How I Cured my RSI Pain (2010)

I suspect what's happening with all the people who this works for is that given there are some people who have a psychological component to their pain and some who have a mostly physical component.

Even if there are far fewer suffering from the psychological version, they are the ones who physical treatment will fail for. So they will be the ones that get as far as trying the pseudosciencey approach to dealing with the pain. So the mind body approach will have a high success rate amongst the people trying it even if it would be a terrible initial remedy to try.

Many years ago I suffered nearly life-changing RSI pain. It happened in the middle of an extreme project where I found myself coding and running CAD for 16 to 18 hours a day, seven days a week for months.

The first good decision I made was to stop all work.

Next, I sought medical opinion. I was horrified to learn medical professionals were all over the place. I got recommendations spanning from surgery to vitamins.

I concluded that I'd do my own research and come to my own independent conclusions.

I focused on two areas: understanding the physiology or mechanics of the damage and taking a deep dive into ergonomics.

I came out convinced that the root cause was poor ergonomics. I had not caused enough damage to require surgery. I set out to test out various ergonomic products. Nearly all of them sucked. Gimmicky crap.

The ultimate solution was to design my own desk. The goal was to promote a fully relaxed posture with proper alignment and support.

The standard 29 to 30 inch high desk was designed in the dark ages for writing. Placing a keyboard or laptop on it throws your entire body out of alignment. Your fingers, hand, wrist, arms and shoulders end-up operating in tension as opposed to from a neutral stance.

My desk featured a dropped (about three inches) front section for the keyboard and thumb-operated trackball. I ditched the mouse as it caused too much tension. I found a thumb-operated trackball to flow naturally and comfortably.

A dropped keyboard shelf wasn't enough. The front edge got a solid piece of wood, 2x2 inches in cross-section with generously rounded edges. This created a forearm support across the entire width of the keyboard shelf. The net effect was that my hands very naturally drooped onto the keyboard and trackball. My shoulders were not unnaturally pushed up or pulled down.

I played with monitor height and settled for looking slightly down at the monitors (24 inch). I tend to alternate between sliding down in the chair and sitting up, which means that at times I am looking straight at the screens.

The end result was that all pain was gone and I could get back to work. I also took regular breaks every two to four hours based on flow.

Two words: music physiotherapists. Musicians get RSI-type problems a lot, and when it's career-ending for a concert pianist, people really pay attention. Plus there's several hundred years of accumulated experience dealing with these problems.

I still have fluid around my tendons 20 years later, my RSI was so bad - visible roundness in my forearms - and I haven't had a day of pain in a decade. It took six sessions, and they only worked on my neck.

Highly recommended.

I won't begrudge anyone who finds comfort in this "mindbody" stuff. If your pain is gone, good for you. But I really really hope you folks won't take away the wrong lesson and assume that all RSI is mental. It's not.

Overcoming my own physical pain was tough, but I eventually conquered it. Here's what worked for me.

* I learned to type Dvorak. Since learning how to type on a C64 at the age of 3, my typing form has always been terrible. If nothing else, Dvorak taught me how to put my fingers in the right places.

* I picked up a split-in-two-halves keyboard. The right half of the keyboard is rotated counter-clockwise to address the extreme ulnar deviation in my right forearm (following an old injury).

* It's also nice, with these broad shoulders, to spread out the two keyboard halves. This helps a lot with my neck and shoulders.

* I tented that keyboard to ease pronation in my wrists. I started at about 70 degrees (almost fully vertical) and eased down to 15 degrees over time.

* I grabbed a vertical mouse to match my vertical-ish keyboard.

* I stopped leaning my head toward the screen. Huge help for my neck.

* I started using a sit-stand desk. This is a great way to "take a break" without actually taking a break.

Some other important observations.

* Being in good physical shape reduces all my RSI problems/risks across the board. When I'm fit, I can type in any awkward position for days without pain. When I'm fat, I get RSI just thinking about my keyboard. Being fit at the moment, all my new equipment and good computing habits are making me far more productive.

* Good sleep and good food also help. Sometimes I lose focus and slip back into bad habits when I'm in a cheesesteak coma, for example.

It may be possible to fix your RSI physically if you pay really close attention to what your body is telling you, and earnestly experiment with possible solutions. Some big organizations in SV have ergo labs where you can go test out equipment for free. Use that resource if you can. Do what you must, but don't discount the physical solutions.

For what it's worth, I read this recommendation a year or so a go and it helped a lot despite my initial skepticism. It's mostly a mindful awareness thing.

I'm another person that was helped by this. I was also pretty skeptical entering it, and I hate that I am embarrassed to tell my RSI-suffering friends about it when I know that it has helped many people (including others of my RSI-suffering friends).

To those talking about how it's pseudoscience, all I have to say is that there are at least some people, including the author of the post, who have tried many other options and found that this approach helps. As far as I'm concerned, I'd be happy to sit in a crystal pyramid or any other sort of quackery if it genuinely improved the problem.

(And in reading the book, the author does have some reasoning as to why it works. I think it's at least indisputable that there are physical consequences to many mental ailments like stress, so it doesn't seem like such a reach to me to try treating the mental issue to improve the physical symptoms.)

I've been seeing this book pop up all over the place for the past year or so. It seems to be the go-to recommendation from friends to other friends who are frustrated at not finding relief from chronic pain after trying many other treatments.

I haven't read the book. All I can say is that the results, from my perspective, have been mixed. Some people who have tried it and not seen their pain alleviated blame themselves for not getting to the root of their stress. I haven't heard of anyone's pain disappearing in 2 weeks. I've heard people recommend it for all kinds of pain, not just muscle and back pain. Claims about its efficacy seem to have broadened over time.

The book is set at a very good "it can't hurt to try" price point, and the word of mouth marketing makes it very appealing to people who feel desperate.

I am a random person. My experiences are anecdotal.

Never read the book, but psychology changes helped my RSI issues tremendously.

> if you are unconsciously worried about something (including worried about your wrists hurting while you type), then this can cause your wrists to hurt while you type.

This. If you're scared of RSI and scared of typing, that can itself cause problems.

I'm another person cured of RSI by the same approach. Initially, when learning of TMS, the RSI got worse (progressing from just constant pain to feelings of numbness and nerve damage).

Certainly worth a look if you have RSI--clearly if people can be cured more or less overnight by just reading, there's SOME mental component, whether or not Dr. Sarno's explanations of the mechanisms of TMS are correct.

Claims to be sceptical but then:

"The first medical specialist I consulted was a chiropractor"

Chiropractic was founded by magnetic healer, D.D. Palmer. Magnetic healing is also a pseudoscience but less people take it seriously.

I am unsure this book's claims are correct, and I still remain skeptical. But one epiphany I had in dealing with my recent RSI is that it does make me worry — quite a bit in fact. Programming is not only how I make a living, and also a hobby and my future life as a grad student. Having it all be at risk because of RSI makes me incredibly stressed. Previously when I've had RSI, it's gone away after a week or so. Now I'm the most stressed I've ever been about it because it just hasn't gone away. I don't think it's so odd to suspect that there is a psychological component (and now that I am aware of it I am addressing this it from angle more). There's an unlimited positive pain feedback cycle, which could explain the persistence. I could see some sort of process where RSI's origination is physical (overuse, definitely was in my case) but its lingering is a function of stress.

This article also made me realize that it is silly for skeptics to use the placebo effect (a purely psychological effect) to attack pseudoscience healing crap, but then dismiss psychological explanations for pain. If the mind can limit pain through the placebo effect, why is it so suspicious the brain can cause or continue pain?

While we're discussing anecdotal cures for RSI, I'll disclose mine: deadlifting.

That's it. Consistent, heavy deadlifting has kept it away for years.

I have no medical explanation.

Maybe I'm missing something here, but from his very brief description of the methods used, I thought that there was at least some "method" or "logic" to it.

But then I brought up:

https://en.wikipedia.org/wiki/Tension_myositis_syndrome

Which seems to indicate that the "treatment" is something much more vague like...journaling, support groups, therapy...?

Pardon the stereotype, but I'm imagining some old women's knitting group or something...or all the stuff about "repressed anger" "childhood abuse", etc....if that were the case, wouldn't women's circles, group therapy, individual therapy, anger management classes, spontaneously start curing people of their pain? I don't see anything specific about this method.

Maybe I'm missing something very basic? Distraction and getting your mind off of it is a well known way to deal with pain. I didn't think that was new.

The cycle is like this:

1. Pound away at the keyboard indiscriminately for years, no pain 2. Pound away, start to get pain but it goes away after some off time (could be as little as a night) 3. Pound away, get pain but it goes away after extended rest time 4. Pound away, the pain never really goes away, it just subsides.

It is much like the straw the breaks the camel's back, the frog in a boiling point of water - what you take for granted (the ability to input your thoughts into a machine) might not always be toll-free.

If you get pain, stop. Don't be macho or in denial. Go out and do some whole body exercise like swimming (http://totalimmersion.net rocks)

-Someone who has residual pain of 3 on a scale of 10, with spikes going higher. I've become very efficient and have long ago since started diversifying out of programming.

I guess whatever works for you.

Personally, I was having problems in my dominant hand and switching from a mouse to a Wacom tablet with a pen made a colossal improvement.

To anyone suffering significant hand, arm, neck & shoulder pain, I suggest you consider asking your doctor about Thoracic Outlet Syndrome. (https://en.wikipedia.org/wiki/Thoracic_outlet_syndrome)

I was diagnosed with bilateral arterial T.O.S. last year after reading about it in a comment on HN. I very recently had corrective surgery on my right side and I hope to have my left side done soon. I was diagnosed when an ultrasound showed full occlusion of my subclavian arteries whenever I lifted my arms (but only when sitting or standing upright, like at my desk, which was not a standard discovery).

If anyone has any questions feel free to message me.

Me too, not the RSI though.

I am generally as skeptical as it gets, but I read the book, then spent some time contemplating how it applied to my situation and - poof - a debilitating hip joint pain I had a mispleasure experiencing every few months was gone. I went through an MRI and a bone scan prior to that and all I got back was that everything was A-OK. Frankly, I was stunned that thinking about the problem was the remedy. You can basically talk to your body, say "stop that" and it will comply. Really weird.

My experience was almost identical to the author's. As improbable as it sounds, reading the book and following it's advice completely eliminated my RSI pain after 3 years of dr visits (steroid cream), physiotherapy (tens, ims, massage, art, etc), and every ergonomic input device I could get my hands on failed to help. My RSI was starting to bother me even when I wasn't at a keyboard, to the point where it hurt to drive. I'm the last person I would have ever expected to use some "new age" treatment, yet as soon as I started to read the book, my pain lessened and was 100% gone within a month. I strongly agree with the author's premise about emotions playing a role in this, and in my case the onset of RSI corresponded with a very stressful time in my life.

Maybe this won't be the case for you, but it certainly was for me. I can once again type on a normal keyboard all day with no pain. 2 years ago I would have never believed this possible. If you're in a similar situation, you should give it a shot. It costs nearly nothing, and has helped many people (read the book's reviews on Amazon).

I like this article about Dr. Sarno's theories: http://www.bettermovement.org/2011/a-skeptical-look-at-the-t.... In summary: his treatment probably works, but his theories explaining chronic pain are most likely incorrect.

This does not work at all. The causes behind RSI are physical and real.

I don't know what's more impressive... the results, or that the top comment on the article is by Jeffrey Friedl. I've communicated with Friedl a bit at Y!, and if he says you changed his life, I believe him.

Pain treatment is one of the few areas where a placebo actually 'works' (in the sense that it leads to better outcomes than non-treatment). See Pollo et al, "Response expectancies in placebo analgesia and their clinical relevance."

So even if it's full of nonsense, it's not surprising that the book could work (and not just anecdotally). The question is whether this book is any better than a placebo, and anecdotes can't answer that. (I also wonder if it's any better than any other book that would help you cope with psychological stress.)

The book helped me try to stress out less about some frightening RSI I had years ago. The speculative mechanical explanation for the "stress -> pain", something like: stress means less oxygenated blood to extremities, was never convincing - more like a dumbo's feather for those skeptical of general mind-body woo.

Coincidentally, I got better. That was probably just rest and time, but I'm grateful that the book helped me not worry so much.

I'm not selling this dvd, but even the 5 or so videos here really helped. http://www.youtube.com/user/HealthyTyping. It is very practical, showing how tendons are strained in positions that seem like they should be pain free.

Since then I don't use arm rests so I can keep my elbows in, and dont curl my fingers. The pain went away almost over one weekend.

I was also very, very skeptical about this. But I have to say, it worked for me. I read this book in desperation after learning Dvorak, getting a fancy Kinesis keyboard, and getting expensive physical therapy (massaging of my forearms, hand strengthening exercises) to no effect. I repeat, no effect.

I don't know what else to say. It still sounds like bullshit to me, but it worked when all of the other methods did not.

I have to say it does not help your case that the your link to the book on amazon is an affiliate link....

Learning and using macros helps a lot. Don't keep pounding the same sequence of keys.

If, for instance, you use vim, check out the map feature ... http://vimdoc.sourceforge.net/htmldoc/map.html

Thank you for sharing. It's always great to learn about effective strategies to deal with/cure RSI; especially when so many said cures are failing. Already ordered the book, and I hope I won't be disappointed :)

these links(http://en.wikipedia.org/wiki/Myofascial_pain_syndrome and http://en.wikipedia.org/wiki/Myofascial_release) seem related to the above problem ..In fact, couple of my programmer friends (been coding for 17 yrs) had this posture related problem and massage therapy more or less cured them

i was hoping that my rsi pain was either bad ergonomics or just mental, then last week i got the results from a 2nd MRI of my wrist:

- torn TFCC - positive variance of distal ulna as well as an intraosseous cyst

it's going to suck to get this fixed (especially the bone saw + plate + screws part), but the pain is pretty bad these days and the success rate is pretty high for what needs to be done. it's hard to bring myself to the keyboard when it's not absolutely necessary these days.

Please be careful with this article. It is not remotely skeptical, and seems to be highly biased in the favor of Dr. Sarno's book. Chiropractic medicine for anything other than lower back pain and Acupuncture are two forms of alternative medicine that are well known to work off the placebo effect, yet the article mentions their use despite alleging to be a skeptic. This is a major red flag.

There is not a large amount of unbiased information about Dr Sarno's methods that I could find quickly, but from what is available TMS appears to be a form of alternative medicine that has no basis in science, and instead relies on pseudoscience and the placebo effect.

Rather than the pain relief being due to TMS, there is probably a more likely cause behind the result. Perhaps stretching exercises or pain medicine was involved. Or perhaps even just the placebo effect itself.

Please read this article for more information. It even contains a brief mention of Dr. Sarno.

http://www.sciencebasedmedicine.org/why-do-people-turn-to-al...

verisimilidude touched on a couple of these points already but apart from training your mind to not worry about pain you can also train it to type in Dvorak. I went even a little further and bought a $30 datahand keyboard (a really, really good price) but even with that dvorak'd wacky thing it only took me about 3 weeks of typing to get proficient and pain free. A good chair goes a long way as well.

"Relax" to ease pain stemming from tension. Who would've thought.

This book is NOT "rigorously scientific". The guy comes off as a bit of a nut, and wastes paragraphs defending Freud (seriously, wtf?).

That said, he might be right that there's a psychological component to RSI, even if his explanations and theories are incorrect. After all, fall and winter come even though Demeter isn't actually crying for Persephone.

This book helped my RSI by convincing me enough that it might be psychological, even though I tossed the book in disgust after a few chapters. For a few years my pain seemed to have gone away completely, although it's back somewhat now.