Seeking advice for Tenosynovitis

Question: I am a tenosynovitis sufferer and I have found, through experience, various things that helped me. When it was really bad, I could only type for three minutes on a flat qwerty keyboard before feeling sharp pains in my hands, wrists, and arms. I was advised by a local computer access centre to try a Maltron ergonomic keyboard, and I was only allowed to try it initially for half an hour. During that time I found that I could use it with some discomfort. I was then invited to try it again the following week for an hour. I had the same positive experience. This convinced me that if I was going to keep my job then this was the piece of equipment to go with.

That was nine years ago. I am still a tenosynovitis sufferer, and I still use a Maltron keyboard (as I am now, typing this). The tenosynovitis is still there but it is a lot easier to handle and to live with. I think it was within about six months of first using the Maltron that the pains turned to aches (and for me this was infinitely preferable) and it seemed to have a kind of therapeutic effect upon my hands, wrists and arms, thus enabling me to perform gentle typing motions (like calisthenics), and I wouldn’t swop it for a flat keyboard any day. There were other things that helped me. My eldest son was younger then and liked to be swung between two people in a towel. I had to dip out of partaking in this as the pulling action on my wrists would have aggravated the teno. This puzzled the family no end as, of course, the reason for the pain cannot be seen.

I also had to take care with lifting heavy weights. One day, my wife handed me a heavy box to carry, and I suffered from the after-pains of that foolish action for days, if not weeks, afterwards. Needless to say, I do not lift any unknown weights, and like to see how heavy it is before trying. I brainstormed various ways of reducing the amount of keyboard work I did on a daily basis, by utilising such things as macros, copy and paste, taking greater care with the intensity and speed at which I worked, using a dictation machine, taking frequent rest breaks, using a programmable mouse, ensuring the height of the chair was correct, and purchasing and using a height-adjustable workstation. Even so, I still needed to take care with the amount and intensity of keyboard work I did. Then I found that using the mouse was aggravating the teno. I tried various programmable mice and finally settled for an ALPS Glidepoint, but even this does not completely alleviate the aggravation. Although being able to program a lot of actions onto various keys on the keyboard certainly helps.

I used to eat chocolate from boredom of the job. Apparently chocolate narrows the arteries, so this didn’t do any good for the teno either – and it didn’t do a lot of good for my waistline! Long terms of sickness were helpful, but definitely unpopular with my employer! I also found the prescribed application of Oruvail gel (Ketoprofen) helpful during the worst times of suffering with tenosynovitis. However, I’d find this does more harm than good now, and an occasional application of Arnica cream on the affected area is more than enough for me these days. I hope this helps.

Comment 1: I have voice recognition equipment at home but not at work, but it would make sense anyway to look into keyboards, for use when I have to type. I need to be able to live with mine better: it has in fact got worse, pain now extends up beyond my wrist, into the forearm, in the right hand-arm, and I have shoulder problems on the left. There are a number of things that hurt me; any twist of my wrists will. I can’t avoid all the things that hurt my hands etc., though I try: I do try not to twist my wrists. I avoid lifting heavy weights; I try to, anyway. Sorting papers (for example) also hurts; and I know this applies to other people on the List – reading books can too. Rather a large number of things can! I’ve reduced the keyboard works with voice software, here at home.

I move the mouse with the flat of my hand, slowly, and click by voice if I can. I did try a trackball that was recommended but using that hurt more: it can be clicked with the side of the hands but that hurt badly. Oh. I like chocolate! And I fall back on it a bit when I can’t get a proper meal — I can’t cook a full meal, my hands would not cope — well, thank you for warning me. I can’t take time off: I agree that rest is important, and I probably need it badly. I found the gel helped too. I used it at night: I could not sleep because of the pain, otherwise but it must be a bad idea long term. I’ll try arnica. My thanks, also, to the doctor who wrote about anti-inflammatory: I agree. Unfortunately, I also needed and need painkillers for a head injury following a fall (that was after I got RSI)

Comment 2: There are various book stands and holders on the market. Perhaps you could use one of these, or just lean a book against something, like other books, or a cushion (if you like to read in bed as I do). “Oh. I like chocolate! And I fall back on it a bit when I can’t get a proper meal — well, thank you for warning me.” – I’m just the same, but I like to think that I’ve gradually trained myself to accept it in moderation – sometimes – the words chocolate and moderation don’t sit comfortably with each other)  I can only say, lay off the chocolate! In fact have little or nothing artificial in the diet. Try eating natural foods, vegetables, fruit, whole meal foods, salads, and/or organic foods – whatever takes your taste or pocket (I could do with taking my own advice here!). Otherwise, such things as meal-bars exist, although I’m not suggesting you go on the Cambridge diet) There are plenty of ready meals on the market too, although admittedly they are comparatively expensive.

The Health and Safety (Display Screen Equipment) Regulation 1992 require employers to make provision for rest breaks. It says under article 4, Daily work routine of users: “Every employer shall so plan the activities of users at work in his undertaking that their daily work on display screen equipment is periodically interrupted by such breaks or changes of activity as reduce their workload at that equipment.” You are well within your rights to take rest breaks away from the computer. Do something else, like some admin or filing, or make a drink or “powder your nose”. If there are objections to such breaks, get support from your union.

Comment 3: I am not a keyboard worker: I am a lecturer. Really I meant rest in the sense of time off work. But I know what you mean – your advice on work-practice, that is, as the VDU regulations don’t apply in my case (I assume). I think “keyboard workers” here have been sent the regulations. It isn’t brief breaks that are the problem though of course if I am teaching I simply go on teaching. I think I didn’t get advice on anything early enough and I think that I am just going to have to try to find the time somehow to see my GP again and try to get some local advice and help. – the reason I didn’t was that it was thought I had a mild case of tenosynovitis and I was completely recovered. As soon as I had to type again, the pain etc. began again. But it was a while before I could find out about physios and whether they might help and so on. I am grateful for your advice and sorry if I sound a bit negative. For some time I have been waking up at night to find my right hand and wrist, which are the worst affected, outside the bedclothes, obviously trying to rest in comfort (before that I was twisting my wrist as I slept) and I just seem to be in a lot of pain rather too much of the time:

Comment 4: If you have problems cooking a meal using the basic ingredients (nothing ready prepared) then you are entitled to Disability Living Allowance. DLA is not means tested, so you can be at work earning loads of dosh (some chance) and still claim it!

Comment 5: Yes, I am going to apply – I have the forms. But thank you for posting, as there may be people who don’t know about this. I had no idea: and I have been unable to do that kind of thing since early in 1995. There *are* people who earn a lot of money who get this benefit, and I just wish the various benefits could be made more equal, somehow!

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