8 months ago
For the past couple of months, I’ve been dealing with some pretty significant wrist and hand pain while working, primarily on the right side. I’ve exhibited some classic symptoms of Carpel Tunnel Syndrome, including numbness and pain in my hand after two much typing, weakness in my wrist, waking up at nigh with numb hands, etc. I’ve put together some random thoughts on the matter.
As a programmer, typing is essential-unless it isn’t.
I spend a lot of time tooling around on the computer when I’m not working. The first thing I’ve done is to cut back on this.
I recently spoke to a gentleman who does all of his development work using Dragon Naturally Speaking, and with its support for custom macros, it hasn’t slowed him down any at all. I’m not ready to take that plunge when it comes to writing code, but since our discussion, I have started dictating things like notes. In fact, I’m dictating this blog post.
The computer mouse is Evil.
Let’s face it, by and large, a mouse is not an ergonomically designed piece of equipment, and when it comes down to things that trigger pain, the mouse seems to be the number one source of problems for me. So I’ve started more seriously attacking this problem. Here are some tips I’ve come up with based on my experimentation.
- More keyboard shortcuts - sure, minimizing typing is great, but if your problem is with the mouse, learning keyboard shortcuts can save you a world of hurt. It also gives you a big performance boost.
- Switch it up frequently - I now switch from touchpad to mouse to WACOM throughout the day. Sometimes I use the touchpad left-handed (it’s the only one I can seem to control well with my left hand).
- Squishy is good-I bought a mousepad with a gel wrist rest. Since CTS is a compression injury (basically). I do my best not to put any pressure on my wrists, but sometimes that gets tiring when doing a lot of mousing, so the gel pad helps keep things cushioned.
Finding the right keyboard is hard.
I like the feel of the standard Apple keyboard. I didn’t at first-after all, I was switching to it from a Model M, but after a year of getting used to it, I really like it. When my hand and wrist pain started to get bad, I briefly switched to a Microsoft ergonomic keyboard. To put it bluntly, I hated it. My husband now uses it and loves it, but it’s designed for hands bigger than mine. I have yet to find a good alternative.
While not ergonomically designed, some people have reported good success with mechanical keyboards, since the buckling spring design means you don’t have to bottom-out the key, which means less jarring on the fintertips. I never did have any issues when I was using the Model M, so I may pick up a Mac-compatible Unicomp keyboard at some point. In the mean time, I’m trying to lighten up and not pound the Apple keyboard so hard. The chicklet keys don’t have a lot of room to move and I am a heavy hitter from years of using mechanical keyboards.
The EMG was kind of weird, but I’m glad I did it.
I can list all kinds of tips, techniques, and ideas for alleviating and preventing hand and wrist pain while programming, but the bottom line is this: your hands are very important and if they’re hurting, see a doctor. I’m still in the process of sorting out a proper plan for dealing with my hand problems, but going to a doctor has helped me sort out exactly what is wrong and given me peace of mind and an informed position from which to form that plan.
If you’re having a lot of hand and wrist pain, it’s important to check for things like nerve damage, inflammation, and poor muscle function. There are a lot of exercise and treatments you can do, but if you start doing them on your own, you could cause further damage if you don’t know exactly what problem to treat.
Physical therapy is gold, ice and wrist splints are kinda great, too.
All of that said, what has worked best for me so far, and what I think the ultimate solution will be (since I thankfully have no permanent nerve damage) is the occasional ice pack, wearing a wrist splint at night, and a bit of physical therapy. I’ve been given a couple of stretching exercises to do (above is an image of the one that’s most helpful, which should be done with the arm fully extended).
Hopefully, over time, I can cut back on the splints and ice. My primary goal right now is to alleviate symptoms and form a routine that will prevent them from getting worse again and causing serious damage.
So to wrap it up:
- Wrist splints at night if the pain is significant and wakes you up
- Lots of stretching once you’ve determined it won’t cause further injury
- Don’t type if you don’t have to - there are many cases where you don’t have to
- Cutting back on typing is, sadly, often easier than finding a comfortable keyboard
- Keep pressure off your wrists and ice them to reduce swelling
- Mix things up when it comes to using the mouse
- See a doctor
None of these changes will have an immediate effect. The biggest thing you can do for immediate relief is go on vacation and forget to bring along the laptop. After a couple of weeks of reduced typing, frequent stretching, and some changes to how I use the mouse, I’m finally starting to see some improvement. However, I still have days where I go to bed at night feeling like my hand has been through a meat grinder. Usually this happens when I get really busy and overdo it. Part of the process is learning my limits.
Oh, one last thing; joint problems can lead to muscle pain. Muscles become tense and sore because your body naturally tries to compensate for and protect a weakened joint. I’ve gotten a lot of good relief from muscle pain by hand and forearm massage.