Mouse elbow or Computer elbow

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what is called mouse elbow is actually not a new  disease. it is a variant of a well known RSI disease called epicondylitis.  Pretty much the same condition as golf elbow Medial Epicondylitis, but in case of mouse elbow the condition is affecting selected finger muscles/tendons which are the only one that produce pain.  Often it is a single finger tendon/muscle combination -- index finger.  This is especially typical for gamers, who are using programmable mouse like Logitech G600 with multiple buttons.

Medial epicondylitis, is caused by damage from overuse to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repeated stress — especially finger motions. Improper posture, bad  equipment,  as well as too little warm-up or poor conditioning, also can contribute tot he development of the disease.  Absence of wrist support on the mousepad and palm support on the keyboard (as well as wrong inline of the keyboard (it should be negative with F-keys lower then the blank key, like in Microsoft Natural Ergonomic Keyboard 4000)  is pretty common and can be another contributing factor

In case you condition is connected with keyboard abuse (too much repetitive input of sequences like Ctrl-C), you more often get a variation of  tennis elbow (lateral epicondyle.)  which has more difficult to treat.

Epicondylitis is a type of musculoskeletal disorder that refers to an inflammation of an epicondyle. Types include:

The fact that you need to know is that many small and very precise movements of the mouse for 4 hours or more (with one  hour break for lunch only) eventfully tend to destroy the health of your tendons pretty reliable. The pain  starts in women earlier then in men.  Older people are more affected. but eventually even very strong enbow tendons will be damaged by RSI. Especially if you use mouse for 12 or more hours in total, like many programmers do.  Type of disease you get many vary, but, in essence, you get what you deserve -- human hand is not designed  for such a load.  Contributing factors are (see also Preventing RSI) :

  1. Incorrect position of hand that is holding the mouse
  2. Inability at least for some time switch hands (half day right hand, half day left hand),
  3. incorrect positioning of the chair (often too low to ensure 90 degreed angle for the elbow,
  4. incorrect position of keyboard,
  5. overcrowded desk.

Judging from forums I read this affect women more frequently then men.  But both sexes need to do their best to avoid this condition, because after it arise, it is very difficult to cure.

Mouse elbow is characterized by:

The easiest test is to try to lift you desk with one of your finders. Some fingers, usually index finger which is the most overworked finger for heavy mouse users,  might feel pain. the fact that only selected fingers feel pain when trying  to lift your desk with a finger is a typical symptom of mouse elbow.

You can also get it on your left hand with the excessive number of Ctrl-C Ctrl-V combinations while typing (using programmable keyboard can help: you can replace a combination with a single keystroke).  On left hand it also might be an upper shoulder pain, as left shoulder is less trained the the right shoulder and more easily damaged by RSI.

Pain is a sign of inflammation. Usually pain from inflammation is a sign to rest the area and allow healing to take place. Ice to the area while protecting the skin with a towel for 15 minutes two to three times a day may help. Massaging you arm before use of the mouse and putting your elbow on ice after a period of work with the mouse is actually not a bad strategy.

But generally to improve your condition you need a break for 2-4 weeks. During this period you need to take anti inflammatories (such as Advil) and concentrate on massage and wrist extension exercises/stretches.

Mouse elbow is actually a very tough condition to eliminate and it takes a long time to recover from this condition.   Often it look like "nothing help". But this is not true. Consistent efforts. Combination of three measures: massage, rest and painkillers eventually will help. But this will not happen overnight. Not even in a week. It takes longer, sometimes much longer.

One important fact is that you almost should rest on some kind of foam to absorb excessive stress more readily and you wrist should not be too elevated to hold the mouse. Those two inch memory foam  sheets that is sold for bed covers or pillows can be adapted for use with the mouse. In case of bad sheets you can cut a strip from one side as they are often oversized (or you can buy larger size intentionally). 


If index finger tendons is the only one  that suffers from RSI you can try offload some load by using middle finger instead (G600 has second button that is convenient for such purpose).  brace in this case will not help, but elastic sleeve can help and you should weal the elastic sleeve all the time you work with the mouse.  

For some vertical mouse might provide some level of relief,  at least psychological, but your mileage may vary.  You can try several cheap model and see yourself if they help or not:

FotoFo  and Sharkk mice are of adequate quality and both are less then $10 on Amazon.

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Computer Elbow is Real-10 Tips to Prevent & Relieve Pain Writing and Wellness by Colleen

90- degrees angle for your arms seems to be an important tip. Elbow should rest on the surface of the table, not not on hard surface but some king of foam pad (can be cut from "memory foam bed cover or pillow) or at least on a tower which should raise it one inch or so.
August 19, 2014 |

Over the last few weeks, I've felt a nagging and persistent pain in my elbow, right between those two little bones on the underside (if you hold your arm slightly bent).

... A classic case of strain caused by overwork, it can develop in three ways:

"Chronic exhaustion" is a good term for what's happening here. We use the muscles and tendons over and over again, tensing them consistently without relaxing them often enough. The result is a repetitive stress injury. We experience inflammation in the muscles, and possibly in the tendons as well (though there is some medical debate about whether tendons actually become inflamed). There may be tiny tears in the fibers of both.

What to Do First

In most cases, the problem occurs because we're typing with poor form. That's good news, because it means we can make some adjustments to prevent the injury from happening again.

If you're already suffering, though, you have to heal first. Here are some tips to help you do that more quickly:

How to Prevent Computer Elbow

Next, it's time to make some changes. Keep in mind that if you continue to work the same way, you may end up with a chronic condition that gets steadily worse-eventually causing more pain, tingling, and numbness. Severe cases can interfere with your job or your daily writing goals.

  1. Don't raise the back of your keyboard: This actually forces the wrists to work in a "cocked" position that increases strain. You want your hands and arms to be in a straight line. Consider lowering the back of the keyboard instead. If you can't adjust it this way, try raising your chair a bit, or add something underneath the front of the keyboard to make it level.
  2. Use a wrist pad. You want your hands to be level with the keyboard. If they're not, use a wrist pad to make it so. I'm checking into some for my laptop computer as well-like the Intelligel wrist rest, the Grafiti Palm Pads (for Macs).
  3. Check your mouse: Make sure your mouse is close by and easy to use. If it's too high or too far away, you're extending the forearm too much (over and over again throughout the day), increasing risk of injury. Also, make sure the mouse fits your hand. If it's too small, you're finger, hand and wrist muscles will have to remain in a tense position to operate it. You want your hand to be as relaxed as possible. I use a tracking ball mouse and have found it to be the most comfortable of any I've tried. (My elbow pain is in my left arm, not the right, so the mouse is working well!)
  4. Relax your shoulders: Do you ever notice that your shoulders are up around your ears while you're working? Remind yourself to relax. Muscle tension in the shoulders can radiate down into the arms.
  5. Keep your desk clear: Clutter causes you to reach and extend more often. You want a clear space between your keyboard, mouse, and working area to minimize muscle work. Remember that the problem here is "repetitive"-the more you lift, extend, tighten, etc., the more likely you are to suffer pain.
  6. Stretch your fingers: Constantly curled fingers cause writer's elbow. Stop every thirty minutes and stretch them back toward you. Get up and walk around with your hands down to allow the blood to flow into them.
  7. Maintain 90 degrees: This is the magic angle. Your forearms should form a 90-degee angle with your upper arm. If you find your forearms are too low or (worse) too high, adjust your chair and keyboard to fix it.
  8. Fingers in line with forearm. This is one of my problems with my current work setup. My fingers tend to be higher than my wrists and arms. Bad idea. Use a rolled up towel or other cushion to keep your fingers in line with the backs of your hands and your arms-close to how they are when you're playing the piano, for instance.
  9. Get a split keyboard: These help your hands stay in a more natural line. I have one on my desktop computer, but of course my laptop, which I use just as much, doesn't come with this convenience. I wish it did! I have found that propping my wrists up a bit so that they can move with my fingers has helped, though. (See wrist pads above.) Resting my wrists on the computer actually makes the pain worse because my fingers are held up and must move without the help of my arms-resulting in strain.
  10. Strengthen the muscles: Increasing muscle strength can help prevent the injury from recurring in the future. Do this only after the pain has subsided, though, as otherwise it could worsen the injury. Try squeezing a tennis ball 25 times, or make a fist with your hand and then bend your wrist forward and back using only your hand.

Have you suffered from this condition? Do you have treatment tips? Please share them with our readers.

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