Nilesh D Kapadia

(Work in Progress)

In this entry (which may end up being a series of entries), I will describe how I conquered wrist pain. It was so bad that I did not work for almost 1.5 years in an attempt to recover from it. After trying all kinds of treatment methods I finally found something that worked -- using a "mindbody" technique. I recovered 100% and it hasn't been a problem since.

I have tried to recall the chronological order of the events as best I could, but it's been difficult since I am recalling this over 3 years after the fact. I wish I had written about it earlier, but I've been putting it off. At least this shows that I have been 100% recovered for 3 years.

My story starts like most other people who think they have "RSI" ("Repetitive Strain Injury"). I have always used my hands a lot. I've been a computer enthusiast ever since I was 9 years old when it became my favorite hobby (programming, video games, and anything computer-related). I eventually learned how to touch type when I was around 13 years old which made me a faster typist. In high school I learned guitar and bass. I went to college for a computer engineering degree. I played a little bit of drums occasionally. My computer use and video gaming use never slowed during this time. I also worked out with weights. Nothing serious, just some exercises with 10-15 lb dumbbells.

At some point I heard about "carpel tunnel syndrome" and similar problems that were being attributed to typing too much. It was starting to get covered in the news. I decided I needed to do something about my ergonomics. I had a wrist rest for my keyboard, but wanted to get a keyboard tray to place the keyboard lower as was suggested by literature talking about these typing-related problems. Yet I put it off and never did anything about it.

At some point I experienced wrist pain. One time was after going go-kart racing for about 4 hours in one day. My wrist hurt for several days and it worried me a little, but the pain went away. When trying to play drums my wrists would hurt. Occasionally weight-lifting would hurt. I tried bench pressing weights and my wrists would hurt from that even with relatively small weights.

I actually had some pains that would last quite a while. I've had back pain since I was a teenager (or younger?). It would last a few weeks. I would go to the doctor and he would simply say not to worry about it, prescribe ibuprofen, and give me some literature on back exercises. I would occasionally have a stiff neck that would have no good explanation but would last a while.

As a side note, I had allergies a lot when I was in college. For a while, I was sick every few weeks and it would last several weeks. The doctors' explanation was allergies and prescribed allergy medication (I tried a few different ones, the end result being the side effects were worse than the symptoms). One of my friends told me he used to get allergies, but they went away after he starting spending a lot of his time outside.

I graduated from my university in December of 2000 and began my job search. I kept playing video games, especially one in particular, Marvel vs Capcom 2, which I played in the arcade as well as home (I had an arcade stick at home). This game was one of those fighting games where you had to punch in rapid combinations of buttons to do moves. One time I was playing at a video arcade, I went to open a restroom door as I was leaving the restroom and someone opened it too quickly causing the door to fly into my hand and hurt my wrist. When I went to go play MvC2 my wrist hurt. When I was playing at home, the pain continued, which was scary, so I quit playing to give my wrists a chance to heal. As I was about to start working I become acutely aware of how important my hands were.

The beginning of 2001 was right after the times when the dotcoms started crumbling and jobs for computer professionals was very scarce. Perfect time for me to be looking for a job. I got one job offer, which was actually quite good, from a very stable company. But the job did not fit what I wanted to do, so I made the very difficult decision to turn it down. After I made that decision I was very worried that made a mistake and a bit stressed out. But a few weeks later another job offer came which fit better and I took it.

I was very happy to be working there. The first month was great and not stressful at all. I did not have a keyboard tray at my desk but I didn't bother to ask to have one installed. I was still working out with weights at home. I had started using heavier weights. One day working out I experienced sharp wrist pain so I stopped. I didn't think too much of it and tried to work out again a few laters. The same thing happened, sharp wrist pain. I felt numbness as well which I didn't really understand.

The pain was still there when I went back to work. Only in my right wrist. It would hurt and eventually go numb. I switched to using my left hand for the mouse to compensate for this. I didn't think it was too big a deal, and thought it was going to go away after a few days. I talked to one of my friends who said it might be "carpel tunnel syndrome." So I started searching online and read about CTS. The information I read matched my symptoms pretty closely. When I realized this I freaked out -- had a short spell of nervousness and anxiety. It's really scary to think you may have seriously injured your hands. I theorized it was a combination of a lifetime of typing with poor posture and a weight-lifting injury accelerating the damage.

So I scheduled an appointment with my doctor. When I went to see him he told me it was nothing to worry about and would be gone in a few days and prescribed me ibuprofen. I mentioned my concerns about it being carpal tunnel. He said he really didn't think it was that. His opinion didn't really make me feel better. I was starting to think my doctor saw me as a hypochondriac, not taking my problems seriously (as he had done so with my back pain). He said if it continues come back to him.

So the problems continued. One weird thing is shortly after the wrist pain started, I was stepping into the shower one day and heard a pop in my ankle. I had pain in that ankle for a while. The wrist pain and numbness continued, and I starting trying different treatments I had read about online. I tried wrist braces, ice packs, heat packs, etc. I told my employers about it and they told me to take a break from typing until I got better. So at work I spent all my time reading books, which was ok, since I was in training anyway and doing a lot of reading already.

Eventually I had problems even reading a book. Holding a book up in my hands hurt my hands and putting it on a desk hurt my neck because I was hunched over it. So I alternated between different positions but the pain began to grow in my neck. Meanwhile, I had been avoiding using my right hand (since that's where the pain was) and was using my left hand for things I commonly used my right hand for. It got to the point where I was even opening doors with my left hand. Eventually the pain appeared in my left wrist.

I had also been going to see chiropractor. My insurance covered it, so I decided give that a try since I was able to see the chiropractor immediately and was hoping that maybe I could get immediate results. They did x-rays, and found that my neck was "too straight", possibly because of a previous injury. The chiropractor asked if I had been in a car accident. I said no, but I did recall some neck pain I had before which may have been injury related, but I was not sure. The chiropractor didn't say much about it and didn't think it was that big a deal, but it did enter my mind that I had a physical problem with my neck. They used some kind of electric device which they hooked up to me which seemed to stimulate my muscles using electricity. It was weird, but I was hoping it would work. They also gave me ice packs to use. In one visit the chiropractor did an adjustment.

I had also seen a massage therapist at some point, I don't remember exactly when. Someone at work who had wrist pain in the past said that it helped her. I had 2 or 3 sessions, but it didn't really do much.

I started to get more hopeless and felt that I wasn't getting better. So I saw my doctor again. He sent me to a neurologist (CHECK). The neurologist did nerve conduction tests on me which measured how well my nerves were responding. This nerve conduction test was one where they places electrodes on the skin and send electrical pulses through the nerves, measure how fast the electricity travels. The test results showed a slight deviation from the norm in one of my arms at the elbow (CHECK). The results validated to me that there was a physical problem. The neurologist referred me to a physical therapist.

For physical therapy, I went to Healthsouth and had 6 visits over the course of 2 weeks. They had me do excercises and various other things that I don't recall at the moment. I had different people help me for different sessions, so there was a bit of a varied approach depending on who I had. After physical therapy, I didn't feel any better and the problems persisted.

At this point I think I asked my employer if I could take time off work. They said ok, take as much time as you need, focus on getting better, and when you're completely better we'll have plenty of work for you. I had no idea that I was going to spend over a year without working. I was thinking a few weeks of resting my arms and I would be ready to work again.

I saw the neurologist throughout the entire experience. I think the next visit I complained about neck pain. He did another type of nerve conduction test on me, one where they stick needles inside you and send electric pulses through nerves. It sounds painful, which it was, but not nearly as bad as you'd think. Just mildly uncomfortable. The test results showed that there was supposedly nerve compression at my neck. This gave my mind more physical evidence that I have something physically wrong with me. The neurologist talked about the posibility of it being thorasic outlet syndrome.

My research thorasic outlet syndrome (TOS) made it seem especially bad. People who had it generally struggled with it. It seemed like a catch-22: your wrist are injured which puts more strain on your elbows which puts more strain on your shoulder muscles which puts more strain on the rest of your body. There wasn't really a clear path to recovery, either. Gentle stretching and gentle excercises seem to be the proposed cure. From what I read, you don't want to overdo anything because then you can set yourself back.

At some point I had another round of physical therapy where they worked on my neck. This of course didn't help. There was this machine that was supposed to stretch out your neck. It actually seemed to hurt me more.

I was pretty open-minded about trying alternative therapies. I tried various yoga classes. I tried accupuncture. I tried more massage therapy. I saw another chiropractor that was recommended to me. None of it really helped. I tried meditating daily. Breathing excercises.

Keep in my mind that I was not working. I had all the time in the world to try different things. I spent a lot of time researching possible cures. From what I read (on the internet), recovery was going to long and drawn out. So I was patient about the whole thing.

To keep myself busy I did a lot of reading. I watched a lot of movies. Listened to radio programs. Took lots of walks. I didn't drive much at first, but I did drive more often after a while. I wore wrist braces when I drove, and got really good at using my leg to steer so I could use my arms as little as possible.

I still did use the computer, but I was very careful about how much I actually typed. I had a program which monitored every one of my keystrokes, and gave me statistics on how much I typed, which keys I pressed the most, etc. I experimented with voice recognition software.

I play guitar and bass guitar, but during this time I didn't play much. Eventually I started playing bass again with my friends, but I would occasionally have to stop playing when I had pain.

It was really frustrating that my creative outlets were stifled due to the problem with my arms. But I tried my best to not let things get to me, and I wasn't as unhappy as I should have been.

[Knee pain, back pain.]

The neurologist had me do more tests. MRI of my neck. Later a brain scan. Nothing abnormal was found. After not being able to cure me of this pain, he concluded that I have "fibromyalgia." Fibromyalgia is basically one of those diagnoses that says "I don't know." It has a set of symptoms that are associated with it, and is thought to be affected by stress, but they don't really know much about it.

At this point, I decided I really can't go on like this without working. So I talked to my employers to see if I could start working again and just try to work through my problems. I started working part time.

I did get frustrated by the whole thing. I didn't understand how the human body could be so fragile. I just assumed it was maybe because we were using the body in ways we had not evolved to handle (e.g. typing on a computer keyboard).

The neurologist sent me to see a rheumatoid(CHECK) specialist to get an opinion. Then I was sent to see a hand surgeon.

My breakthrough finally came around this time. I had subscribed to the "sorehands" mailing list which was a list for people with problems such as mine. Most of the list was filled with people with stories that sounded exactly like mine. The nearly identical nature of these stories really solidified the idea that this problem was very real and that many people had it. Most of the stories didn't really have happy endings, they were from people still suffering. Some had gotten slightly better or had learned to manage things better, but not many full recoveries.

I eventually read a post on the list by Nate McNamara, who claimed he had cured himself 100% through a mind-body approach. Being generally willing to try anything, especially after suffering with this problem for so long, I was very intrigued. I read what he said: he cured himself 100% and was back to doing everything he did before and was taking drum lessons. He used his hands as much as he wanted, and didn't worry about posture, ergonomics, or anything. The idea of a 100% cure sounded very nice. I read an article he linked to that was a summary of Dr John E. Sarno's ideas which I found to make a LOT of sense. I immediately bought and read the book "The Mindbody Prescription" by John Sarno. It made a huge amount of sense and really was kind of a revelation to me.

I just took the understanding that the book gave me and just returned to using my hands like I normally do. I started just started typing again without worrying about it. Within a week I was feeling better, and within a month I was back to normal. I started working full time and started getting back into all the things I had been missing. Without 2 months there was no trace of the pain left. It was really wonderful to have a complete turn around like this. It was like waking up from a bad dream.

The funny thing is, I did have it suggested to me that my problems were all in my head by a few people. I was generally very offended by this. I had so much evidence that I did in fact have a physical problem that I felt like these people just really didn't understand what I was going through. The thing is, I didn't have it explained to me the way Sarno's book did. The way I felt when people made these suggestions were that they were saying I was faking it and that my problems weren't real. Sarno says that the problems are in fact physical, but that physical condition is created by the mind.

I did find some ways that this intersects with more abstract practices such as Yoga, but Sarno's writings give a very logical, scientific understanding of it that really just made sense to me. Maybe it won't make sense to everyone.

chiropractors
Other neurologist test
MRI
massage
acupuncture
yoga
massage in India