WUWT Status report

Some of you who have corresponded with me lately may have noticed that I have been brief with my responses.  You may also have noticed a number of spelling and grammatical errors in recent WUWT blog postings. This is due to the fact that after over five years of blog posting, I have succumbed to a problem that plagues many people who use the computer too often -carpal tunnel syndrome.

During the last week the problem has gotten severe enough to interfere with my ability to use the keyboard and mouse, as I have constant pain in my right hand.  So tonight I decided I would try something new.

That “something” turned out to be speech recognition in Windows 7, which until tonight I didn’t know existed.  I started looking for a off the shelf program to do the job but in the Google search discovered that it was built into Windows 7.  After going through the tutorial on it I am using the speech recognition utility to write this blog posting.

As with any new technology it takes some getting used to.  But, I am getting the hang of it with continued practice.  So far I’ve only had the correct about six or seven mistakes in the paragraphs preceding this.

Over the next few days I planned to take a little bit of a break in blog posting and I will use that time to get more familiar with the speech recognition software.  Hopefully by taking a short break I will be able to improve the situation with my right hand.  Of course, I also have to learn how to dictate more effectively as it is something I’m not used to on a regular basis.  I will say that that dictating to the computer allows me to write faster than I have been able to for quite some time.  Further, it seems the speech recognition software is quite good at picking up the nuances of my voice and inflection which results in an overall increase in typing speed.

For those of you that have Windows 7, you might want to try getting a USB headset with a microphone and practice learning how to use the speech recognition software -it may help you write better comments.  One of the most interesting things I learned is that screaming at the headset results than nothing being typed at all – the computer gets confused.  So, on the plus side if everyone use speech recognition for writing comments we would probably have less trolls because they tend to shout.  🙂 it even recognized when I said the emoticon in the middle of the last sentence.

In the meantime, those of you that wish to submit stories should use the submit story button on the WUWT menu. Please bear in mind that when submitting a story it should be submitted as if it’s actually going to be posted rather than as a tip or advice.  Please use tips and notes in the menu for those sorts of notifications.

As always, thank you for your patience and consideration.  -Anthony

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Mark and two Cats
June 26, 2012 11:11 pm

Bravo Anthony!
Carpal diem!

Jenn Oates
June 26, 2012 11:12 pm

I have the same problem, Anthony–it first manifested itself when I was in my early 30s while slinging around five gallon buckets of mud at an archeological site, and when I saw my doc about the pain he said it was my carpal tunnels rebelling at the labor. I told him that I was too young to get carpal tunnel, and to his credit he only smiled, not laugh derisively.
It’s a pain, but for our sake I’m glad you’re finding a workaround!
Okay, okay, for your sake, too. 🙂

June 26, 2012 11:17 pm

How is the contextual stuff working out? Can it distinguish between “recognize speech” and “wreck a nice beach”?

Hilary Ostrov (aka hro001)
June 26, 2012 11:23 pm

Thanks, Anthony … going to pass this on to my (almost 90 yr old) Dad, who’s been struggling (unsuccessfully) with Dragon for several years – and who against my better judgment (countermanded by my sibling and step-siblings), a year or so ago got new laptop with Win 7 and MS productivity minus “Office 2007”!
But I did notice one error you might want to correct in your post: “So far I’ve only had the correct …” I’m sure you probably said “So far, I’ve only had to correct …”

Jimmy Haigh
June 26, 2012 11:34 pm

Isn’t technology wonderful? Of course one will have to mind one’s ‘p’s and ‘q’s…

June 26, 2012 11:35 pm

Nice tip, thanks, gotta try that out. I bought a Dragon NatSpeaking 10 years ago but after benchmarking I found that with all the corrections I had to make I wasn’t faster than typing – it wasn’t bad but I’m a fast typer so the bar was too high and I abandoned using it. Also, the windows integration wasn’t good enough for me. Let’s see whether this one works better…

June 26, 2012 11:35 pm

Anthony – glad that you are using that software.
I did 4 things to address my issues:
1) Increased my water intake (it turns out that dehydration aggravates the condition)
2) Increased the recommended flexibility exercises with the soft squishy rubber ball thingy provided me
3) Took an anti-inflammatory
4) Installed an ‘ergo’ software to remind me to take breaks
The condition is now well-managed. Hopefully you can address yours as well…. I’m keeping my fingers crossed (wait, that doesn’t sound right…)! ;-D

June 26, 2012 11:37 pm

has Romm discovered Voodoo, I wonder

Patrick Davis
June 26, 2012 11:38 pm

Although I don’t suffer from your condition I know how RSI can render people almost unable to do things comfortably. I know this technology in Windows 7 is quite good out of the box so to speak. I recall setting up an IBM PS/2 running OS/2 back in the early 90’s for an employee who suffered from multiple sclerosis, took a while to setup, but worked rather well. Enjoy the new toy.

June 26, 2012 11:40 pm

Speech recognition training is mostly about training yourself to enunciate properly and leave micro-pauses between words.
For carpal tunnel syndrome I recommend therapeutic gloves or wrist bands. They worked well for me and over a couple of years my CTS seems to have faded almost completely.

June 26, 2012 11:42 pm

Hey Anthony
Sorry to hear about your wrists I have suffered with issue myself but the good news there is a solution without surgery. I know you have probably heard of miracle pain relief products a dozen times. But I can assure you as some one who lost complete use of both hands (carpenter turned heavy computer user) this stuff works. I keep buying it 6 at a time and end up giving most of it to others I tell about it who suffers from carpal, tendinitous any joint swelling pain. Usually takes just a few days for initial relief then a few weeks to be almost like new. Last lady I gave it to was back to work renoing her house after just 3 days. Just check amazon reviews of the stuff I’m not sure there’s a single bad one. You can find it at http://www.penetrex.com/
Check it out I think you will be amazed.
PS In thanks for such a amazing site. I’m gone hit the Tip jar to cover your first jar of the stuff

June 26, 2012 11:43 pm

I have been using a keyboard since the mid eighties. (actually a bit before) and have never had this issue. In fact, I have been using a keyboard for so long, that when telling someone what keys to push, I keep messing up and tell them to hit the return key. (enter).
I don’t doubt that it’s a problem… I have had other non keyboard repetitive stress issues… but they mainly are due to extended periods of mouse use or leaning wrong for too many miles while driving.
Hope you get better!

June 26, 2012 11:44 pm

One of the most interesting things I learned is that screaming at the headset results than nothing being typed at all – the computer gets confused.

Reminds me of an autobiographical note published by Isaac Asimov some decades ago, in which he mentioned – disappointedly – his failure to make dictation and transcription work for him in his fiction writing.
Apparently, Dr. Asimov “thought” his dialogue and narration in very vivid terms. At the keyboard of his computer, he could put no more immediate emphasis on his prose than hammering the hell out of the poor gadget (the old steam-powered Smith-Corona portable I used in college and med school still bears the marks of my fingernails grooving the keys commonly struck by the second and third fingers of both hands).
When he tried to dictate, however…. Hoo, boy.
His transcriptionist had to give up in despair, reporting to him (according to Dr. Asimov) that especially in dialogue he projected the emotions of his characters – particularly in conflict – so frenziedly that she couldn’t understand him.

June 26, 2012 11:54 pm

Yet somehow I’ve managed to use a keyboard all day, every day, since 1980. I’m skeptical.

June 26, 2012 11:59 pm

One option is to get a tablet like wacom and use a pen.

Hector Pascal
June 27, 2012 12:05 am

Commiserations Anthony. My carpal tunnel syndrome is chronic, not acute, so I can manage. It peaks in spring at the end of the snow clearing season (16 metres last winter).
Does the voice recognition thingy respond to “dig, shovel, faster”? That would be cool!

June 27, 2012 12:07 am

I had bad pain in my right thumb/wrist area, cured it by switching from a small short oval mouse to a large tall ergonomic mouse that allowed my hand to be more open.

June 27, 2012 12:09 am

I suffered from carpal tunnel, repetitive strain injury and tendonitis from using computer mice, keyboards and controllers. Being a video editor I had few options other than to not work. I eventually switched to using a Wacom pen and tablet and have been able to manage the condition for the last ten years. Still get occasional bouts when I’m busy but on the whole I get by without any serious problem. Pen and tablets get a little time to get used to but they are so much better than mice. Just try writing your signature with a mouse. Voice recognition software is invaluable too. I use the iPad’s built in speech software to dictate blog posts, articles and documents. And this message!

June 27, 2012 12:10 am

When I first tried using speech recognition I was very impressed when it got “I’m too tired to walk two miles” (with the three forms of ‘to’) correct. I’ve since given up with it as much of my work is overseas and having spell the name of each raingauge or flow meauring station slows things down too much.

June 27, 2012 12:12 am

Maybe you’re doing something else wrong. Maybe your diet is bad. Maybe your exercise regimen is bad. Maybe you’re not sleeping well. Maybe your stress is bad.
I encourage you to avoid chemicals and quick fix products.
I didn’t mean to sound rude before, but carpel tunnel doesn’t happen to healthy people. I encourage you to investigate your health instead of fixating on one issue.
I hate to promote a site, but if I had to, I’d promote MarksDailyApple.com

June 27, 2012 12:15 am

Crap. I have no association with MarksDailyApple.com, other than the same first name.

June 27, 2012 12:17 am

It was probably about 15 years ago that I first used a program called ‘Dragon-naturally speaking’;
It was totally hilarious to the point I seriously thpught about asking the TV people to make a game show of it whereby everyone spoke a pre prepared text and the one that was changed the most into a totally incorrect but still reasonably lucid story was the winner.
Obviously things have moved on. I commend you for your ability to continually adapt to changing circumstances

June 27, 2012 12:19 am

Go get ’em, Tiger. You must be greatly relieved. I find that voice recognition software is sketchy owing to my workplace, where there is a constant background din. So, I type. But for you and your seemingly tireless running of WUWT, wow. What a revelation, eh?

June 27, 2012 12:20 am

I’ve been using Dragon for about 13 years, often professionally, through numerous sequential versions. The training period has improved from about 3 weeks (in the early days) to 30 minutes or less with the current software and I’m *very* happy with it. 130+ words/min, comparable to a competent typist.
Tried the Windows 7 software 6 months ago and found it decidedly inferior.
However, Dragon is now quite expensive and upgrading your O/S might make your earlier version inoperable, necessitating a big hole in your wallet. Not so good!
I have similar gripes with Quicken, whose policy in this area is outrageous.

June 27, 2012 12:24 am

Seems to work very well, Anthony – who’d have thunk it?! I hope it takes the strain off the hands.
A friend of mine was attempting to show off his new ‘virtual assistant’ (aka SIRI) on his iPhone 4s at the golf club the other day. Unfortunately, it kept getting all the commands wrong and we all sat there, patiently humouring him in his vain attempts to get it to do something even remotely clever – until, red-of-face, he finally blurted at the phone “do what you’re told, YOU STUPID F****** ****!”
After a brief pause, the ever-polite voice said sternly “I do not respond to profanities”. End of conversation. He was well and truly pwned, and by his own telephone! {:oD

June 27, 2012 12:27 am

If it is a mouse RSI problem..simply train yourself to use the other hand. I did. If I run into problems again……I shall switch back.

June 27, 2012 12:35 am

Anthony, I’m right handed and haven’t used the mouse in my right hand for 15 years due to CTS. I was a hard-core software geek and 18 hour code-a-thons were not unusual. The pain, from my wrist back up my forearm got worse and worse until I abandoned the PC for a week but not before hitting up Google and a few fellow sufferers for suggestions. My suggestions are:
1. Learn to use the mouse in your other hand. It felt like sitting backwards driving on the wrong side of the road for a while… but I got used to it.
2. Never rest your wrists. Lateral mouse movements need to be with the big muscles in your arm, not the small muscles in your wrists. Tension in these small muscles apparently traps toxins.
3. Becoming a mouse-leftie was a bit unweildy at first. I ended up using my little finger as a ‘brake’ on the mouse pad given the forearm of your non-primary limb is a kinda sledgehammer approach to moving a mouse
4. Drink plenty of water (already suggested and I concur with that)
5. Take regular breaks. My 18 hour code junkie session are over. My family thanks me!
Wishing you a speedy recovery, and a succussful alternate input strategy!

June 27, 2012 12:36 am

One thing that is a definite cause of carpal tunnel problems is bad posture. The most common reason for bad posture when sat at a desk is a bad chair.
A lot of people who get the problem report that they got a new chair 6-12 months beforehand. The worst offenders of the chair world, in my experience, are the big, luxury boss-type ones.
For proper posture, you need to have your wrists parallel to the desk top, i.e. any weight that you put on them should run along your whole forearm and not just on your wrist. That normally means having a chair that can go quite high. You also need to make sure that nothing puts pressure on your elbows — big, padded arm wrests that seem to support your arms are just as bad as hard plastic ones. Your hands should be able to be on the keyboard with your forearms along the desk and your elbows free from obstruction.
I can’t claim to be qualified in this area but I’ve had to use some truly dreadful desks and chairs over the last 20+ years hopping from customer site to customer site and have had carpal tunnel syndrome come and go due to them.
Hope this helps.

Richard Briscoe
June 27, 2012 12:39 am

Anthony, may I make another suggestion ? Try using the mouse left handed for a while.
I work in IT, and a few years ago I started experiencing pain in my right wrist. I switched to left handed use. It’s easily done – go to Control Panel and you can reverse the buttons. I quickly adjusted, though it annoyed anyone else who tried using my machine! After a month or two the problem with my wrist has gone away, I switched back to right handed mouse and have had no problem since.

Paul Matthews
June 27, 2012 12:39 am

You say the main problem is in your right hand and it’s related to mouse clicking.
When I got pains in my right index finger as a result of this a few years ago I simply started left-hand mousing (so I use the 3rd finger of my left hand for the usual left-click). It was fairly easy to switch and so far no problems with the LH fingers.

June 27, 2012 12:39 am

Hi Anthony,
I’ve a tip that may work for you too: If you’re righthanded, use the mouse with your left hand! It worked for me. It may take a couple of days to get used to it though, but it’s worth a try. I’m painfree for over 7 years now.
When I accidentally use my right hand with the mouse I have pain within 5 minutes. With the left hand I can use the mouse all day long.
Somehow with the other hand one uses the mouse in a more relaxed way and that avoids a too firm and tensioned grip which causes the complaints imo. I have had no more complaints since the switch.
Kind regards,

June 27, 2012 12:41 am

If I might be so bold to suggest…..
Quite a few years ago (I forget how many–before I was fired for being too old in 2003) I was diagnosed with CTS–went through the splints thing, listened to some serious talk about how I “needed” the surgery…..
Short summary–the splints helped (or seemed-to) early on–eventually got to the point that they caused as much discomfort as they helped. I stopped using them regularly, but I kept them (but haven’t used them in a while–not sure what happened to them when we moved a year ago) to wear at night when I have misbehaved–they keep me from bending my wrists in my sleep.
I quit the Naproxen because it makes me angry, and the Vioxx and Celebrex which developed scary reps. I use Naproxen now and Ibuprofen and Tramadol at night sometimes. (sometimes together, some times not–the target is seldom my wrists, usually knees and angles.)
The big breakthrough was getting referred to a Physical Therapist that taught me hygiene and posture techniques that have eliminated the problem,. E l i m i n a t e d.
Every now and again I misbehave and the pains return, but quick attention to corrections in the posture and what I called “hygiene”–exercise, tension control, rest stops it before it gets bad. As I say, I have not needed the splints for a year or two, and then only at night.
Take from this what ever is useful–I don’t want a debate, or even an acknowledgement. Mods, I don’t even care if it is released.
It worked a miracle for me and I feel a need to pass it on. End of story,
Good luck. Good Bless. Thanks for what you do.

June 27, 2012 12:46 am

Minor glitch, which is obviously the software’s fault: “I started looking for an off the shelf program to do the job…”

June 27, 2012 12:52 am

… acutally, have just realised that it was altavista not Google that helpd me out!

X Anomaly
June 27, 2012 12:54 am

Hey, maybe there is a usb foot clicker/ pedal out there somewhere…….

June 27, 2012 1:08 am

Mark says
“I didn’t mean to sound rude before, but carpel tunnel doesn’t happen to healthy people. I encourage you to investigate your health instead of fixating on one issue.”
Of course Carpel Tunnel Syndrome can happen to anyone. It is a physical condition not a biological condition.

June 27, 2012 1:09 am

I am sorry to hear about your condition. Acupuncture can be very helpful indeed with carpal tunnel, and an ergonomic mouse. It is important to fix it before it becomes chronic. Good luck and do rest.

June 27, 2012 1:11 am

The mouse is a killer on the wrist and forearm.
Has the pain woke you up in the middle of the night or caused you to lose grip on a steering wheel? I hope it hasn’t gotten that far. Did you ever try an ergonomic mouse with a thumb track ball? If you get one and find a way to mount it so that the bottom face on the mouse is perpendicular to the top of your desk, and facing to the left (I’m sure you with your son that is a Boy Scout could tinker together a wooden, or metal holder for the mouse so it faces that way) and top of the mouse faces to the right and fits in a natural position into the palm of your hand, in a relaxed position, without any tension on the forearm muscle, you may find the pain going away.
If the palm of your hand is always facing down, toward the top of your desk, you will ALWAYS get pain in your forearm muscles since those muscles are always tensing to hold the hand in that position. Human muscles are not meant to remain tensed for long periods. The longer the hand is held in that position the worse that pain will be. You could end up feeling pain 24 hours a day.
For the wrist:
If the palm of your hand is facing down, toward the top of your desk: if the TOP of your hand is in a straight line with the forearm, or worse yet, at an angle slightly bent back (i.e., actually meaning up in this case) toward the forearm, you will get sharp pains in your wrist over time. The palm side of the hand must always be flexed forward, in an angle slightly toward the forearm. But again, this only applies when the palm of your hand is on a conventional mouse, facing down, toward the top of your desk.
If you have an ergonomic mouse mounted in the way I described above you will find freedom for your hand, wrist, and arm 🙂
A nice ergonomic mouse made by Logitech:

Bob from the UK
June 27, 2012 1:14 am

I’m a programmer, so I type all day and I developed this syndrome many years ago. I was told by a specialist to rest my wrists when typing. It cured it completely. I now always make sure I can rest my forearms on the table whilst typing.

June 27, 2012 1:15 am

Glad to see that you are obviously enjoying the new technology! BTW, is it the type of speech recognition that learns to adapt to your voice, so improves as it goes along?
And we’ve all got other things (the SCOTUS Affordable Care Act decision) to look at today!
Have a good break.

Mindert Eiting
June 27, 2012 1:15 am

Your problem is also well known to musicians. There are physicians who are specialized in these job-related handicaps. In your case there may be an oldfashioned solution. I think that there are many nice women or men around who want to be your secretary for free perhaps on a part-time basis. Not using mouse or keyboard for several months would be my approach.

June 27, 2012 1:28 am

The Git has carpal tunnel syndrome in his left wrist; he’s a right handed mouse user. Go figure…

June 27, 2012 1:34 am

Sorry to hear about your condition. Irrespective of what happens with the important work you are doing here for which so many people are in your debt, all the best to you and hope you can get on top of the pain issues mate.

June 27, 2012 1:36 am

“You may also have noticed a number of spelling and grammatical errors in recent WUWT blog postings”
I never noticed any errors, anyway, how can carpal tunnel affetc grammar ? ;-)))

June 27, 2012 1:40 am

Yo Git, when I was doing lots of phone support and work, I taught myself to use the mouse left handed so I could write and use the computer at the same time.
Now I have bad rsi in the tendons that connect the forearm to the elbow, and despite all the proper and alternate remedies, I can’t get rid of it
I had to sell the motorbike because I couldn’t control the clutch :-(((((((((

Scottish Sceptic
June 27, 2012 1:49 am

Anthony between falling off a climbing wall, hitting myself with a trowel and getting a lump of bone growth and constant computer use, I too have suffered from painful wrists.
What I think has helped is:
1. A roller-ball type “mouse” (with the ball on the top). I was quite sceptical of this and I miss the wheel for quick page scroll, but there is no doubt it has improved.
2. A “ergo-???” designed keyboard (I used to just use the laptop). I started using this the same time as the rollerball. The slight change in wrist direction when typing may have helped.
– also I use a soft wrist support. It’s a rubber thing about half an inch by 3 inches – it probably predates the internet, so I’ve no idea where you would get it.
3. Stretching exercise. Stand with your arm out to the side with the palm flat against a wall. Hold it there for 30 – 60 seconds. (Alternatively put hands together as in “prayer” and move away until you feel things getting tense).
4. The other things I was told generally was to move the monitor top level with your eyes.
… and measure progress over weeks, don’t expect some kind of miraculous change (which is why I’m not really sure what helps)

Eric (skeptic)
June 27, 2012 1:51 am

Anthony, I had that problem in both wrists (at different times) in the 80’s. I have changed a lot since then including diet, exercise (the rest of the body), stress reduction, etc. That’s probably the main reason it hasn’t come back along with coincident problems like neck ache.
My advice right now is extremely simple: if a wrist hurts badly, stop moving it completely. If that means brushing teeth with the other hand, then do that; spend the extra 10 minutes. Pain is a wonderful warning signal so pay attention to it carefully when considering the advice above (e.g. if some “wrist exercise” hurts, don’t do it!)

June 27, 2012 2:05 am

I have been typing on computer keyboards for 40 years, often for 12 hours a day or more and have never had RSI or CTS. But as my computer use predated the mouse by at least a decade, I never did warm to that new fangled device and use keyboard shortcuts where ever possible.
You might checkout the Headmouse. I’ve never had a need to use it, but knew someone who used a similar device and I recall his speed of navigation was impressive.

Hector Pascal
June 27, 2012 2:17 am

I had to sell the motorbike because I couldn’t control the clutch :-(((((((((
Oh noes! That’s worse than death.
I’m left handed, but I use a mouse set up for a rightie. It sits diagonally between thumb and forefinger, with the forefinger falling naturally on the left button. It feels completely natural and relaxed. My CTS is on my right (power) side, not my left (control) side.
On the bike, clutch is fine, but twistgrip causes problems. Not enough to give up biking, though.

June 27, 2012 2:19 am

Well, I guess we can add that to the list – Global Warming causes Carpal Tunnel. Can’t deny this one I guess.

June 27, 2012 2:25 am

CTS is often caused by non-ergonomic equipment and bad posture (which includes bad ways
of using the equipment.)
The biggest problem is the non-ergonomic mice we suffer these days. I have XXXL hands (British glove size) and I cannot get a mouse to fit my hand—anywhere. I’m also stuck with
needing a left-handed mouse—using a mouse right handed is really really awkward for me,
being very strongly left-handed. And, of course, almost all mice these days are right handed
I found a kiddy’s toy mouse (a large turtle) was big enough and this worked really well—until
it wore out. I tried to replace it but, of course, they were no longer stocked, forcing me to
revert to a (tiny, right-handed) modern one—again. So I use the mouse as little as possible,
which meant learning all the keyboard hot keys and short cuts. Nearly 20 years ago, I set out to learn how to touch type properly as the Modified Vulture Technique made keyboard use unpleasant too.
Correct keyboard use means I can use the keyboard more with less damage, even though I
type at half the speed of someone who learnt to type at school. Knowing the keyboard
shortcuts means my mouse use is greatly reduced so the poor fit to my hand doesn’t have
any noticable effect any more.
Analyse your tools for fit, action and comfort, fixing what you can with new tools where you
can find comfortable ones. Analyse your use of the tools:
—could you support your arms differently to take load off the hands
—is the mouse too small for your hand—ie you’re pinching the hand and fingers in to fit the
mouse and hence having a tense hand
—are you moving your hands around the keyboard correctly (consult a touch typing manual
here: I learnt a lot from one!)
Hope this helps …

June 27, 2012 2:25 am

I’m glad you found a workable solution Anthony, though switching to the left hand for mouse control does seem to be a popular solution.

June 27, 2012 2:38 am

Sorry about the CT syndrome. Painful. I have used Dragon voice recognition but if your voice changes over a short time, as mine does due to some problem I won’t bore you with, the VRS gives up. I found it was not good for any writing which included mathematical or scientific notations which had to be hand typed.
I gave up and type more slowly.

June 27, 2012 2:38 am

Hi! Sorry to hear you have the dread CTS. The “work station” modifications are a good idea but should should perhaps consider if you have developed trigger points-No one seems clear if TP’s create the problem or follow it but whatever, they do keep it going. Googling CTS + Trigger point gives lots of sites with DIY diagnosis and advice.
I have back and leg pain and my bible is “The Triggerpoint Therapy Workbook” by Clare Davies. A very good, easy to follow book for DIY treatment. (No DoI needed)

Ed Zuiderwijk
June 27, 2012 2:41 am

Working with a mouse is rats!

June 27, 2012 2:48 am

Dear Anthony,
Had the same problem with my mouse at work — and voice recognition won’t work when coding R. Switched to my laptop’s keyboard, enabling me to tap with my left thumb on the track pad, rather than click with my right hand on the mouse. Hand trouble is now easing up…

Tom Bowden
June 27, 2012 2:51 am

Take a look at Dragon Naturally Speaking foo. Excellent product.

Tom Bowden
June 27, 2012 2:53 am

Obviously I meant “too” not “foo” and I typed that on my droid, so it has nothing to do with Dragon.

June 27, 2012 2:55 am

“Wreck on nice beach.” Excellent euphemism for CAGW papers.
Very sorry to read that you have CTS. A very painful condition which I hope will clear up soon with rest and treatment. I’ve been recomended a trackball mouse such as Logitech’s Optical Trackball Marble Mouse but haven’t tried it.
I’m truly amazed at how well the Windows 7 speech recognition works.

June 27, 2012 2:56 am

I tried it a few weeks ago for the first time. Didn’t improve my character input but it really does help to improve your oration because it forces you to, as they put it, speak like a newsreader.

Gary Hladik
June 27, 2012 2:57 am

Anthony, as a TBBT fan you must know the potential drawbacks of talking to an electronic device:

June 27, 2012 2:59 am

Try using a vertical mouse. They are awkward and look stupid but a few days use relieve any pain I get from using a mouse. I leave one plugged in to a spare USB port so I always have the choice.

June 27, 2012 3:01 am

Another form-factor change besides a mouse that folks could try is a Wacom tablet. The pen will have its own peculiarities, but can be used as such. I have one, but don’t use it often.

June 27, 2012 3:02 am

I will endorse many comments here. I also work in IT and got “tennis” elbow (never played tennis). Used the mouse in left-hand like many others, used a joystick mouse which rotates hand 90 degrees, like many others. The hand rotation gave almost instant relief (but I am talking about a different part of the arm to Carpal Tunnel) and after a little while I can now mouse all day with a standard right-hand mouse. Rest it and the body is a great healer. Continue to aggravate the issue and you are headed for a life of pain.

June 27, 2012 3:09 am

As you have hinted at and from what I recall speech recognition software gets better the more you use it and correct it. Unlike some programs (cough* computer models *cough) I know 🙂

Steve C
June 27, 2012 3:16 am

Ouch. You have my sympathy for suffering CTS, Anthony. I’ve known one or two other people with it, and the nearest thing to a usable solution was indeed voice recognition. A Scottish friend had very good experiences with Dragon (unlike you!), and after a bit of training it soon produced excellently well spelt and grammatical output. Like anything, I suppose, practice makes perfect, and his good experiences were a fair few years / software generations ago so everything should be even better now. Ee. Nun. See. Eight. Clear. Lee!
Mercifully CTS is one thing that’s never hit me. “Glass arm” from sending too much Morse code, on the other hand … owww …

June 27, 2012 3:16 am

My wife had Carpal Tunnel in both wrists (she types for a living) and used a product similar to this – http://www.askergoworks.com/products/1660/RollerMouse-Free.aspx which she said made a big difference. She still ended up having surgery on both wrists, it takes less than an hour and about a month to recover, but she has been symptom free for a few years now. I am not sure why there is such a vehement anti-surgery vibe on here, maybe there are drawbacks I haven’t read about, but I can say from experience that it certainly can correct the problem.
Hope it gets better,

June 27, 2012 3:17 am

Hi Anthony,
just wondering if you can approve comments using the software?

June 27, 2012 3:29 am

Anthony. Has carpal tunnel actually been diagnozed ? Thought it was also my problem, but it turned out to be a C/6 nerve root impingement due to arthritis in the neck.

June 27, 2012 3:35 am

As someone with 68 years of total right handedness I was getting pain in the right wrist even having had the carpal tunnel operated on ten years ago. I switched my mouse to left handed and after a couple of days problem gone and no loss of speed. It might even be that the change could liven up my right brain and make me more creative!

June 27, 2012 3:59 am

Jimbo asked “just wondering if you can approve comments …”
Try “click” ? Or create a variant.
The Win 7 software copes very well with my “talk like a pirate” diction. I have tried translating expletives [in two] into commands in the computer aided design software [IOUs] I use, eg convert “s**t” into undo. Found undo is already a voice command, so I guess I’ll have to look at how you create aliases…. or give up cussing at the thing …

Julian Braggins
June 27, 2012 4:05 am

TonyTheGeek says:
June 27, 2012 at 3:16 am. I am not sure why there is such a vehement anti-surgery vibe on here, ————————
Perhaps, like me they have a relative or friend who finished up with a dropped wrist, and had to wear a brace thereon.
Clique2 says:
June 27, 2012 at 2:38 am The Trigger point Therapy Workshop, Davies and Davies, got a copy last Nov. very good for most pain relief.

Julian Braggins
June 27, 2012 4:07 am

Oops, that should be Workbook, (it was a long way away!)

Brian Johnson uk
June 27, 2012 4:09 am

Latest iteration of Dragon Dictate for an iMac user with CTS has worked really well.

June 27, 2012 4:16 am

Try 5,000 IU of Vitamin D3 supplement a day. Vitamin D deficiency is very common that nobody seem know about. It’s a type of hormone steroid that does so many things in your body. FYI, daily recommended amount is only 600 IU a day based on badly outdated studies (a cup of milk contains only 100 IU). That should tell you something… There are tons of latest studies indicating that we need a lot more vitamin D but it’ll take 10-20 years before they finally “officially” announce the need for that much vitamin D (if at all, I’m not keeping my hopes up because of what I’ve seen for 20 years). They move so slow… Another thing, when sunbathing without sun block lotion and t-shirt, people with light skin will easily get 10,000-20,000 IU vitamin D from the sun after 15-30 minutes during 10am-2pm. Won’t work too good if too early in the morning or too late in the afternoon. Air pollution will also reduce the amount of UVB sunlight from reaching you in large cities. Most don’t do that due to jobs, comfort of house, etc. Not to mention sun scare which turned out to be like CAGW.
In short – Vitamin D at right dosage can do things
– fight cancer, virus, bacteria (very effective against cold and flu)
– keep organs function at optimal level
– prevent autoimmune like diabetes type one, asthma, etc and also improve conditions of existing ones (anti-inflammatory)
– too many to list
One very promising thing – prevention and treatment of autism. Basically no different than preventing Spina Bifida with folic acid.

June 27, 2012 4:20 am

Anthony, after many years online for 50+ hours per week and as an author constantly writing/editing/revising book drafts, I *VERY* suddenly developed the same problem last November/December. Rapid onset, quite severe, VERY worrying obviously. I was unable to hold my hand out in front of me and turn it palm side up, and any typing at all was torture. As soon as I realized it was more than a temporary “duh, I musta pulled a muscle” thing I started researching and asking around. I did eventually did four things and the problem completely disappeared.
1) Tried taking a break for a week or two, doing only the most essential typing and doing almost all of it with finger pickin’ with my left hand. My thinking was “I have an irritated tendon and it will quickly heal if I give it a rest.” Nope. Virtually no help: the problem immediately resurged itself on any return to normal attempts to use the right hand.
2) I borrowed a friend’s wrist brace and used it for several weeks. It seemed to help and may have prevented further damage before I incorporated 2 & 3. I do NOT believe however that it “solved” the problem at all.
3) Dragon Speak v. 11.5 as a Christmas present from my brother and his family. I’d tried Vista’s speech recognition several weeks into my problem and had enough trouble with it to find it very frustrating except as a last resort. The amount of time training and then STILL correcting mistakes for lengthy periods with each writing just wasn’t workable. I had tried Dragon just as a cute thing about five to ten years ago and had had a similar experience. The Christmas present turned out to be WONDERFUL however. Dragon 11.5 was AMAZING in comparison: VERY little training — it actually did better with 5 to 10 minutes of the intro training than Vista had done after multiple intense hours of training. It quickly became good enough that about the only reason I still use the keyboard is because I think better when I type! LOL! **HIGHLY** recommended! (One caveat, I have one online friend, an older man in his 70s/80s perhaps, who tried Dragon for the Mac and was so unhappy with it that he returned it… I have no idea if the problem was him or the program however.)
4) Microsoft Ergonomic Keyboard 4000. Here it is from Tiger for $39:
and I got mine for $22 from someplace (although it came without proper docs) I credit this keyboard with 90% of my success in totally wiping out the Carpal problem. I had been afraid of a steep learning curve after decades of steady typing on a regular keyboard, but amazingly I found that I was typing pretty comfortably by the second day and within a week I found I would **NEVER** voluntarily go back to the old keyboard style. I had never thought of the old keyboards as being uncomfortable at all … but they ARE!!! The Carpal tunnel twinges (even with Dragon and the wrist brace I was still having problems) disappeared VERY quickly (within that first week or so!) and have never shown even a trace of returning no matter how much typing I do. I’ll still occasionally use Dragon for some of my extended less-formal work (E.G. sending someone a long rambling email where I’m not worried about even checking for the occasional small errors that sometimes pop up (Dragon makes a valiant attempt at automatic punctuation (very convenient: you don’t have to SAY “period,” “comma,” etc) but it’s not perfect), but other than that Carpal is now nothing more than a brief, although very bad and scary, memory.
Best of luck and hope your problems disappear!
P.S. Additional suggestion: If you’re currently using a mouse, try switching to an ergonomic trackball. I made the switch years ago and use a Logitech sculpted to fit the natural hand shape with the thumb track ball on the side and would never return to a mouse.

June 27, 2012 4:22 am

Thanks for the update Anthony and I hope your discomfort is gone soon. I’m struggling with golfer’s elbow, was ready to hit the links this summer but got sidelined by the driving range. I have a squeeze ball on my desk, wrist curls are great too and when my right hand starts twinging I switch to my left, pretty good with either now. There are many valid solutions to a problem and it looks like you have found a “sound” one.
Just wanted to tip my hat to you for the link about the supposed oyster crisis in the Pacific Northwest (Nov. 21, 2011). It seemed to shut down the propaganda machine on our climate forum, for now. “Ocean acidification *is* the last refuge of the global warming scoundrel.”
All the Best,

June 27, 2012 4:26 am

An additional PS: Dragon will “type” at over 150 wpm for me with a pretty acceptable error rate for casual writing — and anyone who’s ever heard me speak will know that’s QUITE an achievement! LOL! The nuns used to take me out of class sometimes and try to make me speak with a tongue depressor or spoon in my mouth to help … nope, didn’t help. I *still” called them “Shister Shusan” and, if standing, would ask them if I could “sh*t.” etc. And don’t even get me started about chasing cwazy wabbits or my Brooklyn/Irish accent!

June 27, 2012 4:35 am

Sorry to hear about your condition, and it’s good news that you are already dealing with it. As someone who spent 25 years chained to a keyboard, I have to be very careful about mouse usage. The fact is that the standard mouse puts strain on your wrists immediately – your wrist is rotated at 90 degrees from its rest position (think how your hands are when your let your arms down by your side). So getting an ergonomic mouse (one that makes you rest your hand on its side when you use it, and NOT on your palm) will help hugely.
Check out these guys – they are Dutch but I’m sure you can buy equivalents in the USA

Robert of Ottawa
June 27, 2012 4:36 am

To overcome physical problems with constant use of computers at work and home, I do the following:
Change all “select” features to ‘one-click’ instead of the usual double-click; this reduces by half the operation of the index finger. Some people use pistol-grip style mice. A wireless mouse give more freedom for a comfotable position.
Sit upright, there is a tendendcy to crouch over a computer screen. Have the display in a position that you can comfortably see it without bending your kneck. Use the mouse on a surface/table/desk that allows your elbow and forearm to rest on it while using the mouse.
Get up and walk around every 30 minutes or so.

June 27, 2012 4:38 am

Hi Anthony
I suffered from wrist and arm pain for 11 years and had got to the point where I could only use a keyboard and mouse for a few minutes before the pain became worse. Then I was given the book Clique2 mentioned earlier: The Trigger Point Therapy Workbook by Clair Davies. I traced the pain back to trigger points/knots in some neck muscles. Four days of massaging those muscles later I was pain free and have been for the last four years. I can work all day on the computer without pain.
I had been to various doctors/specailists/physios etc for the problem and not one of them looked at anything except where the pain actually was. However pain can be referred from the cause to different parts of the body. I strongly recommend either gettting the book or seeing a massage therapist who specialises in trigger points. It certainly changed my quality of life.
All the best. First time poster. Great site.

John Silver
June 27, 2012 4:40 am

Variety is the ticket. Buy a number of DIFFERENT input devices and cycle between them.
Pad with pen, trackball, ergonomic mouse and so on. Don’t be cheap on your health.

Gary D.
June 27, 2012 4:45 am

I switched my my mouse to the left side years ago for CTS pain. I convinced my wife to switch her mouse when she was having shoulder pain. She did and the pain went away.

June 27, 2012 4:47 am

Funny story on this theme. The software company that I worked for over 20 years finally agreed that the workstation environment that they provided for a guy 6’6″ tall, with a 36″ inside leg, and arms 2 inches longer than is usual for someone of my height, was not what it might have been.
I had for some months been working form home, so insisted they sorted out my working are before I returned to the office.
So – they raised the desk on blocks. They extended the desk with a block on top so that I could rest my forearms comfortably. They got me a nice big monitor for my dodgy eyes. They got me a seat made. It didn’t do at all. I suggested one of these – I had one at home, and it was superb – http://www.hermanmiller.com/products/seating/work-chairs/aeron-chairs.html – but they wouldn’t stump up. So my chair was rebuilt. No good. Once more – thigh support was not sufficient for my great long legs.
Finally, they fixed the chair.
Next week, they made me redundant. I wanted to go, as I’d been there too long anyway and was close to walking anyway – but now I got paid. And they had a desk and chair which were of no use to anyone!

Keith Pearson, formerly bikermailman, Anonymous no longer
June 27, 2012 4:47 am

My sympathy Anthony, get better! Did you try one of the split ‘ergonomic’ keyboards? So long as you can touch type, it does wonders for your hand and wrist placement. Puts them in a neutral position. Highly recommended for everyone!

June 27, 2012 4:54 am

Hello Anthony,
I switched to a trackball when my mouse hand, arm, shoulder started to act up and the pain went away and never came back. Much less movement with a trackball over a mouse. I don’t know your exact situation but it is an inexpensive thing to try.

June 27, 2012 4:55 am

Here’s something you can try.
It’s widely used by staff in Swedish hospitals.
Best wishes, Fredrik.

Roger Carr
June 27, 2012 4:57 am

Anthony; I doubt any one of us out here would even imagine anything at all would stop you.
My admiration, sir!

June 27, 2012 4:58 am

Thanks for the tip on speech recognition on Win 7. I will give it a try.
Try this set up for your computer station. Move to a corner. It helps to be a carpenter.
I set up my ‘desk’ by using kitchen counter tops and run 8 ft along two walls with the junction in a corner of the room. Core drill door knob holes for convenience. Sit in the corner and the monitor is in the corner with the laptop folded closed in front of it. External USB keyboard can be placed on slide at either side (or use 2 separate keyboards @ $9 ea). Powered USB hub from Wmart @ $18 for all USB conn is convenient. By rotating my chair 90 degrees I can rest either arm on the desk. The monitor can easily be slid to different position depending on which way I want to face. Usually just stays in the corner. For counter top support I used a very small (12″) wide cabinet in the corner set at angle. For the ends I cut an upright ‘entertainment center” in half. “L shaped” counter top just sits on top of the cabinets. Easy to customize desk height. Lots of desk space and could be placed in front of window.
I’ve never been very fast with a keyboard and when my bird dog stepped in a coyote trap this past Jan and I stupidly used my hand rather than my foot to release the trap while she was fighting it. Well the little girl jerked my hand away and ripped the tendons from my index finger. I now have little/no use of it (points straight out and doesn’t want to type). Had to keep hand elevated after surgery and the “L shape” really helped.
Hope this helps in some way. Hey, I hear Willis pounds nails and probably has a saw!

June 27, 2012 5:00 am

Mark says:
June 26, 2012 at 11:54 pm
> Yet somehow I’ve managed to use a keyboard all day, every day, since 1980. I’m skeptical.
I heard a report of a study of runners in their 50s and older who never developed foot and knee problems. The goal was to find what these runners did differently than runners who had problems. The conclusion was that the uninjured runners were different, not that they ran differently.
Congratulations on not being injured, don’t assume that means other people are doing something wrong.
Also – you say you “use a keyboard.” Do you use a mouse too? Mice are evil.
Another anecdote – some researchers were looking for people with carpal tunnel problems. They went to a newspaper and watched people going in and out. Those who pushed open the door with a forearm instead of a hand were the people they were looking for.

Mike McMillan
June 27, 2012 5:01 am

Newegg has Dragon for $50 after rebate.

Randall G
June 27, 2012 5:01 am

A lot of years ago I had carpal tunnel syndrome in my left wrist. The doctor supplied me with a wrist brace that worked very well and the problem soon abated. The brace had an “AMF” logo… it was a bowling wrist brace. Insurance covered all the costs, but I always wondered how much the doctor charged the insurance company for that brace that I could have purchased at the bowling alley for $15.

June 27, 2012 5:05 am

This is typed with 2 fingers. My wife was terrified when she was diagnosed, carpal tunnel in both wrists, best to do surgery on both at same time. An old wag of a friend noted that although she was Presbyterian, not Catholic, she was going to a Catholic Hospital. The friend said “Colleen, you know, when you wake up your two hands will be bandaged together, then you will find it more comfortable to hold them in a prayer position, where there is a danger that they will graft together. Then an old Priest will visit you to ask how your knees are, to see if you can genuflect ….”
When she was in recovery afterwards, an ancient priest came wandering by and vacantly said to her “Have I already spoken to you today?” In her post-op haze, all she could think of was the mischief of the old friend who scared the pants off her.

June 27, 2012 5:11 am

It sounds like carpal tunnel syndrome…but make sure. If it persists then surgery is the answer. In the hans of someone who does this procedure often, it is a short procedure and recovery is not too long

June 27, 2012 5:14 am

I had a bad problem a few years back. Here’s how I got cured:
1.) No typing for 3 weeks. Got someone else to do the urgent typing.
2.) Squeezed a tennis ball every minute that was practical.
3.) Saw my doctor who gave me two injections, a month apart, into my elbow.
That’s it.

June 27, 2012 5:31 am

I switched to using mouse pads with wrist supports and buying the Logitech 5000 series (BT) Keyboards with mice combos on our systems. No more cheap keyboards and mice when using the computer 12 hours a day…
The 3M wrist support Mouse pads are here.
I use the MW310LE. I takes a while for the recovery — but it does work.
Good tip on the speech recognition — I will try it again. I have used it in my ASUS Transformer tablet and was pleasantly surprised.

June 27, 2012 5:36 am

… one step closer to being The Bionic Man, Anthony … just want to take this opportunity to thank you again for WUWT and the effort you put into it. 73 for now. _Jim

June 27, 2012 5:36 am

As a freelancer, I’ve had carpal tunnel, and here’s what worked for me. A splint will really help–you can get one at most pharmacies. Mine leaves your fingers free, so I can punch the keyboard while I wear it. I also use capsaicin cream; I get the kind that comes in a bottle with a self-applicator so you don’t have to get it on your hands. It doesn’t have a scent. The other thing I do is pop a lot of lemon balm in my green tea. It’s a grandmotherly remedy, but it still holds; lemon balm is great for inflammation. Normally I don’t talk about physical stuff, but did so out of gratitude for the work you do and just in case any of this might be helpful to you. My CT actually got better as I got older. Can’t figure that one out.

June 27, 2012 5:38 am

I’m a proofreader and we do constant mousework. I have occasional boughts of wrist pain, but I stay very hydrated due to the demands of medication for another condition (migraine) and I also have prescription Naproxen on-hand for migraine. I take the Naproxen for the wrist problems when they flare up and wear a couple of wrist braces until things subside. I usually have one bought a year. Did I also mention that I crochet, a lot, and do a lot of computer stuff on my own time at home, neither of which are wrist friendly?
Make sure you take frequent breaks to rest and stretch your wrist and get one of those mousepads that have the gel wrist rest. I also look for a mouse that fits my hand so that it’s not all balled up. My hand is narrow and my fingers are long, so that’s easier said than done these days. But, I feel that the more relaxed my hand can be while it works, the more relaxed my wrist will be.

June 27, 2012 5:39 am

I had something like this 20 years ago, though it was diagnosed as tendonitis and not carpal tunnel. So I was told to not type for a couple of months — sort of hard for a programmer. It didn’t get better. Then I read about a guy who had a similar problem and he did the opposite of what you’d think: get a tennis ball and squeeze it for a few minutes per day. It cured me.
Just passing it on. I wouldn’t want you to actually make your situation worse. But carpal-ish symptoms can be triggered by an over-use of one set of muscles and under-use of another.

June 27, 2012 5:40 am

I haven’t read all the comments so excuse if this is a repost, but take a look at the Evoluent mouse. http://www.evoluent.com/

Richard Garnache
June 27, 2012 5:42 am

Hi Anthony; Genemachine is right. I almost had to give up my computer until I got an Evoluent vertical mouse. The pain was gone after three days. Give it a try and I hope you get better. The world needs you.

Pamela Gray
June 27, 2012 5:43 am

I’ve had CTS, tendonitis, and am developing arthritis in my hands. It’s much worse during the school year. The first week of fishing after school got out was awful!!! But no pain, no fish. It’s better now because of more opportunities to rest my hands. Catching fish helped too.

June 27, 2012 5:43 am

Good luck Anthony.
Just want to reiterate the benefits of left-handed mousing. It really helps. I changed several years ago when my right wrist started to swell and hurt. (Fortunately my left wrist remains okay.) In addition to resting your bad wrist there are other advantages and previously noted. The best one being you can make notes with your right hand while browsing.
Good luck and mend well.

P. T O'Day
June 27, 2012 5:48 am

You might try Anatabloc – – powerful new no-side-effects anti-inflammatory – – over the counter at anatabloc.com or any GNC store. Johns Hopkins and Roskamp researchers are all over it. Remarkably effective for all NF-Kb driven ailments from nasal drip to arthritis to Parkinsons – – you’ll know in a few days. Good luck. We need you at the joystick.

June 27, 2012 5:57 am

Hi Anthony,
I am a heavy computer user. I type on Kinesis “contoured” ergonomic keyboards at home and at work. I have no wrist strain problems at all even if I type all day. If I switch back to a regular keyboard, my hands hurt after even a relatively short time typing (but I have no problems switching between the two types, eg, when using my laptop).
It takes a little getting used to but they have a mostly typical layout (querty and so on) so it isn’t too bad. They are a bit expensive but it’s definitely worth it for heavy users. They last a long time too – mine are around 10 years old and still work fine (except for some of the F-keys; their F-keys suck but whattayagonnado?).
You also need a good chair and desk for good posture too, and a mouse that suits your hand.
Whatever solution you use, I hope your problems go away soon.

June 27, 2012 5:59 am

Sorry to hear about your problems but I think you can see a lot of us have/had the problem. I too had problems with the mouse and one simple thing I have done is that I am now in the habit of positioning the mouse directly in front of the keyboard so my right arm isn’t off to the right. Obviously a cordless mouse is ideal. Also I do a lot more stretching and have even tried going to yoga classes and it all helps.
Good luck!
Best regards,
Greg Olsen

Theo Barker
June 27, 2012 6:01 am

Hello Anthony,
I am also a software developer. I have 2 mice. 1 for my left hand and 1 for my right hand. I use the 1 on my left hand more than the 1 on my right hand. I started having problems with right hand mousing in the early ninety’s. Had second DeQuervain’s release surgery in 2001 from left-handed mousing. Now I just alternate hands. Essentially trouble-free since. FWIW.

James Ard
June 27, 2012 6:03 am

Does the software allow you to say a word to perform a computer function, like saying left click to have a comment approved?

Sal Minella
June 27, 2012 6:03 am

Sorry to hear about your Carpal Tunnel problems. About seven years ago I experienced a noticeable weakness in my right hand when gripping and lifting heavy objects, but no pain.
I took a drive out to Redding CA (from NY) to do some hiking around Lassen and Whiskeytown. By the time I got back my thumb and index, middle, and half of my ring finger were constantly numb. I tried all of the braces etc. to no avail over a period of about three months.
I finally went to see a hand surgeon who ordered a nerve conduction test to evaluate the motor and sensory aspects of the Median nerve through the Carpal Tunnel and through the elbow. Showed major loss throught the CT and normal function through the elbow.
The surgery took less than an hour and the recovery about two months. The sensory and motor nerves recovered fully, however the large muscles that adduct the thumb had atrophied somewhat from the lack of motor stimulation. I’ve worked diligently at trying to recover the muscle, but, as the surgeon told me, some of the muscle loss is permanent and the weakness is still noticeable.
I would urge you to consult a physician as the muscle loss is progressive and, if treated early, can be negligable or nonexistent.
BTW, I tried all of the web-available quackery – none of it works.

LC Kirk, Perth
June 27, 2012 6:07 am

@ Pompous Git, 1.28am
I too was diagnosed with carpal tunnel syndrome in left wrist 6 or 7 years ago, even though I am right handed. The suggested solution was to cut the membrane around the muscles, etc., etc. Didn’t like the sound of that, so instead took off the cheap, velcro-banded, Bali-imitation sports watch that I had taken to wearing about six months previously. Hey-presto: end of carpal tunnel syndrome! Now I just wish some of the other deterioration was as easily addressed..

June 27, 2012 6:08 am

Anthony –
I’m a programer and a couple of years ago I ended up with a similar problem, severe pain in my right wrist. I tried dictation software and it didn’t work for me, nor did the trackball mice. But I determined the pain was primarily associated with using the mouse. Like several other suggestions above, I switched from a mouse to using a a Wacom Intuos graphics tablet. You use a stylus to point to where you want the mouse to go, and click using the stylus. Your wrist is in a much more natural position, just like writing. While it took a couple of weeks to get used to it, after using it exclusively over the course of a year all pain was gone. And now I’m back to using a mouse again, albeit sparingly so I don’t reinjure myself.
Best wishes for a speedy recovery!

D.R. Williams
June 27, 2012 6:12 am

Here’s another vote for changing your mousing hand. I did so more than a year ago after symptoms started appearing in my right arm. I now use the left hand for mousing in the office, and my right on the trackpad on my laptop, and the right arm is fine. I’d also recommend keeping a stress ball on your desk and giving it a few good squeezes with both hands several times a day.

June 27, 2012 6:21 am

MLCross says:
June 27, 2012 at 2:19 am
Well, I guess we can add that to the list – Global Warming causes Carpal Tunnel. Can’t deny this one I guess.

That’s the thread winner!
I have a tendon tear in my right arm, which was aggravated by mousing. So, like several others above, I switched the mouse to my left hand. It was awkward at first, but after a few months feels completely natural. Helps, I think, that I mostly use my Mac’s Magic Mouse (bluetooth), so a lot of movement is just with fingers—not an option for you, with a PC. But it’s not hard getting used to a regular mouse; I never even switched the buttons.
/Mr Lynn

Matt Bergin
June 27, 2012 6:24 am

I concur with Tony. I have just had CTS surgery on June 1st on my left wrist and I will be getting it done on my right next month. I have been an electrician for 25 years and CTS is very common in my trade. My hands were constantly numb 24/7 and since the surgery the numbness in my left hand is gone. I tried all of the supposed fixes and cures, suffered for ten years after I was diagnosed with CTS, before getting the surgery. Hope you find what works for you.

June 27, 2012 6:27 am

PS I also use a Microsoft Natural Ergonomic Keyboard 4000. If you use the front riser it comes with, it actually directs your hands down a bit, in a less stressful, more relaxed attitude for typing. There isn’t another ergo keyboard as good, especially for the price ($50 at Staples), but they do wear quickly—and it’s the only board I’ve ever owned where the most-used letters wear off in a few months!
/Mr Lynn

June 27, 2012 6:28 am

I had CTS surgery years ago. The problem had been induced mostly by lots of bad guitar playing and lots of typing. I should have just quit the guitar and blessed the world with less bad music. After the surgery my CTS was fixed, but they wrecked my ulnar nerve by binding my elbow in a fixed position while they carved up my wrist. So the trouble just shifted from the thumb and first couple of fingers to the bottom fingers. And that trouble has proved to be permanent nerve damage. The only thing for that has been to avoid arm rests at all costs everywhere so as not to further impinge the nerve in my elbow. Oh, and I also moved the phone in my office so I didn’t have to reach for it, and I use the speaker phone feature a lot. It drives people crazy but it saves me from repetitive stress.
My experience with Dragon Naturally Speaking has been frustrating, humourous and useless. And I’ve tried the latest version every 3 years or so over the past 15 years. There is an iphone app from them that’s strictly for note transcription that is okay for laughs too. I correspond regularly at work with a guy who uses speech recognition software of some sort and the tells are really obvious but occasionally subtle enough to cause difficulties or confusions in our communications. You really need to proof read it carefully. Same goes for my rotten typing I suppose. I’ll have to try the Windows 7 application on your recommendation. I have never got to the point of effective navigation with speech recognition software, that would really help mouse induced problems I suppose. Better to abandon the mouse altogether than to fool around with different designs of it.

June 27, 2012 6:33 am

Now get the free NaturalReader from NaturalSoft http://www.naturalreaders.com/download.htm and let your computer talk to you.

June 27, 2012 6:35 am

The last time I tried the speech recognition in Windows 7, the system dutifully ignored everything I said. It turns out that Win 7 isn’t smart enough to decode my mumbling. ;->
One thing Anthony might try that seemed to help my sore mousing wrist and arm is a trackball. When I switched from a standard mouse to a Logitech trackball, the minor (for me) soreness seemed to fade.

June 27, 2012 6:37 am

Two things I did to improve the mouse-induced wrist problems that started bothering me 15+ years ago:
– switch from a conventional mouse to a Logitech Trackman Marble Mouse ambidextrous trackball.
– learn to use the left hand for mousing, so you can switch back and forth when needed.

June 27, 2012 6:37 am

I play the piano. In the past when I played too long for too many days, the pain was cured by running hot water from a faucet where the inflamation or irratation was. Worked great.

June 27, 2012 6:39 am

As a physician, can I suggest that you check that really do have a carpal tunnel syndrome? Nerve conduction studies in doubt. You should be screened for diseases that cause CTS. If it is driving your crazy at night, I would suggest that you have surgery. It is a small procedure, performed under local anaesthetic, brings instant relief and has a low recurrence rate.

Myron Mesecke
June 27, 2012 6:40 am

Mine isn’t carpel tunnel but I have pain in the back of my right hand. It is definitely interfering with the drafting I do.

Tom in Florida
June 27, 2012 6:44 am

Hi Anthony,
I am using speech recognition on windows seven. This is pretty cool. As with you I am learning to speak slowly and clearly so that this program works at its best.

Paul Westhaver
June 27, 2012 6:45 am

I have used it for years. I can only type as fast as I think when programming so I use Windows recognizer when doing non-programming documents. It works great.The only issue arrives when new words come up and in WUWT there will be a lot of “new” words. Also if you get a cold, the recognizer starts to go wacky.
Look at handheldspeech.com. The guy who wrote it worked on mobile apps back as far as the 90s. Greg Gadbois is his name. Very sharp physicist. That way you can blog via text to speech with a mobile device.

David Ball
June 27, 2012 6:49 am

Had the surgery 8 years ago on my right hand. Haven’t looked back. No complications whatsoever.

June 27, 2012 6:51 am

I don’t have carpal tunnel, but have a similar problem. Symtoms present as cubital tunnel– the other three finger and part of the thumb. Most noticable at first was pain at the wrist, sometimes in fingers, slight lack of sensation in smallest fingers. Then burning and inflatmation in the wrist/forearm and pain at the elbow. Pain in the scapula.
The thing with nerve pain is that it can trigger other problems and it doesn’t always present at the source. Since I am in pain all the time, it’s hard to notice when I’m doing something that is irritating it or something else. Narcotics aren’t very helpful, but when I get that little bit of relief, I become aware of pain in other places that I neglect.
You can have small neck and shoulder problems that compound the wrist problem. Fluid pressure in the spine and also make you more sensitive.
Anyway, the things I’ve found that help:
Lots and lots of ice. Use ziplock bags, 1:2 alcohol:water, squeeze the air out, seal and then double bag. Makes a nice slush. You want crystals without freezing solid since the melting draws heat. Move the ice around to avoid burns. Try using ice at different places too, e.g. elbow, shoulder, and scapula. I’ve had relief and release in my shoulder when icing my wrist.
Cranio-sacral therapy
If you drink, don’t over do it. Alcohol causes inflamation, can irritate the nerves, and acts as a nerve toxin. Best to avoid.

June 27, 2012 6:51 am

Anthony writes: “It isn’t the keyboard so much as it is the mouse clicking approving comments is very mouse click intensive.”
Had the same problem ten years ago. Switched to the trackball mouse and haven’t had the problem since. I was doing a lot of writing then and am also a general contractor (now semi-retired) who uses his hands alot. The track ball was a big help. A mouse pad with a nice soft gel pad to support the wrist also helps.

Crispin in Waterloo
June 27, 2012 6:53 am

Hmmm…..”Of course Carpel Tunnel Syndrome can happen to anyone. It is a physical condition not a biological condition.”
There is a difference between carpal tunnel syndrome (CTS) and repetitive strain injury (a sort of tennis elbow). People from the Azores (somewhere near there…) seem to have a gene for CTS. Only one person in my family has not had CTS and it is definitely a physical condition. Thickening of the ligament ‘band’ holding the wrist together closes the hole for the nerve. Failure to ‘decompress’ the pinching leads to permanent loss of strength, constant tingling and pain up to the shoulder.
There is a classic test for CTS which is: hold the painful arm straight and rotate your wrist to turn your palm down, all the way around. This means: right hand rotates counter-clockwise to its limit. If you get immediate partial relief, you have CTS because this motion opens the nerve passage slightly. Typically the ring finger (4th) is numb or substantially less sensitive on the surface between it and the pinkie (if you have standard nerve distribution). This is easily checked using a pin-prick comparison with other fingers.
Carpal tunnel decompression is a very simply operation that takes about 20 minutes. It has the highest % of 100% success of any type of surgery. 99% of operations are 100% successful because is has a simple cause and relief method. It is pleasing to see so many people managed their wrist problems with a variety of methods. Chiropractors have always claimed to be good at treating it, in particular the treatment now known as ‘active release’. To me, it appears to treat the ‘tennis elbow’ version.

June 27, 2012 6:56 am

Did not have time to read all the comments so this may be completely redundant, but I would like to add a vote for the vertical mouse…there is a very large black plastic one, almost a rat, that cradles your hand in a vertical position. It does miracles for my CTS…without it I can’t work at all. You click the mouse sideways, and that makes all the difference for some reason. Good luck with it!

June 27, 2012 7:03 am

You might want to consult a “rolfer” also known as “Structural Integration”. It’s a form of massage that concentrates on ligaments and tendons as opposed to just muscles. I have cubital tunnel syndrome and it has really helps minimize it a lot. I almost don’t notice it anymore.

June 27, 2012 7:05 am

> It isn’t the keyboard so much as it is the mouse clicking approving
> comments is very mouse click intensive.

Just a thought about mouse clicks. Have you considered using an IPad or similar device (Android, Win7 or 8 or whatever). Using your finger instead of a mouse might be more comfortable.
Don’t know if it will be better, but it might be worth thinking about.

June 27, 2012 7:08 am

Anthony: I see Robert and Michael J. McFadden above have also recommended the trackball mouse. I use the logictech blue tooth one. The beauty of it is that you never have to move your arm. The intregrated wrist pad on the mouse pad (purchased seperately) supports the weight of the hand and arm and the thumb manipulates the cursor with the track ball. The index and middle fingers do the left and right clicking. Works for me.
I got the idea from a worker at the local construction permit desk . I saw she was wearing a wrist brace (she’d obviously been having problems) and using a track ball. I asked her about it and she swore by the trackball. Said it made a big difference. It did for me also.

June 27, 2012 7:08 am

Hello Anthony. I do not have carpal tunnel syndrome, but I use Dragon NaturallySpeaking to do most of my writing. Dragon 11.5 is much improved over the earlier versions of the program. With training, I have gotten the accuracy up to 99+%. I can speak much faster than I type, and I find that I make fewer mistakes using Dragon than I do typing. (This probably says more about my poor typing that it does the abilities of Dragon NaturallySpeaking.) With Dragon NaturallySpeaking, editing is very important. I find that the READ THAT command is very useful in discovering errors. As usual, I wrote this reply using Dragon NaturallySpeaking.

June 27, 2012 7:09 am

As someone who has also had wrist problems (albeit minor ones) from excessive keyboard use on various occasions in the past I would suggest that you need a good holiday! A couple of weeks away from your computer would work wonders. (You should resist the temptation to take it with you or to check your email on a smart phone). If you cannot take time off then try and cut back on computer usage for two or three weeks and instead use the time for catching up on other things. These aren’t meant as alternatives to the suggestions from other people. Many of those look sensible too and I think you should take them up, but you need a break too!

June 27, 2012 7:10 am

Anthony – I’ll second ‘jeez’ suggestion. I had issues and moved over to a trackball 10 years ago. I am able to keep my hand, arm and shoulder relaxed as my hand simply rests on the trackball and forearm on the chair armrest. I got used to it in about a day. I’ve been trouble-free for 10 years now.

June 27, 2012 7:10 am

> Yet somehow I’ve managed to use a keyboard all day, every day, since 1980. I’m skeptical.
I know a guy who’s smoked for years, but never got cancer or emphysema. Plainly, only an idiot would say cigarettes are bad for you.

June 27, 2012 7:11 am

Elbow splints help too. I wear elbow pads backwards at night. Puts pressure above and below to open up circulation and keeps it straight while sleeping.

June 27, 2012 7:14 am

Unfortunately, besides the ridiculous lags and tying up bandwidth, this web-bling fad has made the interenet very keyboard unfriendly.

Grandpa Boris
June 27, 2012 7:16 am

The Carpal Tunnel Syndrome (CTS), which is a form of Repetitive Strain Injury (RSI) is a single diagnosis, but the causes of it may be numerous and every person is different. Some of the major causes are reduced blood flow to the wrists caused by tension in the shoulders and the neck, very long term muscle tension in the wrist and arm muscles, improper posture and sitting position, improper keyboard and mouse placement, etc. And of course the keyboard and the mouse you are using are major factors.
I found that my CTS, which I’ve had for over 20 years, was helped by switching to a “buckling spring” keyboard and a properly ergonomic mouse. For a keyboard, I found UNICOMP (http://pckeyboard.com/) to have the best quality keyboards made to old IBM specifications. They are clicky, noisy, heavy things, but they are the most comfortable keyboards for my CTS. You may also find gouldtouch.com’s keyboard more comfortable because it can be adjusted exactly for your wrists, but I personally find their key tactility to be disappointing and very much inferior to UNICOMP’s.
For a mouse, someone already recommended Contour from contour-design.com. Another very good mouse is Evoluent, from evoluent.com.
And, of course, you may want to consult a physician who specializes in CTS and RSI.

June 27, 2012 7:24 am

…hot water.

Don Kautz, PhD, MPH
June 27, 2012 7:24 am

I had the CTS release on both hands 20 years ago and it has not come back…..I’m careful so it doesn’t but the surgery was life changing…..think about getting it. The doc used a scope so there was just a small incission and only took 2 stitches to close.

June 27, 2012 7:26 am

Can I just sympathise, Anthony, and endorse Lear Dog’s recommended treatment.
Except to suggest an applicaton of anti-inflammatory gel like diclofenac rather than anti-inflammatory tablets especially if, as in my case, they upset the stomach.

June 27, 2012 7:46 am

For wife – modified a set of flight simulator rudder rudder pedals and universal castors and an optical mouse guts into a foot mouse. Worked OK for a while. Quit on a more durable model when she had successful surgery. The click part was easy and worked fine — may someone could fashion a remote foot clicker for your mouse whiilst retain desktop motion??

Gail Combs
June 27, 2012 7:55 am

Sorry to hear about the carpal tunnel syndrome, Anthony. I managed to get it from using a six pound sledge to drive nails while barn building. Sleeping in braces helps when ever it acts up again.
It is great that the voice recognition software will let you rest the hand and still keep up the blog. Just do not over do and let others write more posts.

June 27, 2012 7:56 am

…forget the pills and surgery…use hot water…it is cheap and it works. Why do people go sit it hot climates and go to warming hot tubes etc ???? 🙂
…from someone older and wiser…

bob alou
June 27, 2012 8:12 am

New product coming on the market. Saw this on Gizmodo (I think). I have pre-ordered one for myself. It supposedly will replace the mouse and keyboard. Hopefully it will.
Since you like electronics and such a new toy is always fun to try out.

June 27, 2012 8:18 am

Some of us type faster than we talk, of course… and don’t use Windows. But I’m glad that you’ve found a solution to keyboard induced repetitive motion entry. I experienced it to a lesser extent playing World of Warcraft some years ago — carrying tension in my shoulders while playing irritated my C6 radiculopathy. Fortunately, typing still works pretty well, though, and I have my fingers crossed (so far painlessly) against arthritis.

June 27, 2012 8:19 am

Anthony, Try the trackball as mentioned by so many previously for editorial cleanup. Being left handed and ambidextrous was helpful at first in alleviating the pain, I would switch the mouse from left hand to right hand, I had been using a mouse since they became available in the early 70’s. I started using the Trackballs(Microsoft and Logictech) in 2000, right hand only, may be switching to the left in the future since I’m starting to get that cutting pain pain in my right thumb now.

Bruce Stewart
June 27, 2012 8:22 am

I second (third? fourth?) the suggestion to try lefty mousey. I don’t even bother with switching mouse button bindings; that way I am ready for lefty mousey on any computer. Lefty trackball may be even better.
BTW it is my understanding the when the mouse was invented at SRI, the inventor intended it to be used with the left hand. For example, the most commonly used keyboard key is probably “Enter”; with lefty mousey I can hit it without moving my mouse hand.
Get well soon!

June 27, 2012 8:23 am

Anthony: I did a SILLY thing 10 years ago. Very SILLY..I started putting my THUMB on the top of my ski pole when cross country skiing. Within 2 months I had developed a minor “carpal tunnel” on the right wrist. NOT as debilitating as you have gotten to, but really, REALLY, irritating. I was fortunate to mention the problem to a fellow “in line skater/competitor” at the Metrodome (Mpls) during a skating session. This was a Friday evening. He took some time and “examined” me. I.e., grabbing the wrist FIRMLY and flexing the hand.
After he got done scraping me off the roof of the building, he said : “Oh yes, you’ve obviously built up some scar tissue in the tendon sheaths…”..
He had to run off somewhere, but by Monday night the next week, I was able to say…”Surprisingly it feels somewhat better ..how much would I have to pay you to ‘fix’ it, and how many ‘sessions’??”
He responded: “What is your tolerance for pain?” HEH HEH..I said, “I ALWAYS have my dental work done w/o Novocain…” “Great, let’s do it tonight, after we finish skating and you are ‘warmed up’..”
He did do the work. Grabbing my hand/wrist…PRESSING HARD with his Thumbs and flexing. BREAKING UP THE SCAR TISSUE…
I was, as promised, superficially bruised the next day. I FELT the scar tissue MOVE THROUGH MY LYMPH system for the next 5 to 6 days (like a ring of pressure, moving up my arm to the larger LYMPH assemblies…less pressure then..)
That was over 10 years ago. NO PROBLEMS SINCE.
PS: I use the straps properly now, and keep my darned thumb OFF the top of the pole!

David Corcoran
June 27, 2012 8:32 am

Anthony, get the “Buckling Spring” keyboard. It’s a lot less effort to type with. It’s a remake of the old IBM model M “clicky” keyboard.

June 27, 2012 8:36 am

Buy an exercise ball at Walmart(25 inch) and lay on your back on the ball with the center of the ball in upper part of back in between your shoulder blades. Put your arms straight our sideways and push your fingers towards the floor for 2 to 4 minutes at a time – several times a day. You can also do this with your office chair by putting your arms out horizontal and pushing your fingers as far back as possible. You may get a severe tingling in your hands afterward from the rush of blood. The tendons, blood vessels and nerves all go through the carpal tunnel. Unstretched tendons shorten and thicken over time which leaves less room for nerves and blood vessels!!
This is not an over night cure but the only real long term non surgical cure.

June 27, 2012 8:36 am

I’ve had the same thing after three years of renovating my place and using cordless power tools, my right wrist was useless. In the short term put an ice pack on it for 15 minutes at a time when you feel discomfort and wear a wrist brace the rest of the time. In the long term, have surgery. It’s a was walk-in, walk-out operation. No concerns in six years. No renovating either.

Tom E.
June 27, 2012 8:39 am

I will add to the Chorus and wish you well.
I have had issues with my shoulders and left wrist. And the biggest takeaway this post has given me is that everyone is different.
For me, when I type I need to rest my palms on an ergo keyboard, and my mouse pad has a wrist rest. Ergonomics can be everything, find what works for you. I hope you do not have to spend too much money to find a setup that works for you!
I currently use a MS Natural Ergonomic Keyboard 4000

Craig Moore
June 27, 2012 8:40 am

When I was a youth my piano teacher constantly reminded me to keep my wrist straight and not sag it below my fingers. Perhaps lowering your keyboard would help with hand posture so you don’t kink your wrists.
As to you being a dictator, could Josh come up with a cartoon mustache and all?

Tom E.
Reply to  Craig Moore
June 27, 2012 8:56 am

Craig, funny for me lowering the keyboard would have my wrists, shoulders and neck screaming in less than an hour. My seat position is such that my fore arms are resting on, and thus parallel to the desk. With the ergo keyboard allowing me to keep my wrists straight. I simply can not use my shoulders to suspend my hands over a keyboard. It is amazing at how different people are when it comes down to what works for them.
Where I work there are at least 3 people who have their cubical desks set for standing height. For them, the different position has greatly improved back health and other aspects of ergonomic induced problems.
It might also be interesting to see if wordpress has a plug in that would allow moderation to be done with key-strokes in stead of mouse presses?

June 27, 2012 8:51 am

Posture and keyboard positioning is everything. Note that concert pianists who spend a lifetime practicing for up to 12 hours a day don’t have problem with CTS. Also, a good ergonomic mouse, or trackball is priceless.

Cal Smith
June 27, 2012 8:57 am

I, like many if not most of the commenters, resisted surgery for a long time. When I went to a Kaiser P. class on CTS and saw how much damage can result from not fixing the problem I agreed to surgery. I kicked myself for not having it done sooner! Listen to the advise of those of us who have had the surgery. Kicking yourself is far less painful!!!!

June 27, 2012 9:04 am

When I suffered a similar condition, they found in my case that it was overuse of my small muscles and fingers rather then what you have. They told me that I had to type less. My physical therapist told me about the Dvorak Keyboard engineered by Dr. August Dvorak in the 1930s. The original typewriter keyboard was highly optimized to slow down typing to prevent key jams from the mechanical keys colliding.
Becase of the high optimization of the original keyboard “About 16% of typing is done on the lower row, 52% on the top row and only 32% on the home row.” (from Wikipedia,
http://en.wikipedia.org/wiki/Dvorak_Simplified_Keyboard )
I purchased a hardwired switchable Dvorak keyboard from fentek for $95 at
Fentek is a vendor specializing in ergonomic and Dvorak keyboards and they worked with a keyboard company called Matias to develop and market it. I liked it enough that I purchased a second keyboard for my wife. The major advantage of the hardwired keyboard is that the big letters are the Dvorak letters and the small letters are the QWERTY layout.
For a number of years before the Fentek/Matias keyboard, I used the software switch in Windows and Mac OS to switch whatever keyboard I was using to a Dvorak layout and put DVORAK key labels on the keys to see what I was doing.
The overall reduction in “miles traveled” in typing on the keyboard is on the order of 90%. My finger overuse vanished and my fingers regained normalcy. I still take regular keyboard and mouse breaks.
I should note that I did not make the conversion successfully until I had heart valve surgery. This forced me to work at home for several months. I switched my computer and vowed not to use the QWERTY keyboard anymore no matter how it slowed me down. Four weeks later, I was typing faster on DVORAK then I used to on QWERTY. Keeping two keyboards in one’s head was beyond my capabilities.
In the Wikipedia article, it mentions that typing speed contests were regularly won by DVORAK typists and “Writer Barbara Blackburn was the fastest English language typist in the world, according to The Guinness Book of World Records. Using the Dvorak Simplified Keyboard, she was able to maintain 150 words per minute (wpm) for 50 minutes, and 170 wpm for shorter periods. She has been clocked at a peak speed of 212 wpm.” However, I am satisfied with my 30+ WPM speeds. For me, the main benefit is that my fingers stay on the home row most of the time and that it radically reduces the effort I expend when I type.
THere have been occasional attempts to debunk the DVORAK keyboard. Some are detailed at http://dvorak.mwbrooks.com/dissent.html My personal experience is that the keyboard eliminated by pain from typing.
All the advice in the other letters to you appear both important and worth taking. There are a lot of health issues involved with the different aspects of typing and using a keyboard and mouse.
Please consider them all and keep up the good work at your site but at a healthier pace.
Walk in His Peace,
David Gibson

June 27, 2012 9:10 am

I’m not going to try to give any advice, but I can say that I’ve suffered RSI before, too – about 6-7 years ago. Lots of things that can be done, and a lot of them have been discussed already – but after awhile, mine got better after some time, and I haven’t had a relapse since. Being a programmer, that’s doing well, I think.
Wishing you well.

François GM
June 27, 2012 9:13 am

As a neurologist who has been diagnosing and treating CTS (among other neurological conditions)for 30 years, I can straighten out a couple of things that came up in this post.
CTS is caused 99% of the time by having a congenitally small carpal tunnel. Aside from the median nerve, tendons and veins pass into the carpal tunnel at the wrist. It is familial in 50% and bilateral in 50%. With time, tendons get bigger but the tunnel remains just as small, leaving less room for the median nerve. Compression of the median nerve causes the symptoms of CTS (numbness at tip of fingers except baby finger which may become painful and progress to arm) initially only when the tendons are tensed up by flexion of the fingers (tendons get bigger) or at night (vein gets bigger). Holding the phone, the steering wheel, hairdryer (if you have hair) may trigger the symptoms especially in the morning.
Diagnosis is confirmed by EMG which includes nerve conduction studies. The test is easy to perform and has very high sensitivity and specificity. Other causes of hand numbness or wrist pain are quite easy to distinguish from CTS.Diseases extremely rarely cause CTS (hypothyroidism; amyloidosis).
Changing your mouse, your posture, your diet won’t work. Infiltration of the median nerve in the tunnel works but requires to be repeated every 4-6 months which makes no sense for a chronic condition. Medications and acupuncture don’t work. Finger flexing exercises make it worse. If mild, no Rx is necessary. You can just shake it off and hope to get back to sleep soon. If worse or interferes with sleep, custom wrist splints at night work well. If ineffective and interferes with work or quality of life or if motor involvement on EMG, sugical decompression works well: requires 30 minutes but a six-week convalescence.

June 27, 2012 9:14 am

Don’t know if anyone suggested it yet, but the one thing which makes a real difference to the accuracy of speech recognition is the amount and type of background noise.

a dood
June 27, 2012 9:18 am

I hate to pile on with more (!!) advice but getting a Wacom tablet was the bestest thing ever for my developing Carpal. It provides a much more natural position for the hand and wrist.

June 27, 2012 9:31 am

Anthony – Sorry to hear about your CTS problem. I do hope it gets better soon. I was impressed with your Win 7 speech recognition experience. Cool!

Dave Dodd
June 27, 2012 9:42 am

Anthony, I once worked in a manufacturing facility where CTS was rampant. As one of the support technicians it became part of my job to try to fix some of the operations from an ergonomic perspective. While we did have some success with that, I learned even more from the physical therapist who was assigned to work alongside me.
The “fix” quite often is not fixing the external hardware, as much as ithe internal “software” within our bodies. Someone above mentioned vitamin D and that is important, but the primary culprits seem to be vit B6 and B12. The ladies generally have a little more problem with these, but us old geezers can lose our ability to deal with B6 and B12 as well. THAT can have major effects on the internal “control cables” sliding neatly within their tunnels as Nature intended!
The first thing our therapist would do was to send the CTS victim to their doctor for blood work (both CBC and general chemistry) to see if their vitamin levels were correct. Quite often, proper supplements to restore the body chemistry showed better long term results than surgery.
With six and a half decades under my belt and having done much heavy labor and MUCH more keyboarding in that time, I have avoided any CTS problems, but I listened to the therapist myself and continue to keep up on my blood work (at least annual sticks by my friendly vampire docs) Vit D3, B6 and B12 are part of my daily intake. That works for me. A licensed nutritionist could be your best bet on beating this thing!
There is also laproscopic surgery available today, but…it’s still surgery… ;-(
Now, if you can just advise me how to non-surgically deal with the “trigger finger” I have developed on my left (offside) hand… Regards and best of luck, Anthony!

June 27, 2012 9:46 am

I concur with changing mouse hands. I am a right-handed programmer, and in the mid 1990s I started to get massive right arm and shoulder ache, to put point that I grimaced in anticipation of the pain every time I had to reach for the mouse. Not being a touch-typist, I was over-using my right hand, and the enter key is on the right, and the numeric pad. I changed to using my left hand for the mouse, did not reverse the buttons, and have had no issues since. It took a few days to get used to. I also rest both forearms at a height and angle which directs my hands to the mouse and keyboard. The angle is achieved by reclining my ‘boss chair’ fully. This forces me to keep my spine straight (flush with the back of the chair), minimises the pressure in the lower back, and forces me to tilt my head forwards towards the screen. Without the recline and sitting vertically, I get awful back pain between the shoulderblades. This posture would probably give an ergonomist a pink fit, but it works well for me.

Mike Rossander
June 27, 2012 9:59 am

I had the same problem a few years ago. I was a consultant at the time and used the Dvorak keyboard as an icebreaker thought experiment on a project. (If it’s so much better than QWERTY, why haven’t we all converted, leading to a discussion of switching costs change management.) I was bored that night and on a lark decided to actually teach myself Dvorak and see if it was as much faster as they say. After about two months, I was back up to my QWERTY typing speed. Never got any faster. But my developing CTS disappeared. I don’t know if it was an inherently friendlier layout or if just the change was sufficient to allow healing but it seemed to work for me.

June 27, 2012 10:04 am

Anthony Watts says:
June 27, 2012 at 7:57 am
> I just want to thank everyone for all the help – great suggestions. I had no idea that the problem was so common with everyone who visits here.
I figured you’d get a big response, but never expected 168 comments so quickly. I hope your wrist forgives you for approving them all. (Well, REP likely got a lot of them for the EDT morning.)
Also, I didn’t expect to learn so much myself. I’ve had occasional problems, including, perversely, today so good timing!
I think I’ll give that Penetrex stuff that Mryan suggested a try – it might help a foot problem I have in both feet. – I can use one as a control!
Hmm, no one has registered miceareevil.com. I’m surprised!

CRS, Dr.P.H.
June 27, 2012 10:04 am

Hope you feel better soon, Anthony!

June 27, 2012 10:05 am

This is off the subject, but here is an excellent article that you should include in your blog.

Man Bearpig
June 27, 2012 10:06 am

Anthony, did you do the good ol’ Hello World ?
I sincerely hope that you get relief and a fix for your CTS

June 27, 2012 10:50 am

Max Hugoson,
What does scar tissue in your lymph system feel like?

June 27, 2012 10:56 am

Here’s an experiment that yielded an interesting result:
A usual 3-button optical mouse was placed against my shirt which placed the wrist at 90 degrees from ‘normal’ for mouse use, this position on the shirt was kinda to the left of center of my chest (I use the mouse left-handed) … and I worked it in that position for a bit … it felt a little more comfortable than the ‘usual’ position flat on the table, for I too feel some ‘strain’ in the wrist and fingers while using the ‘usual’ mouse.
An alternative is to place a small flat book or other ‘surface’ in the mouse-opposite hand and work the optical mouse against that surface …
Background (to be complete): Right-handed from birth BUT been using the mouse in the left hand since day two (late 80’s ?) so I could take pencil-notes with the right hand … drink hardly any Coke or Pepsi (or other soft-drinks), still drink milk regularly, and cannot really do without a daily ‘dose’ of coffee (NO cream or sugar however) … exercise regularly by biking and some walking/jogging … take breaks while doing PC-keyboard ‘work’ …

John Archer
June 27, 2012 11:01 am

Hey, Anthony, count yourself lucky! It could have been a lot worse. Apparently anything to do with this CAGW scam seems to be high risk.
Mike, Gavin and Phil, for example, are now suffering from severely damaged eyesight having years ago been given over to spending hours crouched under their desks in the foetal position, covering themselves from head to toe in their own drool gawping wildly at well-thumbed snaps of naked hockey sticks and thrashing around crippling themselves with chronic wanker’s cramp, in both paws.
The good news is that the medics say their condition is incurable, and terminal.

Steve Oregon
June 27, 2012 11:37 am

Won’t it be marvelous when technology adds truth recognition?

June 27, 2012 11:44 am

It is very important that you not lay your wrists on a hard surface, especially an edge. You can also produce pain in your feet if you sit on an office chair and put the arch of your foot on one of the radiating legs with a castor underneath. Nerve compression can produce quite a bit of burning pain that lasts for days. Your body is telling you something. It’s the old joke:
Patient: Hey, Doc! It hurts when I do this.
Physician: Well, don’t do that.
I also had shooting pain when I would rest my arm on a flat hard tabletop. That was because I had irritated my ulnar nerve.
Problems are much worse if you have diabetes. A diabetic’s nerves are likely swollen, and they will be more easily compressed. Consequently, pain may develop distal to nerve tunnels. A prime example is lower extremity pain. After some time, the pain goes away, but that is not good, because now the nerves are no longer functioning. A consequence of that can be injury, infection, and ulceration.
We notice our hands more because we use them constantly. We tend to overlook our feet because they are inside shoes. When they become numb, it’s easy to damage them and not realize an infection has started.
You should have a doctor help you with the following, but many people refuse to see one if they aren’t sure there is a problem. A test you can do is try to remain standing with your eyes closed. Realize that if you can’t feel the floor properly, you may fall over and hit something. You could be severely injured if you aren’t careful. It is a good idea to have a helper to catch you, or at least try this in an open area with some cushioning. If you can’t do it, see a doctor. If you know already you can’t do it, see a doctor.
Diabetics and others with severe neuropathy generally don’t survive long if they have a lower leg amputation due to an infection. You can be treated and monitored to avoid that very bad outcome.

June 27, 2012 11:53 am

Anthony, I’m sure it has been said before, but do everything you can to avoid surgery. It is a drastic measure and the recuperation can be murder. I think your quick thinking is an excellent idea. I know for a fact that bad ergonomics have plagued me over the years, as I am an amateur writer and have been typing since 1985. Not just my hand/wrist either! My elbows, my neck, my jaw, even my ankles have become chronic from sitting and writing/typing. A man obsessed may write many words, but it can bring on calamity with the joints. Baby that wrist. It’ll take a very long time for the internal swelling to subside, and it may permanently damaged. Speaking only from experience – mine and my loved ones who have suffered directly from this disease.

David, UK
June 27, 2012 11:55 am

As has been stated already – this is a very common condition. I work as a technical supervisor for a PMI (Private Medical Insurance) company, and we cover treatment of this condition all the time across the UK. Obviously any surgical procedure is not to be taken too lightly, but this is probably one of those relatively quick day-case procedures that a surgeon can do in his sleep, given how common it is. After a few weeks following surgery (including possibly wearing a cast and maybe physio/hand therapy if required) you can be near good-as-new. Many report excellent relief within even a few days. Good luck with however you decide to manage it.

June 27, 2012 12:05 pm

Steve Oregon says:
June 27, 2012 at 11:37 am
“Won’t it be marvelous when technology adds truth recognition?”
Try http://www.wolframalpha.com/
It’s good enough that Apple who bought Siri had to patch Siri – which forwards questions to wolfram alpha – to lie when asked for the best cell phone. It had started to answer “Samsung Galaxy” or something. Not it answers “the one in your hand”.

June 27, 2012 12:09 pm

DirkH says:
June 27, 2012 at 12:05 pm
“It had started to answer “Samsung Galaxy” or something. Now it answers “the one in your hand”.”
That’s funny. Now all the Apple mobile phones and nothing else is mentioned at the top.
Okay, so forget about the truth detector. They might be just a tiny bit receptive to large bundles of Dollar notes.

June 27, 2012 12:20 pm

A friend of mine is a quadriplegic and has used that technology for seven years now and is very fast at it. He uses a proprietary program that cost a bit but works much better than the built-in one. .
I would also suggest taking krill and fish oil which are both excellent internal lubricants and contain valuable Vitamin E. My wife takes tablets containing Condroitin and Glucosamine which are shark extracts and help with cartilage problems.

June 27, 2012 12:26 pm

One of the common misconceptions is that RTI/CTS is caused by “poor posture” when it turns out “good” posture and ergonomic posture are not the same thing. If your elbows (or forearm near your elbow) are not supported, and your wrists are not straight (especially if in extension), you will end up with pain. As for mice – well you can’t get much worse from an ergonomic perspective. I’ve used the thumb trackball from logitech (the most recent version is the M570) for almost 15 years now and have remained CTS free; a couple of my coworkers switched to it after getting diagnosed with RSI/CTS have seen dramatic improvement in their symptoms.

June 27, 2012 12:42 pm

Carpal Tunnel Syndrome is usually a symptom of magnesium deficiency. Get some good supplements, not multivitamins. Pill based multivitamins are almost useless because the body doesn\’t absorb them very well.

June 27, 2012 12:48 pm

And Vitamin B6 too

Gary Pearse
June 27, 2012 12:50 pm

Maybe you could take out “middleman” print and just record facebook-type broadcast.

June 27, 2012 1:00 pm

Like a “band” around the outside of the limb. A “pressure” or general sensation… MOVED day to day (inferior to the elbow to superior to the elbow..to us medical speak.)

June 27, 2012 1:05 pm

Would a foot-pedal actuated left-and-right mouse button clicker help? One would only need to fingers (thumb and index finger) to move the mouse around while clicks are accomplished by foot. I believe I saw someone post up-thread about a modification to existing accessories, but this is off-the-shelf solution:
While factory programmed for mouse button emulation, it can be easily reprogrammed on a Windows PC to perform any keyboard action or key combination.
Full disclosure: We used something similar to this to allow technicians to advance a test/troubleshoot program with feet while their hands were otherwise occupied holding scope and voltmeter probes. Worked quite well for that purpose!
PS. At the link above they also offer “Foot Mousing Devices” but I did not look at how they accomplish that trick …

June 27, 2012 1:08 pm

Oops – it was this website which featured pedals and the “foot mousing” device:
The “No hands” mouse: http://www.fentek-ind.com/nh-mouse.htm

June 27, 2012 1:13 pm

Besides Alexander and Feldenkrais techniques as long term physical therapy w/o the New Age fluff, weight loss via low carb cuisine is highly recommended. This graphic surgical image shows how yellow fat blobs basically tighten up the whole wrist area:
Classic French cooking is all meat sauce concentrates (now available prepaid from More Than Gourmet), meats and fibrous veggies. Indian food minus rice and potato is low carb, as is Chinese and Japanese. Steamed cauliflower or frozen spinach can be puréed with a stick blender and a bit of heavy cream to give thick sauces to add to also steamed chicken or fish or even sausage. If you don’t add any additional liquid to the cauliflower it results in an ideal alternative to mashed potatoes, believe it or not. Anyway, recipes exist that mean an Atkins diet is nowhere near the stereotyped narrowness that amounts to an urban myth, the point being that shaping up is a mood enhancing adventure of learning rather than a drag.
Feldenkrais method was designed by a top notch physicist when “only surgery” was suggested by doctors who examined the bad knees he developed while tweaking sonar designs for WWII submarines.
I also use Macro Scheduler as a more advanced version of simple hot keys utilities, most of which would allow a left handed keyboard stroke to quickly perform the needed mouse clicks wherever required on the screen. Customizability and movement recording allow scripting software to lick the details.

June 27, 2012 1:24 pm

A colleague of mine is a retired heat transfer, thermodynamics professor who is still active and publishing. He uses Dragon 10 or 11 for preparing technical publications that are full of formulae and jargon. He reported that it took a while to “train” it but that it is faster for him to dictate using Dragon and to correct than typing and correcting.
A back story…My late father-in-law suffered from profound hearing loss, didn’t know how to type and wasn’t very interested in learning how. My wife and I thought that voice recognition software might have developed to the point where he would be able to use it to ease his communications difficulties. I was walking by a sports bar in an airport and stopped for a few minutes to watch an NFL game. The analyst was a retired interior lineman who grew up in the Mississippi Delta, went to an SEC school and never really lost his accent. I was amazed that the “crawl” was extremely accurate so I noted the network and went on my way. It took a number of calls to the network to reach someone who knew what how they produced the crawl, a court reporter using a stenotype. So much for voice recognition.

Keith Sketchley
June 27, 2012 2:52 pm

Best wishes for success.
My last attempt at using VR was awkward, Dragon with XP, one has to get used to different words to avoid confusiton with commands, and how to back up to correct.
Technilogy moves forward.

Mac the Knife
June 27, 2012 2:53 pm

Very cool! I’m scheduled to ‘upgrade’ to Windows 7 on my work platform in a couple of weeks and look forward to giving this a try. It may be quite useful, both for taking notes during field investigations as well as dictating final reports.
Thanks for highlighting this!

Keith Sketchley
June 27, 2012 2:56 pm

BTW, last I tried VR, common advice was to get a headset tailored for speech recognition, IIRC non-normal frequency response. Hopefully that “technilogy” improves. 😉 Back then, Blue Parrot was a common brand, but given the bad UI of their Bluetooth phone headset I cannot recommend the company.

Bill Thomson
June 27, 2012 3:05 pm

Hi Anthony. If you are an average sized man with average sized hands then your mouse is too narrow for your hand. Look at the distance between the tip of your thumb and your little finger when your hand is at rest. It will almost certainly be much greater than the width of your mouse.
When your mouse hand is sore try grasping something wide between your little finger and thumb. If this makes it feel better then the narrowness of your mouse may be part of the problem. Stick something (like an eraser) onto the thumb side of your mouse using double sided tape to make your mouse about half an inch or an inch wider.
I have a mouse in my hand for most of the day doing mechanical design and this was my problem. A little bit of rest and a wider grip on the mouse allowed my hand to heal.
Thanks for all that you do.

Warren in New Zealand
June 27, 2012 3:55 pm

Just to throw some more weight into the surgery vs diet recommendations.
One of the many trades I used to do was boilermaking/welding. I ended up with CTS after a 6 week stint using a 9″ electric grinder, (Bosch for those interested) and had both hands cramped over into something resembling eagle claws. After the necessary tests, and discussion, I was advised to have surgery on each wrist separately, which meant according to the surgeon, nearly 3 months off work.
On the day, I argued for both wrists to be done at the same time, taking into account the thought that I would probably need home help for most things, but I’d be back at work quicker.
On waking up in recovery, I was dressing myself, buttoning shirt, tieing shoelaces, while the surgeon was explaining all the things I wouldn’t be able to do, until he saw what I was doing. The relief from pain and ability to use my hands was that quick. Home help wasn’t required, if anything, waiting 2 weeks for the cuts to heal was the most boring part of the whole thing.
I ended up with a small (1/2″) scar on each wrist, and was back at work 2 weeks later.

Tim Neilson
June 27, 2012 4:46 pm

So I take it that it’s no longer technically accurate to say “more power to your arm”?Congratulations on mastering the new technology, and I hope that it results in restoration of full health to your typing hands.

June 27, 2012 4:52 pm

Wear wrist splints at night, it does wonders for me.

June 27, 2012 5:28 pm

Tried Dragon. Three problems.
First, background noise confused it. Plenty of that with a young son, windows open* near a main road, etc.
Second, I can type a coherent paragraph faster than I can say it. The ideas quickly turn into sentences in my fingers, and take longer to find suitable articulation in speech.
Third, changing to Windows 7 meant that it refused to work.
I’ll give the Windows a go.
*In Brisbane, back in the days of Global Warming.

Don Shaw
June 27, 2012 5:33 pm

Sorry to hear about your problems, hope they go away.
As others have, thought I would share my experiences.
I have suffered with Rhumatoid arthritis for over 20 years, so joint pain is something I live with and control with several meds.
I have experienced severe wrist joint pain on each hand. This occurred after using a leaf blower for an extended period and after splitting wood on another. I finally learned to avoid any vibration or shock to prevent re occurance. I too tried the LH mouse use but never did well.
On one occasion the hand Dr diagnosed CTS and sent me to a neurologist who after an hour of testing indicated that CTS was not the problem.
Back to the hand Dr., and he took an x-ray which indicated I have bone to bone contact which would not be cured by an operation. After “begging” for a cortisone shot, the pain went away before I got to my car, not to return.
My learning is that I cannot do any chores or fun things that vibrate or stress the wrists.
Cortisone is effective if there is a problem, and I’m sure my anti-inflamitory meds also help. As others indicated rest is often very beneficial. Also I frequently use the mouse pad on my laptop.
Wish you the best, hope this experience is helpful, your efforts are always appreciated.

June 27, 2012 5:55 pm

Had the surgery on both wrist… It can and most likely will come back… Good luck

June 27, 2012 6:20 pm

wow. thank you all. Anthony I did fear you might succumb.
Partial paralysis feeds into my right arm and shoulder pains that arise with mouse use. I use a light-touch keyboard, my mouse rests on a pad in my lap so I don’t have to lift my arms too much, and I sit high up. Now I know so much more that I can try!

Gail Combs
June 27, 2012 6:49 pm

ntesdorf says:
June 27, 2012 at 12:20 pm
…..contain valuable Vitamin E. My wife takes tablets containing Condroitin and Glucosamine which are shark extracts and help with cartilage problems.
I will second the Vit E, Condroitin and Glucosamine for some types of arthritis/joint pain. If I quit taking it for a couple of weeks I am back in pain again. Unfortunately it works only on some types of arthritis.
The wrist braces that keep your hand/wrist at the right angle really worked well for me too. I used them first 24/7 over 20 years ago and only need them now when I overdo.

June 27, 2012 7:13 pm

Switch to DVORAK! You’ll thank me later. You’ll slow down a little while learning it, but that may not be a concern. What you’ll get is MUCH less movement and strain. I’m a programmer. I’m always on the keyboard. With qwerty, my fingers were locking up and I was in much pain. It’s been over 10 years and never noticed anything but FUN when using the keyboard. YMMV, but it’ll definitely make things vastly better for those times you DO need to use the keyboard in the future.

June 27, 2012 7:24 pm

Try this. It is for all muscle groups but contains a section on hands.
Worked for me.

June 27, 2012 7:44 pm

Dear Anthony,
There is an extraordinary product, much used by mountain climbers, musicians and weightlifters, that will very possibly *cure* your RSI:
Please look into it.

Gunga Din
June 27, 2012 7:58 pm

Does the voice recognition software mean we’ll finally be able to hear directly from your resident Concerned Scientist? (Speak, Kenji, speak!)
Seriously, I’ve prayed for you. Take care. He cares.

Gregory Ludvigsen
June 27, 2012 8:10 pm

Keep practicing the dictation gets easier and better.
I just finished reding and article in a news letter about platelet rich plasma therapy for your carpal tunnel. It has been used successfully for carpal tunnel. http://www.google.com/#hl=en&sclient=psy-ab&q=platelet-rich+plasma+therapy+for+carpal+tunnel&oq=platelet+rich+plasma+therapy+car&gs_l=hp.1.1.0j0i30l2j0i8i30l3.4968.11093.2.14562.…0.0.qws0u7RcuCE&psj=1&bav=on.2,or.r_gc.r_pw.r_qf.,cf.osb&fp=3ddc6ee7f452a242&biw=1124&bih=543
You can also get this treatment at the Whitaker Wellness Institute in LA. http://www.whitakerwellness.com .
Good luck

June 27, 2012 8:31 pm

Get one of the Microsoft split “natural keyboards and prop it up on the edge nearest your body. I’ve had a problem with regular keyboards and can’t type for 2 minutes without my hands starting to tingle and go numb. I can type for 30+ minutes with not a single problem on my split keyboards. I’ve got them at work, home and a couple of extras. If you want I’ll ship you one free to try out.
That or Dragon Dictate 🙂

June 27, 2012 9:18 pm

For Mac people, MacDictate appears to be equivalent. It works quite well.
Also, I gave up the mouse years ago and went to the trackpad. Never had a problem since.

Harold Pierce Jr
June 27, 2012 9:25 pm

omnologos says on June 26, 2012 at 11:37 pm:
“has Romm discovered Voodoo, I wonder”
Rantin’ Joe uses Dragon NS. Where is Buffy when we need her?

Paul Martin
June 27, 2012 11:37 pm

Yeah for Windows 7. Let’s hope the speech recognition in the upcoming Mac OS Mountain Lion will raise the bar even farther. My hands have 40 years of classical guitar, 30 years of pounding keyboards (programming and systems architecture) and a few years of framing houses when burnt out in between jobs. When forced back to the keyboard and mouse, I recommend a Kensington Expert Mouse (trackball) and a Unicomp keyboard with the buckling-spring key switches. Via mergers, spin offs, etc. the latter is a direct descendant of the keyboards that came on the IBM 3270 and 3192 display terminals. Rubber-dome key switches, where every stroke has to bottom/impact out, should be banned. Thanks for everything!

William Astley
June 28, 2012 1:56 am

In support of Philhippos’ comment. Philhippos said:
June 27, 2012 at 3:35 am
“As someone with 68 years of total right handedness I was getting pain in the right wrist even having had the carpal tunnel operated on ten years ago. I switched my mouse to left handed and after a couple of days problem gone and no loss of speed. It might even be that the change could liven up my right brain and make me more creative!”
I also had problems with my right hand. I changed to using my left hand for the mouse and switch from right to left, before there is any onset of fatigue or pain. I would highly recommend that change. It only takes a few hours for a few days to get use to.
I would also highly recommend standing for a portion of ones computer time for heavy computer users. The standing time needs to be limited to the start of fatigue. I stand for a portion of my computer time at both home and at work. I was surprised at the difference it made to my core strength and posture. (I climb (scrambling) mountains and workout regularly.) Standing for a portion of the day is a type of workout.
Grand and Toy sells a standup computer desk which is reasonable priced and well built.

June 28, 2012 3:07 am

Hi Anthony, do take care and I hope some of the suggestions work for you.
Like many other long time heavy users, I experience pain and swelling in the right hand and wrist at times (partly arthritis). Just a quick tip to reduce mouse-induced pain – move the mouse with the right hand, if that’s your favoured one, but ‘click’ with the left by tapping the touchpad. Makes a big difference for me, significantly reduces pain and gives the overused bits a chance to heal. You tend to hold the mouse much less tightly and in a more relaxed way if you are not also priming to click all the time – in fact, I then hold the mouse lightly on the sides between my forefinger/middle finger and thumb with perfect control. HTH.

Olaf Koenders
June 28, 2012 6:17 am

Although I don’t have this problem (apart from physical pain from overstressing tendons in my wrist from lifting heavy sheets of 16-18mm MDF in my job of kitchen manufacture, I can understand how this is an intolerance (not to mention my back!). My wrists, when rotated freely, almost sound like broken glass. It’s something I’ve lived with for years. I don’t expect your recovery Anthony, however, you have my deepest sympathy and understanding.
The best cure is retirement coupled with minimal exercise. Sad but true..

June 28, 2012 6:30 am

I had trouble several years ago. I second William Astley’s comment about switching the mouse over to the other side. That really helps. You can get accustomed to it surprisingly fast. I don’t switch the mouse buttons, though.

George E. Smith;
June 28, 2012 2:05 pm

Anthony, this is certainly NOT something to be taken lightly. I’m aware of two extremely talented individuals; one male, and one female, fresh out of distinguished graduate schools and launching their promising new careers in industry, who literally were forced into de facto retirement,in their 20s, by RSS.
The young lady tried both bio-feedback, and eventually VR software. The VR software simply transferred the problem from her hands to her throat. The carpal tunnel problem became a serious “voice box stress” problem, because even the best such software is totally brain dead compared to a human recognition of voice nuances
If it was me, I wouldn’t focus too much effort on trying to train the VR software. I would just talk as ordinarily as if talking to someone; and then hand correct the errors; otherwise you will have to give up public speaking as well.

June 28, 2012 9:26 pm

Anthony – in case your software does not include this tutorial, it comes highly recommended.

June 28, 2012 10:13 pm

Anthony, my condolences for your tendons and tunnels. I’ve been involved with the evil PC machines since the early eighties. I apologise if someone else has already listed these recommendations. My WUWT reading time is dreadfully short this week.
The whole PC and workplace idea of PC usage are anti-ergonomic. Especially most mice and workstations are the worst things you can use.
Look for a different mouse. I’m currently using an old corded Microsoft optical 3000. Not because it’s the newest or coolest tech, but because it fits my hand. The wireless mouse that came my HP last year had my carpals screaming by the end of the day. There are some great trackballs too that help some (not me sadly).
Place your system so that your entire forearm has a flat surface to work on. Let the desk support your arm! A major of the problem is not only that the mice are absurdly designed, but your are is hanging in the air and repetitively clicking and wiggling back and forth.
Let your arm heal some! the speak to the computer stuff is a great way to let the arm heal. There are still many things that require interaction though. Use the tab key, spacebar and enter as much as possible. Avoid that left click on the mouse until you’re well on the road to healing!
As someone else has mentioned, start with some mild hand exercises. Don’t try for a lot of exercise. A few minutes a day works to start with. Use a soft rubber ball and see how much hand strength you have left (compare it to your other hand). This strength has nothing to do with your muscles right now, it’s the tendons that (and their channels) that are suffering. Personally I’ve been using a NSD Powerball lately, (I’m not affiliated in any way except for buying one).
Remember the old days? Back when parents were always screaming for us to back away from the TV? Monitors, whether laptop or desktop have a proper ergonomic distance. check into and try to keep to it. You’ll get less headaches in the longrun.
Every chance you get, support your arm. Let it rest. Aleve is an anti-inflammatory, though it may be best to get a prescription anti-inflammatory, but aleve does help. So does aspirin. For your tendons to heal, reducing the inflammation is necessary.

Hexe Froschbein
June 29, 2012 6:24 am

Once you got RSI, it will always lurk and be back like a flash the moment you (ab)use your arm normally, it will always remain weak.
Learn to use your left (or right depending) more, I’m nearly ambidextrous now(12 years of RSI…on and off). If you need to write, use a whiteboard(big is good, but the small ones are very handy too), the big pen helps to write legibly with your left, and take pics if you want to keep your notes. I now have readable handwriting with my left with normal pen and paper, but it took a while.
This book might help a little with managing the pain:
http://www.triggerpointbook.com/ Also, don’t just look at your hand, check your neck, shoulder and upper arms for outliers of your issues.
Get well soon!

June 29, 2012 10:36 am

Sorry to hear of your troubles, Anthony, and I also hope it doesn’t interfere too much with your amazing output on your blog. We can’t do without you! Hope you overcome it quickly.
But my advice would be to disregard ALL the other 228 comments on this post… I think they’re all just taking sadistic pleasure from causing you to wince each time you approve their comments 🙂

June 29, 2012 11:58 am

You are obviously a competent typist, we two finger typists never suffer from this painful condition.

Lady Life Grows
June 29, 2012 2:41 pm

I just happen to have downloaded a free book on back pain yesterday that goes into handling the causes of back pain–or carpal tunnel or other similar sciatic pains. Painkilers are compared to handling the oil light on your car by putting duct tape over it. Here is the link to the “ad” for the book–but it is a real book, worth more than most, and it really is free:

Bob Shapiro
June 30, 2012 12:23 pm

I’ve read that Pyridoxine 200mg three times day for a couple of weeks will do wonders for your carpal tunnel problem. Since it’s a water soluble B Vitamin, what your body doesn’t use get’s flushed out right away, so there’s little danger.

Steven Verrall
June 30, 2012 11:28 pm

If it is that bad, why not consider surgery? My wife has had the surgical correction on both hands. Carpal Tunnel Surgery is highly effective and the recovery time is only a couple of weeks.

July 2, 2012 7:40 am

Amino Acids in Meteorites says:
June 27, 2012 at 1:11 am
I’ve been using the Logitech trackball of that style for a couple of decades now, and have been computing since the late 80s. No signs of CTS at all.

Brian H
July 2, 2012 10:17 pm

david.gibson +1
The DVORAK kb is great. I’ve abandoned it now, as the “need” has gone, but loved my experimentations with it. I just used the s/w remapping and memorized the new keys, with help from a taped-up map nearby for reference.
10 yrs + ago my CTS got worse, and as a freelance online editor “rest” was not an option. Ended trying wrist braces (both hands), ergonomic kb (I still prop up the front bottom edge to make them slope down, not up!), wrist pad. Pain had spread all the way up to the left shoulder and was heading up the right arm.
Then on some oddball website I read the assertion that Vitamin B6 was a/the precursor to the lubricating enzyme in the carpal tunnel. Started on 75mg/day, and within days the pain had eased. With a couple of weeks it was barely noticeable. Within 2 months it was gone, and has pretty much remained ‘gone’. If I ever feel twinges, I take it again for a few days.
About kb design: drooping wrists are much easier on the CT than cocked wrists! The “upsloped” kb is the worst possible design.
The best is very rare, almost impossible to find: split vertical. The two kb halves stand on edge, so the wrists don’t have to rotate at all. The problems that “legacy” thinking and design have laid on IT are endless, it seems. 😉

Brian H
July 2, 2012 10:32 pm

Bob Shapiro says:
June 30, 2012 at 12:23 pm
I’ve read that Pyridoxine 200mg three times day for a couple of weeks will do wonders for your carpal tunnel problem. Since it’s a water soluble B Vitamin, what your body doesn’t use get’s flushed out right away, so there’s little danger.

I see now you beat me to it! That’s B6, which I used. But at about 1/8 the dosage you mention, 75 mg once a day. So there’s obviously a wide range of workable doses.

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