My Carpal-Tunnel Solution


It was about 10 years ago when carpal-tunnel first hit me. Every time I put my hand on my mouse, I'd get spasms of pain in my various parts of my arm. I tried special ergonomic mice and trackballs, but they didn't help. I tried speech recognition software, but it was a joke. Whether I could continue with my profession was becoming an issue. I even tried moving the mouse with my feet. Nose mousing was next.

Then I discovered the Wacom tablet. For a long time, it was a godsend. The pain almost went away -- but not forever. A couple years ago, the pain started returning. The Wacom bought me some time, but it was not a permanent solution -- at least not by itself.

Somebody recommended I read Pain Free at Your PC by Pete Egoscue. I'm glad he did. This book has saved my career (even though I'm not exactly following its advice). Its main point is that carpal tunnel originates with the spine -- that is, a spine in poor posture.

When standing straight, the spine is in an "S" curve. Think of the neck, shoulder blades, lumbar and tail bone. When standing up straight, they are shaped like an "S". The spine is a balanced spring with the skull balanced on top. Your arms are hanging straight down and your skeletal/joint/muscle system is at peace.

When sitting with poor posture, however, the spine is in a "C" shape. The lumbar curve is gone or reduced. The spine is a cantilevered, stressed support for the head and arms. The spine, in turn, is supported by the small muscles of the back. But those muscles are meant to steer the spine and body, not support its weight.

Now, what's the connection between the spine and wrist pain? Think of the song: "The head bone is connected to the neck bone..." In this case, the spine bone is connected to the shoulder bone, and the shoulder bone is connected to the arm bone. The bones and the muscles and the ligaments and tendons are connected. It's a system. When the spine is in a "C" shape, the body's structural support is out of whack. As Egoscue puts it (I can't quote directly, I lost the book), a poor posture will gradually make your bones and muscles disintegrate turning your body into a pain-wracked, arthritic, crumbled ruined husk of its former self.

Of course, proper posture is the solution. But how do you make that happen? It's not easy, especially for slouch-meisters like me.

Egoscu's solution: yoga. As I understand it, yoga will strengthen muscles that usually don't get enough exercise. His book has a number of yoga exercises that are specifically designed for carpal-tunnel suffers. He has exercises for light, medium and heavy PC users. His approach makes sense to me.

Unfortunately, the story did not end there for me. I tried to do the exercises, but they hurt like hell. And they took a long time. And I don't have the discipline. I failed.

Instead, I took a different approach to the spine problem.

Let's take a step back and notice that is easier to stand with proper posture than to sit with proper posture. Sitting up straight is a lot of work. Try it. Don't let your spine go "C" shaped for half an hour. You can't do it. Standing up straight, however, is pretty easy. We are bipedal creatures. The human body is built to stride across the Serengetti in pursuit of antelope. It was not built to sit at a desk, hunched over a laptop for 10 hours a day.

My obvious solution: stand while working. All the above yakking is intended to make you understand and really believe this point, and to convince you that this is a real solution and it is worth implementing.

The following photos show my desk setup. The monitors are at eye level when standing. The keyboard and Wacom tablet are mounted at an angle on cheap book stands. The tablet is held to the stand with masking tape underneath. My arms basically hang straight down when I type and when I mouse (actually, when I "Wacom").

The proper height for the keyboard and tablet is important. If they are too low, you will slouch in order to reach them. It is better to have things a little too high than too low. That way you can easily add more cushioning under your feet to get the height right.

Results: Shortly after implementing this desk setup, my symptoms went away. That was about two years ago.

A few months ago, I decided I was sick of standing, and maybe carpal tunnel would not come back. I started sitting again. After a couple months, twinges of pain returned. Now I'm back to standing and the pain is gone.

Note: There is a downside here if you are not careful. If you absentmindedly lean on one foot for an extended period (as I have done), you can hurt your foot -- I guess you could call it a "compression injury." To prevent this, stand on a cushion and shift your weight frequently. Shift your weight to the balls of your feet and give your calf muscles some exercise.

Good luck. Let me know whether this works for you. But if you have carpal-tunneel and can't stand standing, read Egoscu's book and do the yoga.

Disclaimer: Follow my advice at your own risk. For all I know, standing while working might cause other problems, possibly worse than repetitive stress. Maybe your knees will explode.

My desk setup. The monitors are at eye level. I don't bend my neck up or down. The keyboard and tablet are at the height where my hands naturally fall.


Me at work. Standing. Not sitting.


Keyboard and tablet mounted at an angle.


How to use the tablet while standing.


Actually, the tablet will fall over when you rest your hand on it unless you do something to hold it steady. I've piled books on a corner of the bookstand.


Don't hurt your feet. Stand on something soft.



joel.. you must have felt same pain along the sides of the center of your wrist.. i have that now... sigh. Only problem is i game... and work where i lift alot of stuff... most that weigh more than i carry.


Thanks for the tip, I am still in my first year of experiencing CTS and am not looking forward to the next 20+ :) I may have to move to the standing position yet.

For those in the early days of CTS, one simple trick you can try is to vary your mouse hand. It feels odd, and people will notice and give you funny looks, but it's a simple and to some degree effective way to stave off carpal tunnel for a while (especially if you take breaks as well)



I started getting the first twinges of this last year after 10 years pain free. Like you, Wacom staved it off for a little while, but it always comes back in the end. Besides, it has now spread to my left arm too, and my ergo keyboard is not helping. Thanks for all the valuable info. I'm at that critical point now where if I don't act, I believe that I will suffer permanent damage.


OMG, I would have never known that CTS was related to the spine cause I always thought it was localized to the wrists and arm.

Thanks for the reference to Pain Free at Your PC by Pete Egoscu. I am pretty young right now and I don't show/feel any symptoms but I try to keep aware of these things as it would affect my career in computers in the not so distant future.