How I Cured my RSI Pain

Chiropractor, Hand Surgeons, Acupuncture, Massage... what's missing here is a physiotherapist. My girlfriend suffered from career threatening RSI (though RSI is actually a pretty useless term, since it works as an umbrella term for dozens of completely different possible problems). We found her a physio but they didn't really help. Then we found her an excellent physio (recommended by numerous friends) who spent 6 months fixing her. She can now type for 7 hours a day, provided she has at least one day a week with no typing at all. That's going from being unable to type for more than 5 minutes without searing pain.<p>We've referred a bunch of other friends to that same physio, all with excellent results. If you're anywhere near Brighton, UK drop me a line and I'll send you her details.<p>If you need to find your own physio, be aware that just like anything you should be ready to shop around for one. Personal recommendations from fellow RSI sufferers are incredibly useful here.

It's not actually about "How the technique works", it's more "This book worked for me, but I'm not going to give you even a slight hint about how so go buy the book".<p>Anyone have a link to the actual "How" part?

I actually had chronic RSI (CTS) from the age of 16~ due to studying/practicing music (brass/guitar/piano), and a lesser extent computing.<p>I'd tried pretty much everything in that list, as well as an operation on my right wrist. I won't say nothing worked .. because I was able to go from not being able to hold a pen .. to not being able to hold a plate :)<p>I'd actually given up (both therapy, and Music/Software Engineering) due to nothing seemingly working, and by chance started hitting the gym. As a part of my regular workout I integrated some basic wrist exercises (initially, I think it was wrist curls / reverse wrist curls).<p>So fast forward 10+ years and I now have absolutely zero problems. In hindsight I'm sure it was a combination of all the treatments and building significant forearm strength .. but not one Doctor, or Physiotherapist mentioned physical training as part of the path to recovery/prevention.

I too, encountered crippling RSI pain, and eventually switched to a kinesis keyboard (<a href="http://www.kinesis-ergo.com" rel="nofollow">http://www.kinesis-ergo.com</a>). While the keyboards are crazy expensive, and a bit flaky, they completely cured my carpal tunnel.<p>The downside is, I'm now stuck hauling around this weird, non-standard keyboard. :)

Im still sceptical :)<p>Less, though, than when I opened the article; I have independently noticed my RSI worsens when stressed. Im not sure I buy the mumbo jumbo about the solution as much as I buy the explanation of why stress could affect it.<p>I use a powerball daily which has really helped. Saw the same issues with massage that the article writer had (short term fix) but it feels really great so I stuck with that=. But the powerball seems to really keep it in bay (I think it is the rotational stuff that helps).<p>When really stressed I do pull ups and press ups to stretch the relevant muscles.

If the author of this article is reading this : can you please provide a timeline of events? Spreadsheet with column A = date, column B = event, column C = number of hours per day of typing at this point.<p>Events include {Started Acupuncture, Started using ergonomic product A, EtherPad acquired}, etc;<p>I wish to exclude these 2 possible reasons for the cure:<p>a) a simple reduction in the number of hours on the keyboard b) the acquisition of your start-up, which may have released a lot of mental stress

Assuming that the techniques the author describes really work, is it any different from taking a pill to relieve the pain? I tend to operate under the assumption that when our bodies present us with pain, then we are doing something to deserve it. Instead of attempting to remove the pain we should be trying to discover what we are doing to cause it.<p>Vacation, chiropractor, surgeons, acupuncture, massage, micro-breaks...but no exercise? A light dumbbell routine and a few walks or runs per week can work wonders on RSI and any other aches and pains we encounter while at the computer.<p><i>There is a certain "common knowledge" among computer workers that RSI is the result of poor ergonomics. This fails to explain why some people can work for long periods of time under conditions of atrocious ergonomics, but not experience the same pain that I did.</i><p>In my experience, an increase in RSI and back pain correlate directly with my level of physical activity outside of the work environment. A combination of fitness and ergonomics have absolutely made the difference.

If I had known about this 14 years ago I would have certainly tried it, I tried many things... the ones that I think were helpful for me are:<p>Ice bathes for my arms: I filled a sink with water and ice and submerged my arms up to the elbows; this was obviously useful for short term pain relief, and might have helped reduce inflammation over the longer term. It was important to wait until the arms were warmed up again before going back to typing.<p>Keeping fingernails well trimmed; surprising, but it made a big difference.<p>Massage; I think it was through massage that I started realizing that even though my symptoms were in the wrists the problem was probably more systemic, it's amazing how much pain a good massage can discover in surprising places!<p>Stretching; stretching the wrists felt immediately good, as did standing in a doorway, arms on the door frame, and leaning forward. Working on the hamstrings probably helped longer term.<p>Weight lifting, particularly exercises that strengthened the back; lots of people have mentioned it here, and I credit this for being the biggest long term help.

It may seem small, but adding these lines to my vimrc have entirely broken my habit of scrolling with the arrow keys.<p><pre><code> map &#60;up&#62; &#60;nop&#62; map &#60;down&#62; &#60;nop&#62; map &#60;left&#62; &#60;nop&#62; map &#60;right&#62; &#60;nop&#62; imap &#60;up&#62; &#60;nop&#62; imap &#60;down&#62; &#60;nop&#62; imap &#60;left&#62; &#60;nop&#62; imap &#60;right&#62; &#60;nop&#62; </code></pre> It may seem irritating at first, but in the end I argue it's worth it.

Typing in dvorak decreases finger movement significantly. I recommend it.

Amazon link to book:<p><a href="http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pain/dp/0446675156" rel="nofollow">http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pai...</a>

I have tendinitis in my wrists to the point that I need to wear braces whenever I use a computer.<p>I'm pretty skeptical of his claims, though I too agree with what he notes as useless.<p>The only thing that has worked for me has been strengthening my wrists. I do about 600 reps a day (variety of axes and loads) and it has stabilized my RSI.<p>Oh - and I make sure that my keyboard is rather low.

I had an interesting experience with pinky finger RSI. After well over a year of pain and experimenting with different keyboards (such as the Kinesis, which I highly recommend), I discovered that part of the problem was resting my elbows on my arm rests. By restricting some of the blood flow to my fingers by pressing on the elbow nerve, I was developing cubital tunnel syndrome. Within a week or so after lowering my arm rests, I felt a ton better. Several months later, pain returns only rarely.<p>I also love my Kinesis keyboard, too. It is well worth the price if you want to continue programming for decades. After discovering what was causing the pain, it helped me recover quickly and prevent it from occurring again.<p>I haven't read many posts on this solution, but want to remind people to examine all aspects of their ergonomic setup, not just the source of the pain (e.g., hand/fingers).

I'm another guy who had RSI and eventually got better by using Sarno's methods.<p>Sarno's ideas are a little flakey and a little offputting. But if you have RSI and nothing else seems to help, I recommend swallowing your embarrassment and giving Sarno's approach a real try.

This article basically describes my experience exactly. If you have been told you have RSI, do NOT ignore this possibility.

I had very similar symptoms to this guy (pain starting in the wrists and then forearms/elbows). I have adjusted my typing habits and daily routine as follows:<p>* Exercise arms with light weights (~10lbs)<p>* Adjusted chair height<p>* Started using a real keyboard (I think typing on a MBP for extended periods was a big contributor to my RSI)<p>* Drink more water, get better sleep, get some kind of exercise<p>These days, I don't notice any kind of RSI pains. I think generally, RSI (for a typist) is due to combinations of stress, poor posture, lack of general wellness, etc.

It doesn't surprise me. I know that I'm more likely to put my back out or pull a muscle when I'm stressed. I hold myself differently, and my movements are also less smooth.

His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time.<p>After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again.<p>Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal.<p>Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse.<p>For a more medical take, some pieces are conveyed in this article: <a href="http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf" rel="nofollow">http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf</a> . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia<p>So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them.<p>If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon.<p>I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.

This was a great article and it sounds very familiar.<p>On and off for the past two years I've experienced similar pain. (see <a href="http://news.ycombinator.com/item?id=889067" rel="nofollow">http://news.ycombinator.com/item?id=889067</a>). The last three weeks have been particularly bad: I've taken time off, I continue to wear wrist braces at work and at night when I program, I've started doing rigorous hand and wrist exercises daily, and while it has helped a little bit, I still experience a lot of pain. It scares the hell out of me because a lot of my future plans depend on me being able to spend a lot of time programming; without my wrists, I'd be lost.<p>What occurred to me reading this article is that about three weeks ago I found out about an incredible opportunity that may drastically change my life. (Stay at my day job or leave and work on a startup full time). I've spent a lot of time dwelling on it, trying to decide what to do. It can't be just a coincidence that my debilitating wrist pain started at about the same time.<p>I'm going to buy the book. I have high hopes. We'll see what happens.

I have suffered from RSI repeatedly over the years. I use an ergonomic microsoft keyboard, and this really helps. However what made the biggest difference was when I started using a Logitech Mouseman Marble mouse. The pain in my right arm/wrist vanished. I will never use a normal mouse again.

I find it interesting that he got great relief from acupuncture, which has been fairly well studied and found to have no benefit beyond a totally untrained person <i>pretending</i> to stick needles into you. Certainly points towards it being psychosomatic.

If you have RSI typing pain and haven't treated it, spend a whole day typing with wrist braces. It convinced me to switch CTRL and CAPS LOCK on my keyboard. I love keyboard shortcuts, and bending my wrist to hit CTRL was causing my left pinkie to go numb.<p>I also have 'evasive action' that works well. When I feel pain typing, I immediately stop and give the offending hand a workout with a stress ball for 5 minutes. Then I massage the tendons in my forearm and then stretch my wrist on all axes. I haven't had significant RSI pain in a few years, and at this point I'm not brave enough to test which part of the routine helps most :D

Unlike him, I find the Mac program AntiRSI to be really helpful - not only for resting my hands, but also my mind: <a href="http://tech.inhelsinki.nl/antirsi/" rel="nofollow">http://tech.inhelsinki.nl/antirsi/</a>

Well it's nothing new that the mind can cause injuries and even diseases: <a href="http://en.wikipedia.org/wiki/Psychosomatic_medicine" rel="nofollow">http://en.wikipedia.org/wiki/Psychosomatic_medicine</a>

<i>[…]You can eliminate the pain by addressing the unconscious stress and becoming consciously aware that the pain is merely a distraction[…]</i><p>This sounds a whole lot like Dzogchen meditation practices, their way of cleansing the mental palette, achieving "mindfulness". I remember faintly reading a book my one Norbu Chogyal, or a russian translation of said book. I remember it being the only coherent piece of material on meditation that I have ever come across.

massage usually only provides a temporary benefit because it releases the tension in the muscles, but does nothing to keep it from returning.<p>The stiffness in muscles is ultimately caused by poor circulation through the muscle. The sarcomeres pump their own blood supply and if the demand is greater than the supply, the sarcomere can run out of energy in its contracted position.<p>This contraction shortens the entire muscles when many sarcomeres are affected. New blood cannot enter the sarcomeres until something pushes out the depleted blood.<p>Massage can do this, but massage will not correct the poor circulation that caused the stiffness to begin with.<p>And that circulation problem is usually caused muscle sheaths that have not been stretched frequently enough. The body's natural collagen deposition essentially gluing it to itself so that it cannot expand or stretch normally.<p>This creates a tight situation when you use the muscle inside of this sheath. The muscle is thicker when contracted and pushes out against this sheath. That creates pressure and blood takes the path of least resistance away from your tight muscle.<p>The tightness inside the muscle must be massaged and then the sheath must be manipulated and stretched. Otherwise, the sheath is too stiff due to the stiff, thick muscle inside it.<p>Further compounding the situation is the way tense muscles effect other muscles and spread the problem. Muscles work together and communicate that a load needs to be moved. A great system when things are healthy, but a permanent source of stress that will thwart efforts just limited to a muscle and its sheath.

The link to "The MindBody Prescription" is broken:<p><a href="http://aaroniba.net/articles/tmp/.." rel="nofollow">http://aaroniba.net/articles/tmp/..</a>.

I believe it. My dad had chronic lower back pain most of his later life and by no surprise, he also had high anxiety and stress. He read something similar about TMP about 15 years ago after tiring of pain killers, this was around the time he began studying Buddhism to help with stress. Ever since he's been in a lot better shape.

Comment to SimonW I have been having wrist problems for about 6 months now, i live in Worthing and would really appreciate the details on the physio you recommend in brighton<p>Thanks .

Here's my list of things which helped me: Logitech Mouseman Marble, the flat Apple keyboards, regular Pilates, and a conscious effort to sit up straight while typing.

What has helped me is Yoga.

link to book is broken

sacrifice of a few chickens will also help

A gripping tale of medical mystery.