TECH EDGE: Using Technology to Combat Carpal Tunnel Syndrome

By John M. Williams

For 14 years, I have dealt with the severe pain associated with carpal tunnel syndrome (CTS), a condition in which the median nerve is compressed as it passes through the narrow carpal tunnel in the wrist. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result. When CTS in both of my hands is acting up, excruciating pain in the fingers, neck, back, and legs occur. Until a month ago, my CTS had not bothered me in years. Suddenly one morning, it arrived with a vengeance in both hands.

How much of a vengeance? Well, I was unable to type. I could not hold a telephone long, and it was painful, at times, to push the numbers on the phone. My occupation as a writer was not the only aspect of my life affected. I could not use eating utensils. I could not tie my shoes. I could not use my electric lawnmower, electric hand hedge clippers and electric weed whacker. Driving was difficult. What could I do?

One option was to have the median nerve in each hand surgically cut. I decided against this because I don’t believe surgery is the answer to this problem. After seeing my doctor, I began attacking the problem technologically. I started looking at alternative keyboards such as touch pads, joysticks, footcontrolled devices, speech recognition software and keyboards with large keys. I also regulated my typing to 15 minutes on, then 15 minutes off. An alarm tells me when to rest. While not typing, I either read or write. Productivity is important to me.

Two months ago, I dusted off my orbiTouchâ„¢, a keyless ergonomic keyboard that removes the barrier posed by the traditional keyboard/mouse combination. Persons who benefit include those with repetitive stress injuries such as carpal tunnel syndrome, other hand and finger injuries, limited fine motor skills, reduced finger function, and other cognitive and physical challenges.

I used the orbiTouch three hours each morning. The orbiTouch creates a keystroke when you slide the board’s two domes, on which your hands comfortably rest, into one of their eight respective positions. You type different characters by turning the domes to create letters and numbers. The orbiTouch has an integrated mouse, so moving the domes gives me full mouse and keyboard capability. My typing speed, however, was less than 20 words per minute.

I have also pursued other alternative keyboards. I decided to use an on-screen keyboard located in Microsoft’s Accessibility features. An on-screen keyboard is a utility that displays a virtual keyboard on the computer screen that allows people with mobility impairments to type data by using a pointing device, or, as I did, a joystick. Besides providing a minimum level of functionality for some people with mobility impairments, the on-screen keyboard can be used to teach people word processing functions. I have taught children with dexterity problems to type using an on-screen keyboard.

The on-screen keyboard can be used in clicking, scanning and hovering modes. I used them all. In clicking mode, you select from the on-screen keys to type text. In scanning mode, the program continually scans the keyboard and highlights areas where I type characters by pressing a hot key or sometimes by using a joystick. In hovering mode, I use a joystick to point to a key for a short time producing letters, numbers and punctuation on the screen.

The on-screen keyboard can be enhanced in a number of ways. You can display the keyboard with the keys in the standard layout, or in a block layout, in which the keys are arranged in rectangular blocks. You can also display the U.S. standard keyboard (101 keys), the universal keyboard (102 keys), or a keyboard with 106 keys.

While the on-screen keyboard is functional, my hands tire and I still have pain when using the joystick. The pain, however, is not as severe as when I use a regular keyboard. Still, using the joystick, I have not been able to type fast and I need to increase my productivity if I am to survive as a writer.

Soon, I shall return to using voice recognition to operate my computer. I may even try eye-gaze technology. Both of these technologies have served me well in the past. Of course, I am open to alternative ideas. Suggestions are welcome!

John M. Williams has been reporting on assistive technology for more than 25 years. He can be contacted at jmmaw@aol.com.