It's Not Carpal Tunnel?!

2026-01-21 | 10 min read

Note: This is probably going to be one of my longer posts. If you have questions or want to discuss your own experience with RSI, feel free to reach out. I’m still learning and would love to hear what’s worked for others.

TL;DR: What started as mild finger tingling from heavy trackpad use turned into a multi-year RSI journey that was initially misdiagnosed as carpal tunnel, but ultimately pointed to overuse, poor ergonomics, and stress rather than nerve damage. Meaningful improvement came from a combination of aggressive ergonomic changes, reduced typing (especially via dictation), better sleep, lower stress, and gradual strength and mobility work—not quick medical fixes. Recovery has been slow and nonlinear, but symptoms are far less frequent, and I’ve learned that long-term sustainability matters more than pushing through pain.

In this post I’ll attempt to document my journey with repetitive strain injury and compile the literary resources, ergonomic recommendations, equipment, stretches, and strength training that have been part of my (actively ongoing) recovery process.

Background

In March 2023 I was actively working on updating and validating a significant number of data pipelines and regularly running numerous variations of SQL queries to help validate my test run outputs. This involved repeatedly clicking and dragging my finger on my MacBook Pro’s trackpad. That month, I finally began to feel light tingling sensations in the tips of my index fingers. But I mostly ignored it. I don’t suggest doing that.

Over the following three months the symptoms increased but remained primarily in my index and middle finger, so I decided to visit an ergonomist. I got an ergonomic consult at work which concluded with her giving me some recommendations about monitor height and giving me a vertical mouse and somewhat split keyboard (I’ll let you try to figure out which one). Both of these devices felt very plasticky in nature and I didn’t use them.

The symptoms didn’t relent, so a few weeks later I decided to get my first instance of the Logitech MX Vertical mouse. This mitigated many of the symptoms, although the relief was only temporary. As the symptoms began to arise again, they gradually spread into my right thumb intermittently as well. They would gradually elevate from tingling to burning and tenderness through sharp pains. Around this time I managed to purchase a few more instances of the mouse, leaving me with four in total: one for my backpack, one for my office, one for my apartment, and one for my family home.

In January 2025, I felt similar symptoms arise in my left index finger for the first time. A similar tingling sensation followed by burning, tenderness, and occasional sharp pains.

Lifestyle Factors

At this point I think it’s important to mention a few lifestyle factors to illustrate the difference between my lifestyle at the beginning versus now. I’ll look at maybe four or five aspects:

Supplements: For various periods of my life I’ve taken men’s multivitamin supplements from Costco. It’s been difficult to identify a specific impact from these, but the last time I regularly took them was in 2023. I know that there is ongoing discussion about the efficacy and re-uptake when ingested in this form.

Nutrition: I would:

Skip breakfast regularly
Start my day with coffee or chai (nothing beats, nothing satisfies me like a sweet, sharp cup of masala chai in the morning)
Eat about a third of my meals at the office, another third eating out, and another third eating at home

I don’t have a clear tracker on these meals, but I maintain between 2200 to 2800 calories a day with something like 40 to 70 grams of protein (but relatively carb-heavy).

Exercise: I was getting on average probably 30 minutes of light to medium cardio a week and maybe another 30 minutes of strength training on average for all the years since I started working in August 2022.

Stress: Generally my stress levels would be incredibly high, driven by a perfectionist mindset towards every aspect of my life including fitness, nutrition, social interactions, and most of all my work and nonprofit work. I also used to travel for a significant portion of the year. Constantly traveling meant that I was overcompensating in the time that I actually spent at work, trying to get ahead or trying to give myself more breathing room to take time off and/or travel. That said, this wasn’t to say that I was taking a significant amount of time off a year.

I was probably working about 55 hours a week, but about 80% of those hours were hyper-focused and high stress. I also maintained an endless list of documents to read that let me stay up to date with every project that my immediate team members were working on, and often also project strategies and vision documents from organizations as far as all organizations within my VP scope.

Things came to a head starting in June 2025 when I started working on a particularly difficult and ambiguous project with incredible teammates but an initially unclear roadmap—moving with ambiguous requirements and pressure for immediate progress. This led to an extended period (about four months) where I was regularly in the office until 8-9 PM and committed 60k+ lines added, 40K+ removed.

During this whole time, the only ergonomic equipment I was using was my vertical mouse—I simply could not function at work without it. My posture remained suboptimal. I barely used my monitor, and only used the built-in MacBook Pro keyboard. I was getting limited cardio and strength training while taking on enormous amounts of stress from work.

Medical Diagnosis

The next phase of this journey involves a trip to Denver where I brought it up to a friend that’s currently in fourth year of med school. Many of my digits, primarily the index fingers on both hands, were constantly buzzing and this made it very difficult to work. This was becoming a mental issue. He explained that my symptoms were characteristic of carpal tunnel syndrome, and that the typical treatments included PT followed by steroid shots, followed by endoscopic surgery to loosen the transverse carpal ligament. None of these invasive options seemed preferable and I wanted to begin by getting an official diagnosis from a medical professional.

As one might expect, I went to my PCP and she gave me an initial diagnosis of carpal tunnel. I went home and quickly started chatting with ChatGPT to understand more about what tests can be done to verify the diagnosis, what the prognosis typically is, the prevalence in people my age, and how to address it. This freaked me out because I very quickly came upon Mayo Clinic-style resources that give a strong indication of the long-term risks of extreme muscle atrophy, numbness, and paralysis.

My next appointment was with a physical therapist, and a frustrating part of the process is that getting a physical therapy appointment within Kaiser required me to have a referral (and that the first appointment with the physical therapy department was a screening appointment that simply asked me the exact same questions that I’d already answered for my PCP). By the time I went to physical therapy, they recommended me to do some stretches, and mentioned I would be stuck doing them for life. Not exactly a motivating start.

I then went to a neurologist who once again forced me to schedule an in-person screening appointment and did the same thing—then scheduled me again for a nerve conduction study (NCS) test which took two weeks, during which I called Kaiser three times to get it scheduled in the system. The NCS test concluded that my reaction time and amplitude of conduction were as expected for a patient of my age, and so there was likely no nerve damage (though my understanding is this doesn’t preclude me from having nerve irritation that would explain many of my symptoms).

After that I didn’t hear from Kaiser for about a month and a half until I reached out and requested a cervical spine MRI plus a referral to orthopedics. This is the current extent of my medical journey, and I’ll update here once I have more information.

Progress

During October I took three weeks of FMLA that allowed me to disconnect from work for a while and deeply explore the topic of carpal tunnel and repetitive strain injury.

Overall my symptoms have reduced over the last three months from, mild, constant numbness plus tenderness and sharp pains (worsened when I’m working), to:

occasional days without symptoms, particularly when I’m not working
occasional numbness plus dullness/tenderness (primarily in my right hand)
Sharp shooting pains when I deviate from using ergonomic equipment and/or overexert myself with work/typing for more than a few hours

The worst severity of the pain is roughly equivalent, but the frequency is certainly lower.

Resources That Helped Me

I’m going to include a compilation of the most important resources to me during my healing process.

Blog Posts and Community Stories

At the beginning of my symptoms and beginning to acknowledge the injury, the most impactful thing was understanding that I wasn’t alone (that many people had gone on to continue having high output and successful computer careers despite these symptoms and learned to work around them).

Books

Two books that were particularly impactful:

It’s Not Carpal Tunnel: Repetitive Strain Injury for Computer Professionals - This was an amazing primer on the upper body’s anatomy. I’m beyond shocked that it’s not required reading for anyone beginning a career in tech. It offers anatomy of the upper extremity, guidance on working style, stretches, and strengthening.
The Way Out - A great read on neuroplastic / psychosomatic pain. This book effectively summarized the idea behind pain reprocessing therapy. What particularly stuck with me was a table demonstrating how often folks with different types of back pain were tested for structural damage, yet what a significant proportion of the population presents with the same structural damage but does not present with any associated pain, meaning that there’s a good chance that a lot of the pain is not necessarily causative. Also, here’s a list of RSI healing success stories.

Videos and Talks

Breakthrough with Healing Chronic Pain

Ergonomic Recommendations

Proper Ergonomic Setup

Key principles:

Arms shoulder width apart
Wrists neutral
Top of monitor at eye level
Chair with your seat all the way back
Feet flat on the floor
Table low enough that your elbows are at 90 degrees and in line with your torso

Mouse Recommendations

Keyboard Recommendations

Kinesis Advantage 2: it’s ugly, but I LOVE it.
MoErgo Glove80

I recognize that these devices are not cheap, so I would explore the options that your company offers you and, depending on the severity, discuss options with HR. I suggest framing it as a collaborative process because you and your employer both have your best interests in mind in ensuring that you’re able to continue leveraging your experience and domain knowledge.

Other Equipment

My desk
My chair, with the caveat that I don’t keep the armrests or headrests on it)
A good webcam
PopSocket for my phone
Updating my mac’s trackpad settings, including enabling tap-to-click and using three fingers to select & drag (meaning I use four fingers to switch desktops).

Tools and Software

Wispr Flow

I downloaded Wispr Flow, which is an incredible transcription app that costs about $150 a year. It serves as a separate keyboard on Mac/iOS and also an omnipresent tool on desktop. What I love about it is how high-quality the transcriptions are, how quick they are (although it does require an internet connection), how you can teach it specific words, have it take on different punctuation styles, and the company is well-funded and continuously growing. Using this app has gotten rid of approximately 80% of my day-to-day typing.

The bulk of this article was written using this app and then manually edited (about 80% of it was dictated).

My usage stats from the last three months of 2025

I also use the app on my desktop at work where I’ve connected a cheap set of wired headphones. I pick up the mic and speak and can whisper directly into it, allowing me to dictate messages, emails, and prompts for AI tools (Gemini, Cursor, etc.). Others also like to use a real mic on their desk, like this.

Walking and Movement

I also found that long walks were the easiest to integrate as a way to mitigate stress. I was temporarily using a continuous glucose monitor and found that walks significantly decreased my blood glucose spike right after eating.

Breaks

I have been using Time Out, a Mac app, to give me constant reminders to take short breaks (I have it set up to give me a 15-second break every 5 minutes and a 5-minute break every hour).

Lifestyle Changes

One of the biggest changes has been figuring out what helps me relax and decompress outside of work and establishing a more clear balance. That’s cliché I know, but necessary in an environment that will give you constant stimulation, places to exercise ideas, and opportunities to make impact if you choose to.

To sum up how I describe it to my friends: “What do you mean I actually have to listen to my body’s mental and physiological needs???”

Current Supplements

Turmeric: well-known to have similar anti-inflammatory effects to the NSAIDs I was taking at the beginning of my treatment.
Continuing to take multivitamins.

Sleep

Sleep, as I mentioned, is a big factor. Improving the amount and quality of sleep (and giving it utmost importance over exercise, work, and socialization) was important because I had gotten used to not getting enough sleep. I now average about 7.5 hours in bed (and I estimate 6.5 hours of sleep), easily an hour more per night than I was before.

Bracing

I have been regularly using wrist braces for my hands while sleeping about 95% of the night since last September.