Ask HN: Does anybody else get bad carpal tunnel/RSI? Any tips?

You could try a different keyboard layout. Dvorak is pretty good, and there are a couple others as well:

http://en.wikipedia.org/wiki/Dvorak_Simplified_Keyboard

Won't help your current symptoms get better, but could help in the future.

I did have this problem in the past. I fixed it by switching to a Microsoft Natural keyboard (the $40 one). That got rid of the problem for me after about three days.

At first I thought the improvement was due to the ergonomic form of the keyboard, but after using my MacBook Pro's built-in keyboard for months with no pain, I now think that my problem was just that my original cheap, foam-sprung keyboard was just awful for typing. So maybe the answer is to just get a better keyboard.

Additionally, posture and angle of forearms to the keyboard surface is also a factor with any keyboard. Your forearms should be parallel to the ground and your keyboard flat, at least that's what works for me. If your chair is too low this might be forcing you to contort your hands in order to type.

For example, my MacBook Pro's keyboard works fine for me, but the external Apple wireless keyboard (with the same type of keys) causes RSI very quickly. Since the keys are essentially the same on both, I'm sure that this is because the external keyboard is angled (higher in back where the batteries go) while the laptop's keyboard is flat.

I started getting it in the 8th grade, and this is what I've done to this point (sophomore year of college):

-In 10th grade, I switched to Dvorak, more-or-less on a whim. After two painful weeks of hating using a computer, I was semi-fluent in typing and could resume normal use. The key was forcing myself to use it for everything. Although this may be wishful thinking, I feel I have become able to type much more comfortably while using Dvorak, and my wrist pains lessened for a few years.

-I have tried to remove the mouse from most of my workflow; I do this primarily by using keyboard shortcuts and Emacs, although last week I started learning how to use vim because A) (proficiency with) two editors are (is) better than (proficiency with) one, and B) its commands seem shorter, which I think might help.

-When I do use a mouse, I now use an Evoluent vertical mouse; this has been one of the most important changes, and relieves much of my wrist pain. I've realized now how unnatural it is to have your hand flat while mousing.

-This summer, I used a Kinesis Advantage Pro contoured keyboard, and pending financial feasibility (e.g. I'm a college student and I owe $23,000 next month) I'll be buying one for my desk; that thing worked wonders.

-In the meantime, I use a Microsoft Natural 4000 ergonomic keyboard, which helps; I'm looking into cutting off the numpad so that the mouse isn't so far off to the right. It's been done before, there are resources online; it's not that hard.

-I've migrated much of my work to a standing desk; this makes it much easier to get proper posture (IKEA Fredrik desk). I have several barstools I can lean on or sit on at the proper height, if I need to rest, although I find I'm more productive standing.

-I stopped playing video games. (The pain persisted, but video games were the worst transgressor) (I didn't play much, but tetrinet / puyo puyo / etc can be pretty nasty to your hands and wrists)

Of course, all of these things probably have the sum usefulness of taking regular typing breaks and doing the proper stretches, which a doctor I met with years ago told me I should do; however, I've found myself to be quite bad at keeping up with that, both enforcing breaks and doing stretches for the duration. I like all of these options because once I set them up, I don't have to do anything (or at least, very little) to maintain (in my opinion) healthy habits for my wrists.

Maybe someday, though, typing breaks and stretching. Never push through the pain; it'll only make it worse next time. When it gets really bad, step back and stop. I never take Advil or any anti-inflammatory for the pain because I don't want to power through it and do damage when I should've listened to my body.

I have had two runs of hand/finger pain. The most recent bout was the result of using a mouse and a not-very-good keyboard. I threw out all the mice and got a trackball and use it with my left hand, even though I am right-handed. I acquired a Kenisis keyboard and use that. I also paid attention to my wrist positions, and the height of the chair. Over the period of many months, the pain slowly went away and now there is none. I still use the left-handed trackball and at home I use an Avant Prime (remember the omnikey/Northgate keyboards?) and so long as I keep the wrist position good it works. At work, I have the kenisis.

(I used to have a kinesis at home, but an errant cup of tea (with honey) kinda put an end to that one. Now I do more typing at work.)

Dvorak would have not helped in this case. It was all about gripping the mouse and bad wrist juju while typing.

There's lots you can do. First: stop typing. Get voice recognition software. It is possible to program with VR; I did it for a year or two, by using ViaVoice's Java bindings to control emacs. (I stopped when I no longer needed it, not because it didn't work.)

Second: get a good keyboard. The Kinesis is a good first step. You may find that curved keyboards like the Microsoft Natural don't work for you--when I tried one, it required me to stretch my fingers further, which hurt more.

Third: find a doctor. (Actually, call the doctor first; but you should be helping yourself while waiting for the appointment.) If you're in the Seattle area, I can recommend Dr. William Ericson [1]. He did my surgery (years ago, before he moved to Seattle). Some time back, he figured out that a lot of the patients he was seeing, who weren't responding to carpal tunnel treatment, had something in common: extra ligaments near the elbow that pinch the nerves that go through the carpal tunnel when you turn your hands face-down. He can cut those ligaments--they're totally unnecessary; 75% of the population doesn't have them--and the problem goes away. Worked for me--very minor surgery; I was conscious for the whole thing.

[1] http://www.wbericson.org/