Programmers, writers, accountants, and many other people who work in office jobs will often spend their whole day typing. If proper care isn’t taken, injuries can occur such as carpal tunnel syndrome, or repetitive strain damage.
Carpal tunnel syndrome (CTS) is a medical condition caused by the compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms of carpal tunnel syndrome are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger.
Carpal tunnel syndrome (CTS) is a type of repetitive strain injury (RSI). RSI is a term for any damage to tissues caused by repeated physical actions. There are a number of conditions that can be classed as repetitive strain injuries, including: Carpal tunnel syndrome, tenosynovitis, bursitis in the wrist, knee, elbow or shoulder or other joints.
The Canadian Centre for Occupational Health and Safety (CCOHS) lists the following occupations as high risk for CTS:
In particular, people who often work with a mouse and keyboard are particularly susceptible to this disease, with a very high incidence. Data shows that the incidence of carpal tunnel syndrome in the general population is 1% to 5%, while special people like programmers and writers have an incidence as high as 14.5% or more.
For those of us who spend a lot of time typing in front of a computer, especially programmers, carpal tunnel syndrome is mainly caused by the improper wrist positioning, which is usually due to overextension.
Don’t underestimate the importance of wrist positioning. When the wrist is overly bent toward the center of the hand, the pressure in the carpal tunnel is 100 times that of the neutral position. When the wrist is extended excessively toward the back of the hand, the pressure in the carpal tunnel is 300 times that of the neutral position. When a user suffers from bad mouse operating posture, the gravity of the arm will put the wrist under tight pressure on the desktop, increasing external oppression.
As you can see from the picture, we should try to keep our hands as straight as possible without over-bending our wrists. The wrists and palms should always be level. Neither mouse nor keyboard should require excessive twisting of the wrist.
This would be the best solution, but obviously isn’t practical for most people. We can’t seem to change the way we type, and we can’t remember so many “remote” key combinations. Should we stop working with our keyboards? Of course not! A well design ergonomic keyboard can be a good solution.
Optimal ergonomics vary by person, so it is impossible to give a universally standardized and correct answer to what keyboard design is best. Ergonomic designs are better for the overwhelming majority of users. They can reduce finger travel (reducing fatigue) and prevent users from needing to twist their wrists while typing.
Many specialty professions like programming or accounting require users to often use shortcuts and macros. The best keyboards will support customization for these features. Keep and eye out for QMK firmware, the most powerful customization software in the industry.
Some people begin using an ergonomic keyboard and still feel no improvement in their wrist pain. There are two things to troubleshoot in this instance.
Ergonomic keyboards are most effective for prevention of RSI, they cannot solve the problem if it is already severe. If your wrist is already hurting badly, please see a doctor and avoid typing altogether.
A new keyboard layout requires some time to retrain your muscle memory. But don’t be afraid of the adjustment period. Split ergonomic keyboards are notorious for a steep learning curve, but a keyboard like X-Bows requires less learning. Most X-Bows users report getting used to their new layout in 3-7 days and within a few weeks, many report that their overall typing speed has increased 10-20%.
In addition to the usual attention to typing with the correct hand posture, it is best to incorporate with some hand movement to relieve the pressure on our wrists. This exercise is from the Ortho El Paso Orthopaedic Clinic’s website.
Below, you can find some additional resources to learn about CTS and RSI. All cases are different, so you cannot consider anything in this article to be medical advice. If you have significant pain or numbness in your wrist, seek help from a medical professional.
1. Burton, C; Chesterton, LS; Davenport, G (May 2014). Diagnosing and managing carpal tunnel syndrome in primary care