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Repetitive Strain Injuries

Back around February 1996 I was hard at work for MindSpring, writing a software manual and creating web pages and so on. I was telecommuting because we'd run out of space at the office, and it suited me just fine. I would get into a hyperconcentrated space and work for 10 or 12 hours with no consciousness of any time passing. I was annoyed that my left hand kept going numb for some odd reason, but if I stopped typing and moved around the feeling came back, so I didn't think much of it.

I didn't think much of it until the day that I realized that the numbness wasn't going away any more. In fact, my left hand had been numb for a week, and sometimes my right hand was going numb, too. I mentioned it while I was at my family doctor's office being treated for something else and he did take it seriously. In fact, he sent me to a neurologist. The neurologist did some tests and informed me that I'd damaged the nerves in my left arm, and that only about 10% of the normal nerve impulses were getting through to my fingers!

Well, that was alarming. Next was the hand specialist, Dr. McBride. The official diagnosis was "left ulnar compression neuropathy." What that means for the non-medical majority: the nerves that control the hand have to run down behind the elbow before reaching the hand, bundled together like the phone cable before it splits off to the houses in your neighborhood. That bundle of nerves was being squeezed at the elbow, making the outer half of my left hand stay constantly numb (pinky to middle finger) and the rest of it vary from numb to painful, but always fairly weak and clumsy. The more common name for this problem is cubital tunnel syndrome.

Dr. McBride insisted that I stop typing at all with my left hand (one-handed typing was interesting, and not in the sense that some net regulars use the phrase!). He said I could have surgery right away or try "traditional therapies", which meant a brace and rest and anti-inflammatory medication. I chose not to have the surgery right away, hoping it would never come to that. The damage to the right arm wasn't too bad yet, so I simply changed my work habits hoping to keep it fairly healthy.

Unfortunately the non-invasive procedures didn't work, and in April 1996 Dr. McBride did a surgery he called a "release" to avoid further nerve damage. (There is no way to repair the existing nerve damage. Over time it may or may not get better.) The surgery involved cutting my arm open from about half-way between my shoulder and elbow to just below my elbow and embedding that nerve bundle into the large muscle of my arm.

I now have a big ugly scar and permanent numbness in the left hand that may or may not get better some day. My right hand still goes numb from time to time, and both arms and hands ache like the dickens for no particular reason much of the time. I'm told the pain comes from a combination of arthritis and fibromyalgia, and is fairly normal for the site of any injury—meaning there's really nothing to be done about it.

In February 1997 I was finally released to return to work. I'm very careful about varying my movements through my workday, and I use voice control software as much as possible. I try to avoid typing (real straight typing, not pecking in something while speaking with a customer on the phone) more than 15 minutes at a time, or the numbness increases. I'm learning to deal with the numbness and weakness most of the time, although I still think forcing anyone to listen to the way I play the piano now might be a violation of the Geneva conventions.

TechnoMom's Prescription to Avoid RSIs
Hindsight is 20/20

  1. Don't spend 14 hours at a time at the keyboard. Ok, at least move around and stretch and change positions, go get some more coffee, whatever, ok? Switch hands with the pointing device. If you normally mouse around with your right hand, put it on the left side for a while. (Feels weird, doesn't it? You'll adjust.)
  2. Having the keyboard, monitor, chair, etc. at the right height is good but not enough to avoid problems if you abuse your body. There are far more enjoyable ways to abuse your body so just introduce some variety into your life.
  3. Do not lean on your elbows. Ever. This is much more important than keeping Mom from fussing about your table manners. Apparently leaning on your elbows is one of the worst things to do to the nerves in your arms.

The following resources offer much more information:

  • Typing Injury FAQ
  • The RSI Page
  • Break Reminder is a marvelous bit of freeware that reminds you to stop and rest periodically.
  • Dragon Naturally Speaking - yes, there are other voice recognition systems out there, but this seems to be the best overall, which is why I'm interested in it. I'd like to hear from anyone who has used this or similar software in a real working environment, too!.
  • "EASI (Equal Access to Software and Information) is a non-profit organization, committed to the belief that students and professionals with disabilities have the same right to access information technology as everyone else." I figured they said it better than I could. The stuff they deal with is way beyond what I need, but it's a neat organization.