Raible Designs

Carpal Tunnel

Every month or so, after working a long-ass week, my left arm usually starts hurting as if I have carpal tunnel. Usually, I go get a massage and it feels better the next day, or a few days shortly after. The Massage Therapist always asks me if I've been diagnosed with carpal tunnel, to which I reply "No." They also ask me if I have tingling in my hands or forearms, and I always tell them "No, I just get a dull pain in my forearms when I work a long week." So I've never really had carpal tunnel AFAIK, just symptoms every month or so.

That all changed this week. I started noticing the dull pain in my left forearm at TSSJS, and I started noticing the tingling in my left hand yesterday. I've never had tingling before. Furthermore, last week was a pretty light typing week (but I might've played cards too much ). So now I'm worried; I'll probably get a massage this week and I have a chiropractor appointment next week. The only think I can think of that might be causing the tingling is: 1) riding my bike to work, or 2) the cheap-ass crappy keyboard I have at work.

I went to the Apple Store and CompUSA to get an ergonomic keyboard tonight, but had no luck. The Apple Store only sell the standard Apple keyboard and CompUSA only sells black Microsoft keyboards. The M$ keyboard's will work, but it seems wrong to hookup a Microsoft keyboard to a MacBook Pro with a cinema display. I have a meeting in South Denver tomorrow morning, so I'm going to stop by Micro Center. Hopefully they'll have something good.

Carpal Tunnel is a scary thing as a programming professional. It's one of the few things that can put you out of commission as a programmer. It looks like I'd better start taking it seriously if I want to keep slingin' code for the next 10 years.

Related: Carpal Tunnel in May 2004.

A Week Later: I went to a repetitive motion specialist yesterday. They said that hand surgeons hate them b/c they can solve most issues. They worked my left arm and hand, and expect everything to be better with a couple more treatments. It already feels a lot better, but I'm also doing stretches every hour - which helps a lot too.

Posted in General at Mar 28 2006, 09:25:53 PM MST 40 Comments

Comments:

This helped me:

mouse, bike. good luck!

Posted by Marcus Beyer on March 28, 2006 at 11:07 PM MST #

While I don't have carpal tunnel, I try to be aware of how much time I spend typing away at a keyboard. For long sessions, I'll do a few forearm and wrist stretches. Not too sure if this itself has prevented me from having issues, but I have read that it's supposed to be preventative. You may want to try doing the same on a regular basis. IANAD, but I would think every 15-20 min taking 30 sec to do some stretches would do a world of good. My nickel's worth anyway...

Posted by Winston Rast on March 28, 2006 at 11:13 PM MST #

Hi Matt, I had some similar problems last year (without tingling), probably due to a crappy keyboard. I tried with bandagings, massages and ointments without result.
I only managed to feel better after taking a week off from work. No keyboards, no laptops for a week and you'll feel better.
Second rule (for me at least): don't work during the weekend, or , at least, not all the weekends.
Third rule: check your posture: googling around you will find several suggestions. And never, ever, work with the laptop on your knees (this is a reminder especially for me!): the position of the wrist is incorrect (too much bent)

Posted by Filippo on March 29, 2006 at 03:05 AM MST #

It won't put you out of commission as a programmer. One of the best programmers I know was born with a disability that makes his hands pretty much useless. He types with a toothbrush held in his mouth, and he's as fast as some of the best touch-typers I've ever seen.

Posted by Neil on March 29, 2006 at 03:06 AM MST #

I've had RSI problems for quite many years, and there are two things which helps *alot* First of all, don't buy those 'tipical' ergonimic keyboard that you can find on the high street. Order a Kinesis Ergo Contoured keyboard: http://www.kinesis-ergo.com/. It costs quite a bit (240$), but it makes a HUGE difference, and is most definitely worth it. Second, when working on the keyboard, wear wristbands like the ones for playing tennis, that also makes a *very* big difference

Posted by Yannick Menager on March 29, 2006 at 03:36 AM MST #

I had some problems about two years ago. I bought SmartGloves: http://arstechnica.com/reviews/02q3/smartglove/smartglove-1.html My god, what a difference ! Like you, after a very long week, I'll still get some bad sensations in my arms (mostly right), but that's it. Also, I switched from a mouse to a trackball. I'm using the Microsoft Trackball Optical. Not on the market anymore, but you should be able to find a replacement anyway.

Posted by François Beausoleil on March 29, 2006 at 03:49 AM MST #

Good luck, Matt. Hope nothing's serious.

Posted by Muthu Ramadoss on March 29, 2006 at 04:01 AM MST #

I have been using the Adesso Tru-Form Contoured Ergonomic for Mac and love it. It's more like the old style M$ ergonomic keyboard (large) than the newer smaller one. As long as I stay away from using the mouse as much as possible, the tingling stays away.

keyboard at amazon via tinyurl

Posted by Doug Bryant on March 29, 2006 at 06:38 AM MST #

I started having consistent wrist and hand pain a few years ago, and like you got concerned enough to switch to an ergonomic keyboard. I have been using a Kinesis Contoured Keyboard for the last 6 years and it has made all the difference in the way my hands feel. It took 2-3 days to get used to it, but after that I couldn't imagine going back to a traditional keyboard on a regular basis.

Posted by Mark Imbriaco on March 29, 2006 at 07:13 AM MST #

I've been there (and I'm only 26...) but I definitely understand your pain. What helped me is to buy that Microsoft natural keyboard and mouse. It does wonders, and I just can't go back to those normal keyboards and mice - I feel the pain right away. Scratch away the Microsoft logo if it bothers you that much! But honestly, I'd rather be considered a Microsoftie than being in pain half of the time :)

Posted by GB on March 29, 2006 at 07:35 AM MST #

Count me in with the Kinesis Ergo boosters. I've used them for about 6 years and have had arm/wrist pain only a handful of times, usually after I've been using the mouse for an extended period of time. (Games)

The USB version works just fine with my Aluminum Powerbook.

Posted by Chris Winters on March 29, 2006 at 07:48 AM MST #

Me three on the Kinesis ergo classic keyboard. It was expensive and took a few days to get used to, but it completely solved my rsi issue. I paired it with this trackball http://www.logitech.com/index.cfm/products/details/US/EN,CRID=2150,CONTENTID=5001 (which also to getting used to, but I wouldn't switch back for anything). I've also been told that part of the problem may be that I was using a laptop a lot and leaning over a desk to view the screen. The additional pressure of leaning on my forearms was pinching the nerves in my forearms. Now the only times I start to feel pain is when I have to use a laptop or another flat keyboard for a few days (especially hunched over a desk).

Posted by Keith Weinberg on March 29, 2006 at 07:58 AM MST #

Matt: Go to a GOOD doctor to confirm carpal tunnel. The pain could be due to a number of other things - like bursitis, for example. Treatment would vary depending. Jeff

Posted by Jeff Boring on March 29, 2006 at 09:29 AM MST #

Me two with the Logitech trackball - no more CT pain. It also doesn't move around the desk, so you always know where to place your hand (no Hani-style jokes please). Recently started getting finger pains instead - traced to using Tosh laptop nipple, all those little movements and the other fingers being held in unnatural position. Go to a doc.

Posted by Steve Phillips on March 29, 2006 at 09:45 AM MST #

You could find here some usefull toy. I use one from time when hand and forearm hurts, it works pretty good.

Posted by Meshee on March 29, 2006 at 10:15 AM MST #

Matt, you'll never collect workers comp if you attribute your carpal tunnel to the cards. :) On a serious note. Does anybody even make an ergo-keyboard for a Mac?

Posted by Erik Weibust on March 29, 2006 at 01:08 PM MST #

Thanks to all for the suggestions. I ended up getting an Adesso Tru-Form MAC USB Keyboard with Touchpad and a Mighty Mouse at Micro Center today. I figure I'll try the keyboard for a week, take the weekend off - and see how that goes. If the new keyboard doesn't help, I'll start looking for a more exotic one. If I'm still hurting in a month, I'll switch to the Dvorak Keyboard Layout.

Posted by Matt Raible on March 29, 2006 at 01:56 PM MST #

The Adesso keyboard link doesn't work. The site's built using ASP, that's probably why. :)

Posted by zach on March 29, 2006 at 02:51 PM MST #

Switching to a Kinesis Ergo Contoured keyboard made by carpal go away for about 6 years. Lately it's coming back, so I'm going to have to see a doctor. But I'm definitely glad I got the Kinesis, I own two, one for work and one for home.

Posted by James A. Hillyerd on March 29, 2006 at 03:10 PM MST #

Great advice in "All of the Above", Also add these supplements ASAP: B Complex 100/ and B-12 1000mcg. Take every few hours during the day for at least a week, keep near desk, then take twice a day. It will help the nerves heal. If they are tingling something's cutting them up! (Such as wrist in awkward position) Lived with this since 1989 but no problems at all IF I use the split keyboard, a stationary Logitech mouse, and I don't run out of the B vitamins. Ginkgo also helps.

Posted by Christina on March 29, 2006 at 04:24 PM MST #

I had a similar problem and a split keyboard (the from MS) solved it. Cheap keyboards are a biiiig problem for programmers. See http://www.stephan-schwab.com/2005/04/27/1114640731796.html

Posted by Stephan Schwab on March 29, 2006 at 06:49 PM MST #

Try getting a good wrist wrest when you are typing or using the mouse, I find that they help to reduce the tensions.

Posted by Herryanto Siatono on March 29, 2006 at 07:30 PM MST #

Use the kinesis. I have one in Sydney, and one in the US, for times when I'm over there. They are life savers.

Posted by Scott Farquhar on March 29, 2006 at 08:14 PM MST #

Definitely order a Kinesis. I've used one for 6 years and it's a life saver: http://www.kinesis-ergo.com/advantage.htm

Posted by Bill Lynch on March 29, 2006 at 08:46 PM MST #

I've had similar problems as well....in both arms. Getting an ergonomic keyboard and a trackball mouse helped a ton. I've never had problems in my right arm since I started using the trackball mouse. I've also noticed that spending lots of time using my laptop usuallys flairs things up. The keyboard is just so frickin' small and I use a lot of keyboard shortcuts which is a great recipe to really aggrevate the left wrist. Anyway, I usually use an ergo keyboard with my laptop when I'm at home and that has really cooled things down. I've also started doing some weight lifting which has helped a ton (strengthens the muscles and tendons in the arms and wrists). I think the most important thing --once things cool down--is to do some sort of exersice that strengthens the wrists and arms.

Posted by Steven Hansen on March 30, 2006 at 08:37 AM MST #

Matt: you didn't say whether you're a lefty or not (I suspect you are and you're mousing a lot). Mice are evil. I still get soreness in my arm if I'm at a customer site and have to use the damned things there. Get a trackball or a Wacom tablet. I prefer the tablet over a trackball. I also second the Kinesis. My key symbols are all worn off from my fingernails, but besides that, I'd buy another one in a heartbeat. You can also switch between the better cupped layout and a regular QWERTY keyboard easily. Maltron makes something similar now w/ key labels that don't wear off, but it's $100 more expensive :-P

Posted by Ken Yee on March 30, 2006 at 10:19 AM MST #

Matt, I just want to wish you the best of luck in your efforts to keep this from cramping your style. I appreciate much of what your left arm types!

Posted by Sean Gilligan on March 30, 2006 at 12:16 PM MST #

Tons of good advice. The natural keyboard and trackball mouse did it for me, but I highly recommend getting a good, fully-adjustable, keyboard tray. This will allow you to set the angle and position of your keyboard to the most comfortable and ergonomic position possible. If I don't use the keyboard tray, I find that my arm will rest on the desk while using the mouse and keyboard, and that pain comes back in a matter of hours. I bought one from Task2.com years ago, which has keyboard trays for natural keyboards: http://www.task2.com/GL_Display.asp?SEC=9&EntryID=64 Good luck.

Posted by Ron Milner on March 30, 2006 at 01:37 PM MST #

Matt, the adesso won't make much of a difference compared to most of the 'tipical' ergonomic keyboard, in our line of work RSI is the *greatest* dangers, and once you got it once, it will never completely go away, so it's something to be really careful with. Your career is worth spending an extra 150$ to get a kinesis. I got three myself ( one for work, one for home, and a backup ).

Posted by Yannick Menager on March 31, 2006 at 10:26 AM MST #

I use a wristwand and that really helps

Posted by Sam on March 31, 2006 at 04:13 PM MST #

Matt, you of all people have a great opportunity to do tech related stuff without having to use your hands much. Preparations for speaking engagements, training engagements and book writing can be via dictation. You might also be able to take on an assistant at a later point; it would be a valuable assistance to you, and a great learning experience for the assistant.

You can still do hard core programming, especially with all of the great advice mentioned in the 30+ comments above.

Posted by Solomon on April 04, 2006 at 07:52 AM MDT #

Matt, how does one locate a "repetitive motion specialist" - yellow pages? Not that I need one, but I've had a couple scares too.

Posted by Lance on April 05, 2006 at 07:23 AM MDT #

I had chronic issues with my wrists, mostly tendinitis, however. The way I solved it was by switching to the Dvorak layout. Since my switch, I've had next to no problems with my wrists, and I spend about 9 hours a day at the keyboard. With the Dvorak layout, it just feels more comfortable to type. I never realized that with the Qwerty layout there were certain words that, on a subconcious level, I did not like to type. Last note: I see there is some question about the benefits of the Dvorak layout in the entry on wikipedia. All I know is that it worked for me (of course I can't type on qwerty anymore, I've forgotten how).

Posted by gordonjl on April 06, 2006 at 08:26 AM MDT #

Matt, Go to the gym and start lifting weights....You'll not only prevent what sounds like the beginnings of carpal tunnel, you'll shave off a few inches the ole beer gut!... -dh

Posted by The DH on April 10, 2006 at 06:14 PM MDT #

Try Kinesis for ergo keyboards. I use to use one of there's in Openstep.

Posted by Robert Nicholson on April 12, 2006 at 08:08 PM MDT #

Matt, real simple thing is to move away from the keyboard every 30 minutes or so to stretch and get the blood circulating. It makes a big difference. Usually not a bad idea in terms of background thinking and counters excessive microfocus.

Posted by David Bernard on April 17, 2006 at 09:19 PM MDT #

Forgive me if the subject of my comment is a bit intrusive, but I have a product wich I distribute. It is called The True Arm. It is an ergonomic arm support unlike any other on the market. Adaptable to 95% of desks. I would go on further but first would like some feed back on weither or not I am permited to post such comments. Yours truly Michel Germain GERMAIN ERGONOMICS INC. http://www.thetruearm.com

Posted by M. Germain on January 30, 2007 at 01:06 PM MST #

For a long time now I've used some version of an ergonomic keyboard with my own alterations. It consists of a split keyboard tilted backwards, not forwards as all manufacturers for some crazy reason do with all of their supposedly ergonomic keyboards. At one job I even used the non-split, default Mac keyboard, but I propped it up with styrofoam (from the packaging) so that it tilted backwards, that is with the closest side up and the farthest side down. That conforms to your hand, wrist and forearm's natural curve. Look at your hand and arm when you hold it naturally straight, not artificially, rigid straight. Your fingers naturally hang down and your wrist isn't tilted. But if you pop up the little legs underneath some of these ergo keyboards, like my MS split keyboard, that just makes the keyboard tilt toward you and unless you have the discipline of Mr. Miyagi, you're hands are going to tilt up and your wrist is going to bend and your back is going to arch and your head is going to hang forward and your everything's going to go to hell and your career will be over.... phew... My gf is a former massage therapist and her advice has been to separate the keyboard from the laptop. Laptops are awesome, but not for long sessions of work. So, that's the other thing I've added to my home set-up. If you saw it you'd see a laughable looking MS split keyboard with a cardboard contraption I've taped to it to tilt it backwards as well as my MB placed on 2 boxes (about 7.5 inches on the front and 11 inches on the back) off of my desk so that the screen is straight up and down and is almost directly in front of my head. So, if I sit as all diagrams say, correctly, my funky keyboard is on my lap and the laptop is propped up in front of head and my spine is, more often than not, naturally straight. And sometimes I sit on a physioball. And I never use a mouse. A Wacom tablet or my trackpad. And my chair no longer has armrests. Those are bad too. Key in health...

Posted by Melton Cartes on May 27, 2007 at 04:34 PM MDT #

I DO USE a Wacom tablet or my trackpad.... Mice and chairs with armrests are bad. Tablets and trackpads are good. Sorry. Awkward writing there, before. Key in health...

Posted by Melton Cartes on May 27, 2007 at 04:37 PM MDT #

Matt, How do you find information about repetitive motion specialist ? I searched but had no luck. Thanks, Jyot

Posted by Jyot on January 15, 2008 at 08:41 AM MST #

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