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
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.
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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.
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!
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.
Max
PS: I use the straps properly now, and keep my darned thumb OFF the top of the pole!
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.
http://pckeyboard.com/page/category/UKBD
TO CURE CARPAL TUNNEL STRETCH YOUR PECS, BICEPS AND FOREARMS!!
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.
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.
Cheers,
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
http://www.microsoft.com/hardware/en-us/p/natural-ergonomic-keyboard-4000/B2M-00012
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?
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?
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.
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!!!!
Anthony,
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
http://www.fentek-ind.com/kbdvorak2ub.htm
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
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.
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.
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.
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.
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!
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!
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.
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.
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!
Hope you feel better soon, Anthony!
This is off the subject, but here is an excellent article that you should include in your blog.
http://www.nationalreview.com/articles/304069/economists-without-calculators-robert-bryce
Anthony, did you do the good ol’ Hello World ?
I sincerely hope that you get relief and a fix for your CTS
Max Hugoson,
What does scar tissue in your lymph system feel like?