Welcome to No Carpal Tunnel Blog.

Disclaimer: We are not medical professionals, and are not qualified to provide medical information.

We have felt the pain and are here to share our roadmap to recovery from Carpal Tunnel Syndrome, Hand Pain, Wrist pain, and RSI.  The first step in healing is admitting that you have a major problem.

• Do your hands hurt after using the computer?
• Do you find yourself dropping more items?
• Are you constantly re-tying your shoelaces?
• Does it hurt to floss your teeth?
• Are your hands or wrist hurting when you wake up, after driving, after playing videogames or using your smartphone?

This slowly debilitating condition is a product of years of physical abuse on your body. The body wasn’t built to type on a computer all day long. It will take months or years to recover from the damage. The tendons and other muscles were not built to taking the pounding of keyboards, swiping, or mouse clicks all day. Kids are starting to use computers at progressively younger ages, making carpal tunnel a growing problem throughout the population. Adjusting your workstation, popping vitamins, or buying an ergonomic keyboard will not solve all your problems. There is no silver bullet or quick fix.

Diagnosis

The first step in recovery is finding a competent hand doctor and getting a proper diagnosis.  Many hand doctors also perform or mainly perform cosmetic surgery. We have had better luck utilizing doctors that specialize in occupational medicine. Ask your friends, colleagues, and family for suggestions.  We are not medical professionals, and are not qualified to provide medical information. Look for a diagnosis from your doctor and a prescription for hand therapy.  Surgery is a last resort and often only gives temporary relief.

Hand Therapy

Hand Therapists helped me the most with my recovery and education.  Support groups are also very helpful. From them, you will learn techniques including Hot and Cold Transition Baths, Paraffin Wax Therapy, Icing, Wrist braces, Wearing gloves, Weight Training and Ergonomics. These are far more useful than popping ibuprofen  all the time. Keeping a Log Book with your daily entries on pain and what happened during the day, is a helpful step to take. Hand Massage and Relaxing Vacations come into play to help further your healing.

Do not hesitate seeing different hand therapists.  We had to try several before finding one that really helped us.

Books

Education through reading Carpal Tunnel Syndrome books or Books on RSI is very important. An educated patient will recover faster.

Lifestyle Modification

Carpal Tunnel Syndrome and Hand Pain recovery will require changes in how you drive, bike, or even watches and handbags. Any use of your hands will need to be examined and optimized to your new normal.

Work Changes

Computer Ergonomics are important to prevent further damage and to change work habits. Keyboards, input devices, chairs, desks, and other elements require attention.

Smartphones, iPads, and tablet computers contribute to your carpal tunnel or hand pain. Touchscreens with their swiping gestures, can cause undue hardship. Ergonomics and usage reduction are a must when using these evermore present devices.

We hope you find our experiences helpful in your recovery from Carpal Tunnel Syndrome, RSI, or hand pain.  Please comment with your own experiences so others can benefit.

RSI Support Groups

There are many RSI support groups around the nation. I have attended the San Francisco RSI Support group and found it helpful. They have monthly sessions with knowledgeable speakers.

It is always great to learn new things, share tips with others, and realize that you are not alone in your recovery.

Ergonomics is one of the first things users address when confronted with a RSI such as Carpal Tunnel Syndrome. It is really important to setup your computer workstation properly.  Improperly setup computer desks cause extra strain on your hands, wrists, back, and body.

The most important aspects are:

Seating

Buy a sturdy and Ergonomic Office Chair or Ergonomic Computer Chair that fits you properly.  You may need to visit a specialty office store or ergonomic office products company to find suitable products. The chair needs to allow height adjustments, depth adjustment, and provide lumbar support. The Business and Institutional Furniture Manufacturer’s Association has Chair fit guidelines.

• Adjust the chair so your feet are flat on the floor
• Monitor’s top should be in line with your eyes
• Check your posture after 15 minutes, are you slouching?

Workstation

Your work area must properly fit your body. BUY a new desk if need to.

• The work surface must be at the correct height.  Keyboard and Mice should be on an adjustable height platform, no two people are the same size!
• Your elbows should never be higher than your keyboard, but at a seated elbow height. Elbows should remain close to the body, forming a 90° angle. Adjustable keyboard trays can help.
• Sit close to the desk or keyboard tray to reduce arm extension. Keep your shoulders relaxed.
• Mice should be close to your body, not out to the side or high on your desk. Try to minimize the distance between the keyboard and the mouse to reduce lateral arm movement.
• Gel filled Wrist rests work for some people
• Wrist, hand, and forearm should form a horizontal straight line.
• Monitors need to be positioned so the top area on the monitor is level with your eye, using stands or phone books. Consider computer glasses if needed.
• Put the monitor 1 arm length away.
• Also consider a sit to stand Workstation that can help you to change positions.

Computer Eyeglasses

Your vision affects whether you start leaning in to see your monitor. Make sure your prescription is up to date. Consider making special prescription computer glasses.  I have done this and found it helps ALOT.

Input Devices

Setting up or upgrading your ergonomic input devices and  Ergonomic Keyboard to those from vendors like Kensington or Kinesis or Kinesis Freestyle. The mouse should your hand, use smaller travel mice for smaller hands. Consider multiple input devices and swapping them every couple hours.  An automatic mouse clicker also helps.

Work Routine

Taking Breaks is incredibly important. People need to break up repetitious work like typing or mousing by getting up and stretching every 15 minutes or so.

Taking breaks during computer use is critical to healing. I use a timer like this Polder Digital Timer to remind me to take breaks. I set it for say 20 minutes, then it beeps and I stop using the computer and take a break for 20 minutes.

You can vary the amount of computer usage and break length depending on your injury status.

Voice Recognition software reduces your hands usage and hence speeds your recovery.

Ergonomic Assessment

Professionals can examine your workstation and work habits and give you customized advice.  This cost a couple hundred of dollars but has proven useful for me.

Here are some site with useful information. PRINT OUT the information you need. Do not use your computer more than necessary.

Office-Ergo.com
Cornell ergo Tips
Humanics-es – Rethinking work ergonomics
UCLA Ergonomics

American Journal of Roentgenology has a good article covering computer ergonomics and Carpal Tunnel Syndrome.  The diagrams show exactly what type of situations you should avoid.

Remember that just setting up your workstation correctly will not result in instant healing from Carpal Tunnel Syndrome. You have been injured and will probably need months to heal.

One of the first steps people take when diagnosed with a RSI such as carpal tunnel syndrome, is to switch to an ergonomic keyboard. Here are some ergonomic keyboard that I have and continue to use and recommend.

The Kensington Comfort Type USB Keyboard is a low cost ergonomic keyboard that I use. It has angled keys to force a comfortable, relaxed wrist position and light action for easy touch typing. It is easier to switching to than the other keyboard I use…

The Kinesis Advantage USB Keyboard is an ergonomic keyboard that I also use. It has a split design that keeps your wrists in a more natural straight out position, rather than twisted inwards. The Delete, Back space, return, Space keys are used often, so they are positioned so your more powerful thumb can hit it. It took me about a week to get used to it, but it is worth it.

The Kinesis Freestyle solo is a low cost split ergonomic split keyboard that helps prevent Carpal Tunnel Syndrome.  It allows you to detach each side and position it independently, maximizing flexibility for different body shapes.

The Microsoft Natural Ergo Keyboard 4000 is a popular low cost ergonomic keyboard. The goal is to have each wrist on top of the keyboard without twisting the wrist. Everyone has a slightly different distance between each hand, but this keyboard has a fixed width and angle between both sides. One size fits all so make sure it fits you.

Another option to consider is remapping your keyboard to the DVORAK keyboard standard which may be easier on your hands or at least offer a short-term fix with a change in keyboarding strokes.

Try to visit a store to test out more expensive keyboards. A lot of their ergonomics has to do with how far apart your hands are in a neutral position and how big your hands are.

I have two ergonomic keyboards and switch between them during the day.  This prevents my hands from getting stuck in one position for too long.

Positioning a keyboard

Position the keyboard so  that the or the b key is  centered directly in front of you. This is without main area you’ll be typing in, so it needs to be as ergonomic as possible. Keep your pointing device has close to the keyboard as possible, to minimize awkward movement.

Minimize keyboarding

Use a program to create a hotkey combination that performs a variety of tasks or types a bunch of words with just one keystroke. AutoHotKey is a good bet for Windows. The less you type, the better. Also consider voice recognition software.

Carpal Tunnel Treatment requires education. Books that have helped me recover from Repetitive Strain Injury or RSI, which many people call Carpal Tunnel Syndrome:

Dr. Pascarelli’s Complete Guide to Repetitive Strain Injury: What You Need to Know About RSI and Carpal Tunnel Syndrome by Dr. Pascarelli

This is the bible on recovering from RSI. Recognizing the early signs and risk factors, Finding a doctor, Preventing RSI, recovering.

Conquering Carpal Tunnel Syndrome : And Other Repetitive Strain Injuries by Sharon J Butler

This book contains stretching exercises to gently relieve the tension in your body and to strengthen weak muscles. The exercises I employed are on page: 106, 110, 112, 116, 128, 130, 134. I perform them religiously every morning. Alternatively, you can try signing up for Pilates reformer or yoga classes, preferably with an instructor that understands your special needs.

The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition

I learned Trigger points are where muscle problems are located. They can cause pain often far down the line. My shoulder caused my fingers to ache! Once we figured it out, we could address the real problem. Using this book I learned techniques to minimize these trigger points by self-massage. I also utilized a Massage Therapist to help me find trigger points. My condition was covered in pages 88, 90, 98, 139, along with solutions.

Also consider buying a foam roller to perform some of the stretches on.  I find it very useful to play on my back on top of the roller.  While performing the stretches.

It’s Not Carpal Tunnel Syndrome! RSI Theory & Therapy for Computer Professionals by Jack Bellis and Suparna Damany.

I was looking through a book store and came upon this book.  The title says it all.  Very small percentage of people actually have Carpal Tunnel Syndrome, far more have Tendinitis or some other condition. The book is worth buying as it draws upon many user experiences.  It clearly goes over human anatomy, injury, diagnosis, various therapies, prevention, ergonomics, stretches, and lifestyle issues.

When you are dealing with such a debilitating condition, you should arm yourself with as much information as possible for Carpal Tunnel Treatment.

Log Book

photo credit: vitelone

I have been keeping a log book listing my pain level with notes on what I did that day for a while. I find it helpful to understand what aggravates my condition and what therapies really helped.

I have an entry for when I wake, noon time, and evening time. I use the 1-10 pain severity scale.

Because healing happens slowly, you can really see progress when comparing current results to logs months ago.

The Wacom Bamboo Pen Tablet is a low cost ergonomic input device that I use to reduce Wrist Pain – Carpal Tunnel Syndrome. I hold the stylus like a hold a pen and lightly move it around. I wrap the stylus in a rubber – foam insulation so it is about 1.25″ in diameter. This makes gripping it a lot easier. The key to a more ergonomic input device is to try to keep your hand in as close to a natural position as possible.

Another input device I switch between is:

The Adesso USB EasyCat Touchpad is another low cost ergnomic input device that I use. I use my finger to lightly move the cursor around and programmed its buttons to do tasks that require multiple clicks. Wrist Pain – Carpal Tunnel Syndrome is reduced when I used this pad.

The Evoluent Verticalmouse 4 is another input device that I’ve recently added. This input device is available in different sizes, which is great because one size does not fit all. It keeps my hands in a neutral position and contains lots of buttons, but took a while to get used to.

Roller Mouse Pro is a mouse alternative pointing device that has a roller bar that acts like a highly sensitive mouse.  You do not need to reposition your hands to move a mouse, cutting down on excess motion.  You can also program the buttons for specific tasks. Wrist Pain – Carpal Tunnel Syndrome can be reduced when using this device.

SmartNAV is a hands-free input device that uses your head movement. You can click utilizing voice recognition software or a floor mounted click button.

The Kensington Slim blade trackball is another input device to consider.  It has a large ball that can be maneuvered with the entire Palm.  The buttons can be pushed to the side of your arm.

Automatic Mouse Clicker software can help reduce the amount of mouse clicking.

Again, these will not solve all RSI problems.  You need to take breaks, do stretching, and minimize computer use whenever possible. Also consider Dragon Speech Recognition software.

I have found that most of my healing and insight was gained while under care of hand therapists. Doctors just examined my hands and gave a diagnosis and a prescription for hand therapy. The treatment part fell on the therapists.

California Pacific’s Hand Therapy in the San Francisco Area has helped me heal, and I can recommend them 100%. They will help you understand your condition and provide a path to healing. They helped with exercises, therapy, ergonomics, splints, and work tips.

Look for a Certified Hand Therapist or CHT in your area for experts in dealing with carpal tunnel syndrome or RSI.

From hand therapists, you will learn about Hot and Cold Transition Baths, Paraffin Wax Therapy, Icing, Wrist braces, Weight Training and Ergonomics.  Keeping a Log Book is a helpful step to take. Massage and Vacations come into play.

Do not delay contacting a hand therapist, the sooner you do it, the faster you will heal.

Be sure  to look at our Carpal Tunnel Treatment Book Recommendations

photo credit: Akajos

Research has indicated that massage helps with pain from Carpal Tunnel Syndrome or RSI. I have personally tried this many times with mixed results, but then realized a better way to approach it.  The problem may be that many massage therapists do not know how to lightly work on the affected areas, nor do they know the specific anatomy of the hands and wrists area.  After a massage my hands would feel like I typed far too long. It would take a day or two for me to recover.

Massage from my hand therapist has helped my condition and ease pain.  They work very slowly and very gently with the affected areas. When I have gotten some massages from general practitioners, I initially ran into some that were not well-versed in human anatomy, which ended up causing more harm than good. I later found a massage therapist that understood trigger points and muscle anatomy who was able to really help alleviate my symptoms and educate me on how to do it myself. Before you make a massage appointment, try to make sure that the therapist is a “Certified Massage Therapist (CMT).”  Quiz them about previous work with RSI sufferers and ask for references.

Isotoner Gloves

Isotoner Gloves were recommended to me by my hand therapist to ease pain and swelling of hands to to my RSI or carpal tunnel syndrome.  They work like compression socks or tights, providing a very tight fit.

You may notice that your hands are usually cold, due to poor circulation. While washing your hands in hot water can warm them up, gloves might help even more. Mines were used as I suffered through painful Wrist Pain and Carpal Tunnel Syndrome.  I learned from my hand therapist that I could wear gloves most of the time to warm up my hands and improve circulation in them. No need to any special RSI glove, any glove will do.

I like the Ironman Elite cycling gloves because of their thick Spenco shock absorbing padding.  They work well when I’m driving or biking.

Isotoner Gloves

Isotoner Therapeutic Gloves were recommended to me by my hand therapist to ease pain and swelling of hands to to my RSI or carpal tunnel syndrome.  I find that they help ease hand pain. They work like compression socks or tights, providing a very tight fit. These close come in various sizes and even have openings so you can still type. Measure your hand size before ordering as they have several different sizes.

RSI software

You probably use a computer. RSI Warrior is a software package I have used to fight Wrist Pain and Carpal Tunnel Syndrome.  It brings up rest break reminders, stretches, ergonomics tips, and automatic mouse clicking. Try the Free Demo