Repetitive Strain Injuries

Back around February 1996, I was hard at work for MindSpring, writing a software manual, creating web pages, and working on a knowledgebase. I was telecommuting because we’d run out of space at the office and that suited me just fine. I would get into a hyper-concentrated 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 anymore. 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. 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 varies 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 a real nuisance! 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.) The surgery involved cutting my arm open from about halfway between my shoulder and elbow to just below my elbow and embedding that nerve bundle into the large muscle of my arm.

Now I have a big ugly scar and permanent numbness in my left hand. 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.

My doctor prescribed occupational therapy for a while, but I found the formal therapy less helpful than something I did on my own. I picked up needlework again after a hiatus of several years. That allowed me to regain a great deal of fine motor control and some strength in the left hand.

In February 1997 I was finally released to return to work. I’m very careful about varying my movements through my workday, and I used voice control software as much as possible for a few years. I try to avoid typing (real straight typing, not pecking 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 without anyone else being aware of them. I think forcing anyone to listen to the way I play the piano now might be a violation of the Geneva conventions and I’m never going to reach the 100 words-per-minute typing speeds I once had, but I’m no slouch at the computer keyboard.

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 with your right hand, put the mouse on the left side for a while. (Feels weird, doesn’t it? You’ll adjust.)
  2. Get serious about ergonomics. Your keyboard, monitor, chair, and typing surface all need to be adjusted properly to fit you.
  3. Practicing good ergonomics 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.
  4. 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
  • Break Timer is a marvelous bit of software (for macOS, Windows or Linux) that reminds you to stop and rest periodically.
  • Dragon Speech Recognition—yes, there are other voice recognition systems out there, but this seems to be the best overall, which is why I used it when I had access to it.

One thought on “Repetitive Strain Injuries

  1. I want to thank you for publishing this. I’ve had the same problem for years. It started with constant typing in my 40s. It became aggravated by constant jewelry making (pliers in both hands for hours on end) in my 40s and 50s.

    I was told it was all carpal tunnel syndrome. The solution? “Rest your hands and wrists more often.” Good advice, but obviously not based on a sound diagnosis. “Carpal tunnel” seemed incomplete somehow, because it didn’t start in my forearm. The numbness and tinglings started in my shoulders and traveled down to my pinkies and ring fingers (left hand most often).

    NOW, I have something to show the doctors and say, “See?! THIS is what I’ve been trying to explain to you all these years!”

    So, thank you. Even though this page is ages old, thank you.

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