I worked as a programmer for over a decade. I wish I’d focused on ergonomics early, but alas, I sat with terrible posture for hours on end and broke my body. Now I have what’s called a “repetitive stress injury.” Carpal Tunnel is one of the ailments in this larger class of issues that can affect hands, arms, shoulders, back and neck. Typically heavy computer users, dentists, surgeons, and others relying on fine motor tasks are affected. It’s particularly depressing to train for years to do something only to not be able to do it! As my arms burned like they were on fire, I went to a workplace counselor who helped me rethink my work environment with ergonomic gear and reframe how and when I worked. The broad, high-level takeaway is you want to strive to regularly shift your work posture and stance and recreate natural positions for your hands and shoulders when working.

“Your best position is your next one” — Work While Standing & Walking

In hopes of saving others the time and effort it’s taken me to solve this, I’m including here a survey of what I’ve found the most effective.

Tools

• Kinesis keyboard. Your fingers are different lengths and have varying strengths. Traditional keyboards don’t take this into account. The Kinesis mounts the keys for your longer fingers further away and moves oft used keys (backspace and enter) from your weak pinky finger to your stronger thumb. I LOVE this keyboard and can type 10 words per minute faster on it than a normal keyboard. Using it doesn’t make you unable to use a regular keyboard either. Both key layouts coexist in my muscle memory.
• Vertical mouse. You want your hand position as close to natural standing posture as possible. This mouse helps to keep your hand oriented more naturally. The narrow body allows a very natural hand position.
• Kinesis Triple Foot Pedals. When seated I’ll use the pedals for scrolling and the Mac Option key. The theory is to try and reduce keyboard and mouse usage wherever possible. Scrolling while reading articles is a natural application for foot pedals.
• TextExpander. One part of battling RSI is just typing less. For many, that’s not an option. TextExpander is a plugin for your computer and smart phone that lets you save macros. Type a short macro and it expands to whole paragraphs. Huge productivity booster
• Humanscale QuickStand Standing Desk. Get a standing desk. Do it. Standing is a more powerful position and I find I stand about 80% of the time I’m working. It doesn’t have to be this one (there are less expensive options) and tons to choose from. I like the QuickStand because it’s an entire workspace you can move up and down.
• StandStand. I travel a lot and aim to maintain ergonomic environment on the road. The Stand Stand is a perfect, lightweight folding standing desk that works perfectly on top of normal desks, tables and dressers.
• Keyboard tray. Just about any keyboard tray will do. The theory here is that when you’re seated you want your arms to be at a greater than 90 degree angle (obtuse angle for math nerds).
• Ergohead Standing Desk Mat. This padded mat both provides cushion while you stand for (ahem) 12–16 hour days and also allows you to change your foot position. Again, you’re looking for opportunities to change your position throughout the day and it’s various ridges give you options.
• Spiky Massage Balls. These hard plastic, spiked balls are great to rub on sore upper muscles of your forearms.
• Theragun. This device looks like construction screw gun and vibrates like crazy. It’s a great relief to sore muscles.
• Fluid Stance. Pair this and/or other balance boards with your standing desk. They encourage you to constantly change your stance. The founder said a few things really resonated with me including:

“Movement is the ultimate ergonomic position. Sitting is not the anti-Christ, standing is not the silver bullet. The moderation between all positions is the ultimate solution to overcome a sedentary lifestyle.” — Joel Heath, Fluidstance

Techniques

• Dictation. Most modern operating systems have excellent dictation. Typing less helps save your hands. iOS and MacOS both have incredible dictation available for whatever application you’re using. Hit a hot key and the microphone is listening and real time transcoding your text message, email etc.
• Acupunture + TENS. By far the most effective procedure I’ve found so far is the combination of acupuncture with a TENS machine. It’s the rare acupuncturist that will do this so you’ll need to look around. The process goes like this: the acupuncture needles are inserted along your arms, shoulder and back. The various leads of the TENS machine are then affixed to a subset of the needles. The low voltage electricity causes your muscles to twitch, flex and relax.
• Cold Plunge. Spending 5–7 minutes in an ice water bath (~42 degrees F) has documented health benefits including reducing inflammation and improving circulation. I’m in the early days experimenting with this but loving it so far.
• Yoga. Stretching and changing your body position helps to use your muscles and tendons in different ways than typing. Yin is a type of Yoga that is much slower paced and focused on holding positions for many minutes. This can be great for your fascia.

Further Reading

Time — “The Weird Way Acupuncture Helps Carpal Tunnel Syndrome”

From standing desks to physical therapy, ergonomic keyboards to holistic creams and salves, my exploration has spanned industries and years. Hopefully there’s something here that alleviates your pain or prevents your own case of RSI. If there’s something I’ve missed, I’d love to know! Thanks.