Beyond the Wrist: Debugging RSI

I got RSI after a few years of steadily increasing computer time, culminating in a year of 14 hours per day at the computer, almost every day. The first thing is that having never had RSI, there were signs that I ignored during that last year, notably that my nerves gave me small electric shocks in the armpits from time to time, which I interpreted as a quirky oddity. Then just one day it felt like my arms nerves were literally burning, and the pain just became unbearable. After medical examination, my nerves were fairly damaged, so the specialists I saw advised to either worsen the situation enough to make surgery the only choice, or find a way to get better. I chose the latter, which included every solution that can be suggested. More rest, more exercise, I tried a few device change, and most importantly changing posture. It took almost 2 years before computer use become "generally not painful" again.

Device of choice did not make a big difference, except for one: having a secondary standing desk with a treadmill. I took that from an old Linus Torvalds interview, it's a small monetary investment, but a big health one. The biggest downside is that it takes a lot of space. In my case, the main problem was linked to prolonged pressure on a few key points, a problem that doesn't really occur when moving.

Before that, I used to have a laptop so that I could spend the work day in different postures, move to a couch, etc.

Regarding the article, I can confirm that pain was in different modes during these different periods, but that also matches the risk of physical damage. I feel that as long as you're just doing a half-hearted effort that is just an attempt to deceive your body, pain will only worsen. It's only after you learn to listen to the pain that the real progress is made.

Reading one of Dr Sarnos books sorted mine after over ten years.

I don't think agree entirely with the model he puts forward in his book for why RSI happened, I'm naturally sceptical so it took a lot of effort to read with an open mind; perhaps it works a little like hypnotism.

I'd read that some people can get an improvement just reading reviews of his book, so I read a load of them.

Then something strange happened - the RSI started flipping from one wrist to another.

I already knew some slightly odd things could happen: at some point my girlfriend had massaged my arm from the hand to the shoulder and the pain had moved up right with it - then gone back to the end.

So I knew the mind was part of the issue.

After the pain could flip from one wrist to another I bought the book.

After that I could sort of talk to myself internally giving reassurance when the wrist pain happened and it would go away.

This evolved into just thinking about the area in pain.

Sometimes the pain would turn into a anxiety, but I can pretty much make that go away.

Part of his ideas are about the body and mind being linked (which makes sense), so the RSI is a manifestation of stress.

The book I read was The Mindbody Connection.

I find it weird to recommend as the cover makes it look dodgy, and the thesis is a bit new age seeming for me, but it did work for me.

I recommend reading a load of reviews of his stuff and seeing if anything changes.

As someone who had RSI for years, my one recommendation (which resolved things for me in the end) would be: Get your neck and posture checked. Chances are your problems are coming from up to chain.

In my case it took me a good 5-6 years to figure this out. Then I started working on my overall posture, and my issues virtually disappeared over night. A friend of mine, who was also struggling with RSI a couple years later, ended up following the same protocol and he, too, is 100% painfree these days.

I remember carpal tunnel syndrome being a big thing 25+ years ago, and I had friends with wrist braces.

You don't hear much about it now. Is it because treatment improved, or we use keyboards with much less travel, or there's better general awareness of ergonomics, or that there's more mouse/trackpad use mixed in with typing now? Or is it something else?

The article matches my experience and that of many others. It also mentions some key ideas that I haven't seen in other RSI/pain-epiphany writeups:

- It may take a variety of resources to accept the idea that your pain doesn't mean injury (see the first image). Like, you might hear about Sarno's mindbody connection and think it's total quackery because of the language. Maybe it triggers the BS detector in a lot of us. So listen to the same ideas from other perspectives. The author links to Schubiner's talk on chronic pain, which I heartily recommend as the right balance of rigor and tone: https://m.youtube.com/watch?v=0VyH1laOd2M. Curable helped me too: https://www.curablehealth.com/clara/. Click through until you get to the audio sections and give them a listen.

Testimonials from tech people may help break the old mental model of pain, or at least point convincingly to resources that do. Josh Comeau, the CSS guy, has a post that links to further testimonials: https:www.joshwcomeau.com/blog/mindbody

- The second half of healing is calming down the nervous system. The author accomplished this with different therapies, equipped with greater awareness and tools. Others fix their default stress state by leaving the stressful environment, i.e. changing jobs. Either way, the pain goes away.

Kudos to the author for presenting everything clearly.

Switching to a Svalboard has made a big difference for me. It took me a few years before finding this keyboard. The magnetic breakaway keys make it significantly gentler on my fingers than anything else I've tried. It's similar to the old data hand keyboards. https://svalboard.com/

It’s probably anxiety. The brain is a strange beast.

Try a combination of heavy weightlifting, HIIT, and optionally SSRIs.

I have a friend who struggled with RSI for years, tried every keyboard and mouse under the sun, and nothing worked.

Then he quit the job he hated, got a job he enjoyed (both coding), and his RSI went away in a week. Sometimes it really is psychosomatic (which doesn't mean the pain is fake).

Personally I've had mild wrist pain since college (10+ years). Decent posture, a reasonable keyboard, letting my arms form a natural angle, and floating my wrists above the keyboard seems to help. My hands cramp up after 20min of typing in a narrow airplane seat for example. But I can type for hours on my ipad magic keyboard in my lap or my ergonomic mechanical keyboard just fine.

I just ordered a ZSA Moonlander in the hopes it will help, because it’s been getting progressively worse for me. I have an Uplift desk (which admittedly I never use in the standing position; it’s just a great desk that I could precisely position), a Steelcase Leap chair, and every other aspect of ergo taken care of. I’ve been to physical therapy repeatedly.

What baffles me the most is that I can spend hours on my laptop, using its built-in keyboard, and be fine. Maybe there is something to the psychosomatic element – I’ve trained myself that my desk equals pain.

I play multiple music instruments (piano, violin, guitar), play tennis, contact and pin juggle, and work as a software engineer.

The most important changes I made in my life which fixed RSI related issues (carpal, tendonitis, etc) permanently were:

- Proper ergonomic keyboard (consider a split layout)

- Posture (Alexander technique, Taubman technique)

- Trigger point therapy (with a Knobble tool)

I can highly recommend this book:

https://www.newharbinger.com/9781608824960/the-trigger-point...

This is supposed to be awesome: https://www.diyjointpainrelief.com/

I’ve been controlling rsi with upper body mobility and strength training + typing breaks for years. This mind over matter approach sounds like bullshit.