Avoiding Wrist Pain and Carpal Tunnel Syndrome During COVID-19 Isolation

If there’s one thing that white-collar workers around the world suddenly have in common because of COVID-19, it’s that we are very suddenly tied to our keyboards, even more so than before. And some of us were very tied to our keyboards!

Unfortunately, as you probably suspected, sitting in front of a computer keyboard for 8 hours a day is not particularly good for your health.

The bigger rules about using a computer at a desk I feel are more common knowledge. Drink lots of water. At least once an hour, stand up and walk around for at least 10 minutes, and either go outside or look out windows into the horizon. Sit with good posture.

These things seemed obvious to me. What was less obvious is what to do about my wrists. If a high proportion of your job is about writing, you’ve probably already faced this problem, although you might not have acted on it already.

Anywhere between a few days to a few years into typing 8 hours a day, you will begin to get random wrist pain. At first, it’s just a twinge every once in a while. A moment where you need to rub your wrist and think, “That never did that before.” Next, it’ll be mild throbbing but only at the end of the day. Then you’ll notice it more throughout the day until it becomes unbearable. These are all signs that you’re on the path to permanent wrist issues, and at the end of that road is surgery!

As an academic who spends many hours a day writing in front of a computer (and even more now that all of my teaching is at home too!), I know this road well. That is what led me to research what I can do to ensure my home office (and eventually my real office, in the magical future where we aren’t sheltered-in-place anymore) is designed ergonomically, to ensure my future wrist health for years to come.

If you don’t do these things, the best case is that you’ll have moderate but unnecessary wrist pain. The worst case is carpal tunnel syndrome, which is marked by tingling pain and throbbing in your fingers and wrists and eventually, surgical correction. So take steps now to set yourself on a better path.

Here are six general recommendations, some free and some not. At a minimum, you should do #1, #2 and #3 today!

1. Take breaks. As I described earlier, for your general health, you should at least once an hour stand up and walk around for at least 10 minutes (to reduce the chance of blood clots or other heart-related issues), and using that time to go outside or look out windows to the horizon (to reduce eye strain). Another benefit to such breaks is that you give your wrists some time off! Let them just hang loosely and relax while you wander around – don’t hold your phone!
2. Stay flexible. One of the easiest and cheapest things you can do to reduce wrist pain is to increase wrist strength through basic physical therapy that you can complete at your desk. Every day, and especially every time you feel that little wrist twinge, spend a few minutes out these wrist exercises.
3. Sit at an appropriate height relative to your keyboard. Chair height is a very tricky thing to get right. In addition to sitting with good posture, you should be sitting at a height so that your hips are level or very slightly below your knees, which takes the pressure off the arteries in your legs (important for avoiding blood clots!). But it’s tricky because you should simultaneously maintain a 90-degree (right) angle or larger at the elbow, meaning that your arms should angle down, away from you. See these diagrams from Cornell. In practice, it is next-to-impossible to do this if your keyboard is on a desk. Instead, you likely need a keyboard tray that hangs below the level of your desk, like this one or this one. These trays come in a variety of types, but the main thing to consider: do you want to bolt one to your desk, or do you want one that clamps on?
4. Use a vertical mouse or trackball. You might think that mice are all the same, but ergonomic mice are vertical, meaning that you hold them in a more natural angled wrist position instead of flat. Try this: place your hands loosely in your lap and notice what your wrist does – you will notice that the top of your hand angles slightly outwards. Thus, an ergonomic vertical mouse will replicate this angle to avoid wrist strain. I personally use this one by Anker but in the wired version, which has been great (and was cheap), but Logitech has its own design if you prefer a more familiar brand name (although Anker is mainstream among the tech crowd!).
   
   In contrast to vertical mice, trackballs have always been sort of a weird cousin to mice more broadly and that’s still true today. Nevertheless, they are available in a wide variety of styles, some combined with traditional desk-mouse tracking and some not, which tend to be a bit more ergonomic (i.e., they have wrist tilt). There are even handheld versions that you can use without a desk!
5. Use a split keyboard with lifters and mechanical switches. Ok, so a lot of new concepts with this one. Split keyboards are keyboards where the left and half sides are split into two physical pieces, which allows you to place them wherever you want – typically slightly angled out to match the natural position of your wrists when sitting with good posture.
   
   Lifters allow you to angle the keyboard to match your natural wrist angle horizontally, the same way a vertical mouse does.
   
   Mechanical switches are individually actuated so that there is “give” when you press each key; the key gradually firms up as you press it further down, which gives a bit of a “bounce” to your typing and softens the impact on your fingers (one hard key impact doesn’t matter – tens of thousands of presses over the course of a day does). Mechanical switches are in contrast to a “membrane key” switch, which is what you typically find in laptops – the top of the key and bottom of the key are very close together, so every tap is a pretty hard hit.
   
   It’s actually surprisingly difficult to find all three of these features in one keyboard at a decent price, so in order of priority, I would suggest split, then mechanical, then lifters.
   
   If you do want to get all three, I have two suggestions. The first is the keyboard I use, the Kinesis Pro with Cherry MX Mechanical Switches, plus its matching lifters. If you instead want to dive off the deep end into the world of absolute keyboard customizability, I would suggest the ErgoDox EZ. The ErgoDox EZ was actually a kickstarted project by a guy named Ergo to create the “perfect” split, lifted, mechanical keyboard. It is intended for “power users” and even requires some time to retrain yourself to use it. It honestly seems like a bit of a cult.
   
   One thing that surprised me when getting into ergonomic computer accessories was just how pricey they were, which is largely driven by the mechanical switches – they must each, one per key, be manufactured and installed separately, which drives the price way up, as does the two-piece form factor. So if you don’t mind sacrificing the switches and keeping it all a single unit but maintain some of the benefits of the angles, the Microsoft Sculpt has been popular lately, as has the Perixx.
6. Use mouse and keyboard wrist support rests. If you have proper posture and use a keyboard tray, this is less important, but I would still suggest a good set of pads. One of the worst things you can do is rest your wrist along the corner of your desk (pinching nerves and blood vessels), and shortly behind that is resting your wrist on the hard surface of your desk rather than floating in midair above your keyboard. In either case, a good wrist rest will provide insurance that you won’t accidentally rest your wrists somewhere where they’ll be pinching something important. And fortunately, rests are pretty cheap insurance!

That’s it! Good luck and happy typing in your new COVID-19 telework job!