a week or so. Now I'm the most stressed I've ever been about it because it just hasn't gone away. I don't think it's so odd to suspect that there is a psychological component (and now that I am aware of it I am addressing this it from angle more). There's an unlimited positive pain feedback cycle, which could explain the persistence. I could see some sort of process where RSI's origination is physical (overuse, definitely was in my case) but its lingering is a function of stress. This article also made me realize that it is silly for skeptics to use the placebo effect (a purely psychological effect) to attack pseudoscience healing crap, but then dismiss psychological explanations for pain. If the mind can limit pain through the placebo effect, why is it so suspicious the brain can cause or continue pain?

verisimilidude 13y ago

I won't begrudge anyone who finds comfort in this "mindbody" stuff. If your pain is gone, good for you. But I really really hope you folks won't take away the wrong lesson and assume that all RSI is mental. It's not. Overcoming my own physical pain was tough, but I eventually conquered it. Here's what worked for me. * I learned to type Dvorak. Since learning how to type on a C64 at the age of 3, my typing form has always been terrible. If nothing else, Dvorak taught me how to put my fingers in the right places. * I picked up a split-in-two-halves keyboard. The right half of the keyboard is rotated counter-clockwise to address the extreme ulnar deviation in my right forearm (following an old injury). * It's also nice, with these broad shoulders, to spread out the two keyboard halves. This helps a lot with my neck and shoulders. * I tented that keyboard to ease pronation in my wrists. I started at about 70 degrees (almost fully vertical) and eased down to 15 degrees over time. * I grabbed a vertical mouse to match my vertical-ish keyboard. * I stopped leaning my head toward the screen. Huge help for my neck. * I started using a sit-stand desk. This is a great way to "take a break" without actually taking a break. Some other important observations. * Being in good physical shape reduces all my RSI problems/risks across the board. When I'm fit, I can type in any awkward position for days without pain. When I'm fat, I get RSI just thinking about my keyboard. Being fit at the moment, all my new equipment and good computing habits are making me far more productive. * Good sleep and good food also help. Sometimes I lose focus and slip back into bad habits when I'm in a cheesesteak coma, for example. It may be possible to fix your RSI physically if you pay really close attention to what your body is telling you, and earnestly experiment with possible solutions. Some big organizations in SV have ergo labs where you can go test out equipment for free. Use that resource if you can. Do what you must, but don't discount the physical solutions.

nzealand 13y ago
What vertical mouse did you use? I ended up settling on a rollermouse along with the split keyboard.
- verisimilidude 13y ago
  I'm using a left-handed Evoluent VerticalMouse 2. They skipped the leftie in the third generation, but it's back for the newer VerticalMouse 4. I may need to check that out. http://www.evoluent.com/ http://www.evoluent.com/ My keyboard is the Kinesis Freestyle (with VIP attachment). To get the 70 degree tenting when I started, I welded together my own stand from old door hinges. http://www.kinesis-ergo.com/freestyle2.htm http://www.kinesis-ergo.com/freestyle2.htm How do you like the rollermouse? It's a bit weird for me given how far apart I like to splay my keyboard, but I've always admired the general idea.

throwit1979 13y ago

While we're discussing anecdotal cures for RSI, I'll disclose mine: deadlifting. That's it. Consistent, heavy deadlifting has kept it away for years. I have no medical explanation.

snth 13y ago

I was also very, very skeptical about this. But I have to say, it worked for me. I read this book in desperation after learning Dvorak, getting a fancy Kinesis keyboard, and getting expensive physical therapy (massaging of my forearms, hand strengthening exercises) to no effect. I repeat, no effect. I don't know what else to say. It still sounds like bullshit to me, but it worked when all of the other methods did not.

dvdkhlng 13y ago
When talking about physical therapy, did you ever consider referred pain patterns [1], like neck/shoulder muscle tension causing pain in the wrist/fingers? I found the Trigger Point Therapy Workbook [2] quite enlightening in that regard. Maybe you should think about doing some weightlifting or jogging instead of trying to strengthen your hands :) [1] https://en.wikipedia.org/wiki/Referred_pain https://en.wikipedia.org/wiki/Referred_pain [2] http://www.triggerpointbook.com/ http://www.triggerpointbook.com/
jdahlin 13y ago
I was in a similiar situation a few years back, had to stop working due to the pain. Went to a loads of doctors, tried medication, fancy keyboards, changing chairs, improving postures, raising monitors, switching mouse arm etc. It all helped a little, but nothing solved it. 12-18 months of gym/pilates helped in the end, after gaining strength in my hands, wrists and arms I was able to go back to full time working again, without feeling pain.

mr_donk 13y ago

My experience was almost identical to the author's. As improbable as it sounds, reading the book and following it's advice completely eliminated my RSI pain after 3 years of dr visits (steroid cream), physiotherapy (tens, ims, massage, art, etc), and every ergonomic input device I could get my hands on failed to help. My RSI was starting to bother me even when I wasn't at a keyboard, to the point where it hurt to drive. I'm the last person I would have ever expected to use some "new age" treatment, yet as soon as I started to read the book, my pain lessened and was 100% gone within a month. I strongly agree with the author's premise about emotions playing a role in this, and in my case the onset of RSI corresponded with a very stressful time in my life. Maybe this won't be the case for you, but it certainly was for me. I can once again type on a normal keyboard all day with no pain. 2 years ago I would have never believed this possible. If you're in a similar situation, you should give it a shot. It costs nearly nothing, and has helped many people (read the book's reviews on Amazon).

robomartin 13y ago

Many years ago I suffered nearly life-changing RSI pain. It happened in the middle of an extreme project where I found myself coding and running CAD for 16 to 18 hours a day, seven days a week for months. The first good decision I made was to stop all work. Next, I sought medical opinion. I was horrified to learn medical professionals were all over the place. I got recommendations spanning from surgery to vitamins. I concluded that I'd do my own research and come to my own independent conclusions. I focused on two areas: understanding the physiology or mechanics of the damage and taking a deep dive into ergonomics. I came out convinced that the root cause was poor ergonomics. I had not caused enough damage to require surgery. I set out to test out various ergonomic products. Nearly all of them sucked. Gimmicky crap. The ultimate solution was to design my own desk. The goal was to promote a fully relaxed posture with proper alignment and support. The standard 29 to 30 inch high desk was designed in the dark ages for writing. Placing a keyboard or laptop on it throws your entire body out of alignment. Your fingers, hand, wrist, arms and shoulders end-up operating in tension as opposed to from a neutral stance. My desk featured a dropped (about three inches) front section for the keyboard and thumb-operated trackball. I ditched the mouse as it caused too much tension. I found a thumb-operated trackball to flow naturally and comfortably. A dropped keyboard shelf wasn't enough. The front edge got a solid piece of wood, 2x2 inches in cross-section with generously rounded edges. This created a forearm support across the entire width of the keyboard shelf. The net effect was that my hands very naturally drooped onto the keyboard and trackball. My shoulders were not unnaturally pushed up or pulled down. I played with monitor height and settled for looking slightly down at the monitors (24 inch). I tend to alternate between sliding down in the chair and sitting up, which means that at times I am looking straight at the screens. The end result was that all pain was gone and I could get back to work. I also took regular breaks every two to four hours based on flow.

stiff 13y ago
I second this, the only time I ever had wrist pain for prolonged amount of time was from having the desk too high. Ergonomics is not about buying different five different mices, but about making sure the position of your body is such that it can work effectively. There is a good basic description here: http://www.ergonomics.com.au/pages/400_useful_info/420_how_to_sit.htm http://www.ergonomics.com.au/pages/400_useful_info/420_how_t... I don't think you have to go as far as to design your own desk (although the effect is probably great). Just avoid "computer desks" like the black plague and go for a simple large table top on regulated table legs - the keyboard drawer is the worst invention ever in terms of ergonomics.

efnx 13y ago

verisimilidude touched on a couple of these points already but apart from training your mind to not worry about pain you can also train it to type in Dvorak. I went even a little further and bought a $30 datahand keyboard (a really, really good price) but even with that dvorak'd wacky thing it only took me about 3 weeks of typing to get proficient and pain free. A good chair goes a long way as well.

asdf333 13y ago

I have to say it does not help your case that the your link to the book on amazon is an affiliate link....

stafrer 13y ago

how did this bullshit article make it to the front page?

jimgardener 13y ago

these links(http://en.wikipedia.org/wiki/Myofascial_pain_syndrome http://en.wikipedia.org/wiki/Myofascial_pain_syndrome and http://en.wikipedia.org/wiki/Myofascial_release http://en.wikipedia.org/wiki/Myofascial_release) seem related to the above problem ..In fact, couple of my programmer friends (been coding for 17 yrs) had this posture related problem and massage therapy more or less cured them

johannesg 13y ago

I like this article about Dr. Sarno's theories: http://www.bettermovement.org/2011/a-skeptical-look-at-the-theories-of-dr-john-sarno/ http://www.bettermovement.org/2011/a-skeptical-look-at-the-t.... In summary: his treatment probably works, but his theories explaining chronic pain are most likely incorrect.

mrexroad 13y ago

i was hoping that my rsi pain was either bad ergonomics or just mental, then last week i got the results from a 2nd MRI of my wrist: - torn TFCC - positive variance of distal ulna as well as an intraosseous cyst it's going to suck to get this fixed (especially the bone saw + plate + screws part), but the pain is pretty bad these days and the success rate is pretty high for what needs to be done. it's hard to bring myself to the keyboard when it's not absolutely necessary these days.