Hi everyone, I’m looking for advice or experiences from people who have dealt with bilateral epicondylitis or chronic forearm tendon pain.

I’ve been struggling with this for around 11 months now. The pain is not located exactly on the elbow itself, but slightly further down into the forearm area on both arms. About three weeks ago I had to quit my job because I simply could not continue working through the pain.

I work remotely, so most of my work depends on using a computer. I’ve tried several ergonomic changes, including switching keyboards (I’m currently using a Logitech Wave Keys keyboard), using a vertical mouse, and experimenting with voice-control tools like Talon Voice. Unfortunately, I still haven’t been able to use my computer 100% hands-free, and even moderate computer use continues to irritate my arms.

At the moment I’m also doing rice bucket therapy/exercises for forearm rehabilitation, along with trying to reduce strain as much as possible.

I really want to recover and be able to work again as soon as possible. If anyone has gone through something similar, especially long-lasting cases related to computer work, I’d really appreciate hearing:
- What actually helped you improve
- How long recovery took
- Whether you found effective ways to work on a computer with minimal hand/forearm strain
- Any rehab exercises, ergonomic changes, or strategies that made a real difference

Thank you so much.

Seriously, what’s going on here lately?

I come here expecting real talk from people dealing with actual chronic issues, and instead I keep seeing the same pattern over and over again - glowing “reviews,” suspiciously similar success stories, and soft promos for 1HP and programs like it.

No offense, but a lot of that stuff looks like repackaged basics you can literally find for free on YouTube if you’re willing to spend a few hours. Yet somehow it’s being sold as some breakthrough system worth a ton of money?

So what is it? Is there actually something legit behind 1HP that I’m missing, some real differentiator that explains why suddenly everyone who takes the course is “fixed”?

Or is this place just quietly turning into a pipeline targeting people who are already struggling and willing to try anything?

Because right now it doesn’t feel like a support community. It feels like marketing.

I know everyone's situation is different and the grass is always greener. But my RSI has gotten bad enough that I can't game, can barely use my phone, and I'm trying to figure out what's next.

Did you switch careers entirely? Go part-time? Find ergonomic setups that actually made a difference long-term? Move into something more physical, or something with more variety in movement?

What worked and what didn't?

Long time lurker here...my wrists were basically wrecked about a year ago. I'm a developer, typing 10+ hours a day. Sharp burning in both forearms, and some mornings I couldn't even hold a coffee mug without flinching.

Here's what actually made a difference for me. I'm not saying it'll work for everyone, but after a year of trial and error, this is what got me from daily 3/10 pain to basically nothing.

Exercises that helped
Tendon glides first thing in the morning. Three sets of 10. It took about a month before I noticed anything. I also did wrist flexor stretches, the kind where you extend your arm palm up and pull back on your fingers with the other hand. Prayer stretches too. I do all of these 2-3 times a day now, and it takes maybe 3 minutes total.

What I changed at my desk
I got a split keyboard, the Kinesis Freestyle. That was the biggest hardware fix by far. It took me about two weeks to adjust to the layout, but my wrist angle is way more natural now. I also switched to a vertical mouse, and raised my monitor so I'm not hunching forward.

The thing nobody told me about breaks
I used to power through 3-4 hours without moving. Now I use a timer, 25 minutes on, 5 off. During those 5 minutes I actually stand up and walk around. Not just scroll on my phone. It sounds stupidly simple, but it made a real difference in how my hands felt by 3pm.

Dictation, the part I didn't expect to help as much as it did
I was skeptical about voice typing at first, but it ended up cutting my daily keystrokes by maybe 50-60%. That gave my hands enough recovery time between typing sessions that the pain stopped piling up.

I use a few different tools depending on what I'm doing:

For quick stuff like Slack messages or one-line replies I just use Apple Dictation. It's built in, fine for short bursts, not worth paying for.

For longer writing, emails, docs, code comments, I switched between a couple. Wispr Flow ($18/mo) is solid, but the paste-based insertion broke on remote desktop sessions I use for client work. Talon is powerful but has a steeper learning curve than I had patience for.

What I use most now is DictaFlow ($7/mo). Hold a hotkey and talk, release and it types wherever your cursor is. The feature that actually made it stick, if you mess up mid-sentence you say a correction word and it deletes back and retypes by voice. Sounds minor, but when you're dictating a whole email it saves you from grabbing the keyboard constantly.

There's also Voice In, a Chrome extension with a free tier, which I use specifically for web forms and Google Docs. Different tool, different job.

None of this replaces typing. I still type. But spreading the load across my voice and hands meant I wasn't hammering the same tendons for 10 hours straight.

Took about 4 months to feel normal-ish
The first month nothing changed. The second month I noticed I wasn't wincing in the morning. By month four I could do a full workday without thinking about my hands. I still do the stretches. I still use dictation. It's maintenance now, not emergency repair.

What's worked for other people here? Everyone's RSI is different, so what combo of things worked best for you?

Trying to get back into IT and need to figure out a sustainable rig. Planning to use voice (Talon/Dragon) as much as possible but still need physical input options.

Even a vertical mouse triggers me, so I'm especially lost on the pointer side.. trackball? Stylus tablet? Something else?

For keyboards I've been looking at the Svalboard, Glove80, ZSA Voyager, and Kinesis Advantage. Leaning toward pairing whatever I get with a keyboard tray for better arm positioning.

What's actually worked for you?

I’ve only been doing physical therapy for my hands and wrists for about 3 weeks, but they’ve been hurting so much that I feel like something isn’t right. I have trigger fingers in almost all of my fingers on both hands, and I haven’t had surgery.

The trigger fingers started a while ago and were somewhat improving with steroid injections, hot compresses, massages, and some exercises I was doing on my own. But when it started affecting my thumbs, it felt different, especially because the thumb is such an important part of the hand. Around the same time, I also developed De Quervain’s tendinitis, and later pain on the ulnar side of my wrists especially on the right side, but in both hands.

I’ve been trying to avoid surgery and thought physical therapy would help, but honestly it has felt like the opposite. Since starting therapy, I’ve been waking up with severe wrist pain and pain in the palms of my hands as well.

I’ve done some research, and it seems like many of the exercises I’m doing are more for general wrist tendinitis, while some of the trigger finger exercises like squeezing a ball feel too aggressive for my condition right now. I also haven’t received any ultrasound therapy or treatments focused on reducing inflammation first.

I’m still working and regularly lifting and carrying heavy boxes, so I feel like my hands and wrists are already under a lot of strain. Because of that, I wonder if starting with gentler stretches and inflammation reduction would make more sense before strengthening exercises.

Would it be okay for me to ask them to adjust my therapy program? I’m not sure how to bring it up without sounding like I think I know better than the therapist… I just feel concerned because my symptoms have gotten worse

Hi All, I’m looking to try out a speech to text software to help relieve the pain in my hands from typing/clicking.

I think the one built into Word has too many grammatical errors to be productive for me.

What programs would you recommend?

I also have a vertical mouse and split keyboard. If there’s anything else you recommend, please let me know!

I've had RSI for two years. Typing wrecked my forearms first, then my wrists decided to join the party (a bit emotional, bee coding since I was a child).

So I did what everyone here eventually does. Switched to voice.

For about 30 seconds, it felt like the answer

Then the transcript made a mistake. And suddenly I was doing the exact same keyboard dance I was trying to escape

Except now I'm also hunting through a wall of spoken words to find the one wrong syllable buried in paragraph four.

Move cursor, Find wrong word, Select it, Delete it, Retype it, Fix the spacing it left behind. Fix the punctuation. Hope the sentence still makes sense.

That's not a voice interface. That's typing with extra steps and a worse cursor.

I realized: the problem was never transcription. Everyone solved transcription. The problem is correction.

Because speech is fast and loose. Text needs to be exact. And the moment those two things collide, your hands pay the price. Again.

The thing that actually helped me wasn't better AI or smarter autocorrect.

It was a system that shows me what it's unsure about

So I only correct those parts. Tab to move. Enter to accept. A number to choose. Never throws me back into normal editing mode.

It shows me what to fix so I actually fix it in seconds, not minutes.

My hands are still not what they were. But I'm no longer typing through a full day of work just to clean up after my own voice.

Anyone else gone down the speech-to-text rabbit hole and felt like you just traded one problem for another?

I’ve always felt slow using a mouse or trackpad. It works fine at a desk but when I’m trying to work on the go like on a bus or small desks it starts to feel clunky and inefficient.

I’m exploring whether eye tracking could make laptop control faster and easier. Your eyes would aim where you want to go and your keyboard would confirm the action so it doesn’t accidentally click everything you look at.

I’m curious whether this would actually help people work more efficiently when they’re away from a proper desk? Keen to hear people's thoughts.

Not pitching anything. Just trying to figure out if this is a real problem or only a cool demo.

I've been experiencing pain in both wrists for about six months. It started with pain in my left thumb from gaming. I've since quit gaming, but the pain has spread to both my wrists. My fingers also feel stiff when I type and use a mouse at work. I did a few months of physical therapy with some relief, but the pain is still there. I've seen two orthopedic doctors and had x rays taken, and they say that there is nothing structurally wrong with my hands and no inflammation in any particular tendon. They couldn't tell me what the source of the pain was.

The pain is generally not debilitating, except that guitar and music is extremely important to me, and I cannot play to the extent that I used to. The doctors couldn't give me any concrete recommendation as to whether I am better off quitting guitar entirely for some time or if some amount of playing is ok or even beneficial. Have any musicians been in a similar situation and figured out some protocol to rehab their ability to play music?

Hi everyone, I’ve been diving deep into the biomechanics of 'Mouse Shoulder' lately. It seems like most ergonomic advice for office workers starts and ends with 'get a vertical mouse' or 'use a wrist rest.'

However, looking at the anatomy of the upper trapezius and scapular stability, it feels like we are often just treating the symptoms (forearm strain) while ignoring the root cause (static loading of the shoulder girdle).

In your experience, have you found that supporting the weight of the arm itself (taking the load off the trapezius) is more effective than just changing the angle of the wrist? Why is the 'kinetic chain' approach not as mainstream as just buying a new mouse?

Hi there,

yes. 1HP again. tl;dr: Their old 9 min RSI video on YouTube (done daily) tremendously reduced or even cured my RSI in both hands. Developed RSI in 2025 both hands, doing a lot of sports while working in a software development team. Stopped working in July 2025 because of Pain and permanently swollen right hand. Went to many different specialists with no progress. Started doing their "workout" in December and since then it's getting better week by week.

Peace

Hey all Matt here with 1HP!

If you’ve had pain on the back side of the hand that is preventing you from using your hands to type, game, play music or any repetitive activity without pain.

As a quick reminder I'm a Physical Therapist (PT, DPT, OCS, CSCS) and our team has spent the past decade specializing on treating, researching and publishing our work around treating RSI (we've helped more than 3000+ individuals resolve their issues without surgery, more injections, resting, bracing etc. Here is some of our work (we started with the olympians of desk work - esports athletes)

Journal of Orthopedic & Sports Physical Therapy

Tendinopathies in Gaming

Conditioning for Esports (Ch. 8,9,10)

Science of Esports Physical Therapy

Today I want to review how you can systematically approach recovery with pain on the top side of the hand.

We will cover the various reasons and factors that can lead to issues at the top of the hand. We have spent the past 11 years treating over 3500 persistent wrist & hand issues which traditional care has failed to resolve.

This video will include everything we have learned, we’ll discuss:

1. Brief Anatomy
2. What are the causes of pain for this region?
3. How to address each of these causes of pain? Physiologic, Psychosocial, Lifestyle etc.
4. Flare-Up Discussion

Anatomy of this pain region

Pain on the top of your hand, wrist and extending into the fingers often involves the extensor muscles.

https://preview.redd.it/uh519zm6ujzg1.png?width=649&format=png&auto=webp&s=e349adcc0dca6c2daf55b24e2f9f09e6dadd3565

These are the muscles responsible for bending your wrist up towards the ceiling with your palm down. There are several of them which each have different functions and as you will learn in the next section your activities and task-specific movements / ergonomics often influence which muscles / tendons are involved.

The most common extensor muscles include:

1. Extensor Digitorum - Commonly with desk workers due to repetitive use of their fingers and wrists
2. Extensor Carpi Ulnaris - Common in desk workers, especially those who have floating wrist & forearms.
3. Extensor Indicis - Common with R. hand with mouse clicking
4. Extensor Carpi Radialis Longus & Brevis - common in those who have swapped to a vertical mouse or artists using a stylus
5. Thumb Extensor & Abductor Group - similar to above

Because each muscle and tendon is responsible for certain movements when you perform these specific movements based on what you do for work or your hobbies - typing, guitar, crafting, gaming, etc. it can lead to irritation of these tissues.

This naturally leads us to the discussion of “causes”

What causes repetitive strain of these tissues?

For most wrist pain issues caused by repetitive strain (things like typing, gaming, playing guitar, crafting, drawing) it affects the tendons at your wrist & hand.

Your tendons & their muscles can only handle so much stress. If you exceed the limit, then you can irritate those tissues.

This often happens when you suddenly have to use your wrist & hand alot for whatever it is that you are doing. Finishing up a work sprint, drawing project or gaming for 9-11 hrs a day for several days in a row are some of the common examples.

Or after several years of performing your activity without focusing on your physical health and endurance. Add a sedentary lifestyle and your body can become more weak.

Bye endurance, hello wrist pain.

There are other factors that have an influence on pain like your posture, ergonomics. What may be surprising to many is that psychological and environmental factors can play a role as well.

We have written and created several videos you can learn about how this works in the links below. In short when we experience pain for an extended period of time our body can adapt and get better at creating the experience of pain. This occurs through real changes in our nervous and immune system. Our past experiences, beliefs, fears, anxieties and other cognitive habits can consistently influence our pain experience. This is often why individuals who deal with pain for an extended period of time have so much trouble recovering.

Pain often doesn’t behave in predictable ways when it becomes chronic. But it is NEVER hopeless. We have helped thousands recover from cases as long as 16 years.

So to review the common causes are often

1. Activity level and intensity exceeds what your body can handle
2. Posture & Ergonomics influences the amount of stress on your muscles & tendons during those activities
3. Your cumulative experiences, beliefs and understanding of pain can influence pain

As a quick reminder - this pain pattern is DEFINITELY NOT carpal tunnel syndrome. Why? Because it involves pain that does not even involve the tendons OR nerve in the carpal tunnel. Watch this video here to learn more.

How to fix your wrist pain

Now that you understand what the “causes” are around pain on the top of the hand, wrist and forearm

Here are the things you can do to address each of these causes. As you might expect there is a lot of nuance in how to address each of these things. This video will include general exercises, common issues with posture & ergonomics that lead to increased use of the extensor muscles and helpful resources for understanding pain.

Now that you understand what the “causes” are around pain on the top of the hand, wrist and forearm

Here are the things you can do to address each of these causes. As you might expect there is alot of nuance in how to address each of these things. This video will include general exercises, common issues with posture & ergonomics that lead to increased use of the extensor muscles and helpful resources for understanding pain.

Your body can’t handle the level of stress

If your muscles and tendons do not have enough “endurance” to handle what you are doing on a regular basis it is important to build the capacity of those muscles & tendons!

Here are a few exercises you can perform to improve your endurance. (General routine here on YT) The first exercise I’m going to show you will focus on endurance while the other two are better for pain and recovery.

https://preview.redd.it/mn6qchptujzg1.png?width=630&format=png&auto=webp&s=be055f0f08c821d4325b463c784e24ff6f2644f4

The first exercise is DB Wrist Extension . As i mentioned this is for endurance and targets the muscle & tendon involved

You want to choose one that is around 3-5% of your bodyweight. ****

Now there are two ways to do this. One with your arm-rest or resting on your thigh

The main goal is to ensure you are isolating the movement at your wrist. For each repetition you will be rolling the dumbbell ALL the way down to your fingers and then ALL the way back up

if this is a bit too difficult for you, then start with less of the range

You’ll be doing 2 sets of 15-20 moving slowly throughout the movement. You may feel a little bit of discomfort on the palm side of your wrist & hand but this is normal. As long as it is less than a 2-3/10 or it is not sharp, you can continue to perform the exercise.

If you don’t have a dumbbell, you can use a water bottle or backpack filled with books. The DB is helpful since you can gradually progress in weight.

https://preview.redd.it/1ya6yqxuujzg1.png?width=630&format=png&auto=webp&s=beb9696b210243b1a77fa288cf161b32daaa158b

Towel Extension Isometric

This next exercise is an ISOMETRIC exercise. Which means that the muscle and tendon length is not changing while you are performing the exercises.

You can use a towel for this exercise. Roll up one end of the towel to grip in your both of your hands. Step on the other end of the towel with the appropriate amount of tension. Pull up into the towel so you are pushing upwards against the tension of the towel. Rest your forearms on your thigh to ensure they are parallel to the ground We have adapted a protocol from the research for the wrist & hands. Isometric exercises have been shown for certain individuals to provide some relief for their pain for as long as two hours

Perform this exercise for 45” holds, resisting up to 50-70% of your “max” strength. Think about pushing between 50-75% of what you feel is the most you could possibly push.

Then you’ll be resting for 30 seconds and repeating the cycle 3-5 times.

For those who might have alot of difficulty with the dumbbell exercise above, you can try to only perform the isometrics first.

https://preview.redd.it/cjiat8j1vjzg1.png?width=623&format=png&auto=webp&s=4858ee435cf5adf173058c1f2264c480bb447583

Wrist Extensor Stretch

Stretches can be helpful to also provide temporary relief. Especially if you still need to use your hands frequently throughout the day.

This is a stretch directly targeting the wrist & finger extensors. Hold for around 20-30” and perform up to 2-3x throughout the day in response to any extended activity where you are using your hands. So think:

• After your initial work block
• At the end of work
• After a long drive
• After you finish a music, gaming, etc. session
• Anything that requires extended use of the hands (extended us subjective base on your own severity)

If you follow us you know exercises will help to build up your endurance or max HP bar so you can tolerate more activities over time. However posture & ergonomics can influence how much HP you lose over time (and more importantly what muscles are used)

https://preview.redd.it/w32xqz33vjzg1.png?width=633&format=png&auto=webp&s=4f906717a931fbdeb55ffca394bd835c15d3922d

Improving Posture & Ergonomics to Reduce Stress on Extensors

Here are two of the most common issues we see that lead to increased use of the extensors. The first is floating wrists. When individuals float their palm or do not utilize forearm support it increases the use of the wrist & finger extensors.

You are using your extensors to hold the weight of your forearm and hand up against gravity the entire time you are performing your desk work. Support your forearm and palm if you want to reduce the stress per unit time on your extensors.

But remember the exercises still provide the most benefit in building up your capacity and allowing you to use your hands more with less risk of tissue strain.

In other scenarios individuals may have swapped to an input device that may have actually led to an increase in the use of the extensors. Whether it be a larger mouse (which can often lead to a bit more wrist extension → causing the muscles to work harder)

Or a roller mouse which can often lead to an increase in both flexor and extensor use depending on the tasks involved. When scrolling up especially if there is lower overall sensitivity it can require a lot more overall use of the extensors.

These setups lead to an increase in the use of the extensor muscle group - If you don’t have enough endurance to handle this increased usage over your work day, then it can lead to tissue irritation.

One of the most commonly missed aspects of pain is the psychosocial component.

Addressing your Understanding Pain

Understanding the science of pain has made large strides in the past 25 years however there has been difficulty in its integration into the traditional care & medical education model. I’ve written about why this is in previous articles (no incentives, $ comes first, fragmented system).

By better understanding pain and how various environmental and cognitive factors can influence how you are feeling you can have more control over your own life and what you are able to do.

Many individuals with chronic pain allow their pain to often decide what they can or can’t do when it has been proven that pain does not reflect the state of our tissues but is rather more about protection. You learn in depth about the science behind this through some of these articles here

• The physiology of persistent & chronic pain - and what you can do about it
• Understanding Relationship Between Beliefs & Pain
• Case Studies (See my Profile or directly here 1, 2, 3)
• Chronic Pain does not = more tissue damage
• Tactical Guide to Pain Reprocessing Therapy

This occurs as a result of not understanding what the pain actually means, why it may be sensitized in certain situations and whether or not you can safely continue with your activities. Over time based on your repeated decisions of avoidance or activity you are teaching your brain whether you are in a state of “safety” or “danger”

Learning how to create messages of safety rooted in real evidence (based on physiology & understanding of pain) helps to reduce how often pain makes decisions for you. This is of course easy for me to say but is a crucial part of either working with a provider who understands pain science and can guide you to determine whether you need to actually modify activity based on physiologic load vs. overload (strain).

The tactical way to address these psychosocial aspects is to

1. Understand more about pain
2. Work with a provider to understand what actually represents tissue strain based on your capacity and pattern of behavior
3. Gradually increase your activity over time based on your physiologic capacity (tested by endurance tests), activity tolerance and ability to process your pain.

In practice this will look like:

1. Individual reads Explain Pain or The Way out to understand more about the physiology around persistent pain and how variables can even create the symptoms of sharpness, numbness, etc.
2. Individual works with a physical therapist to understand their wrist extensor endurance and is informed how much they can tolerate their activity based on performance of the test
   1. For Example typically for around 3% bw for wrist extensors if you can perform between 40-60 reps (easy) it equates to around 6-8 hours of typing & desk work with low risk of strain, pain or injury.
3. Individual works with the physical therapist to clarify the exact schedule, behavior of pain and current understanding of pain to establish the activity & exercise recommendations for the first week
   1. Individual will exercise daily (1-2x/day), either maintain current activity based on their exact schedule or slightly deload
4. As tissues adapt and individual understands more about pain, the individual works with the PT to gradually increase activity over time
   1. The graded exposure provides real evidence that the individual can tolerate more activity without leading to tissue strain or symptoms getting worse. (Sometimes it can improve or temporarily get worse depending on the recommendations & individual)
5. Over time you will improve your ability to provide yourself signals of safety based on this growing evidence from #4. It requires patience and collaboration with a good provider to help you get here (it is possible on your own as well!)

As a quick overview to address pain on the top side of the hand it requires you to

1. Address any physiologic deficits
2. Modify environment (posture & ergonomics) to reduce stress on your extensor muscles & tendons
3. Improve your understanding of pain and confront psychosocial drivers to pain

Managing Flare-Ups

The road to recovery is never a straight line and one of the most important things to understand is that flare-ups are a part of recovery. Here is a great image about low back pain that captures this concept

https://preview.redd.it/mtc6zif6vjzg1.png?width=667&format=png&auto=webp&s=82029e601a20c7315b556de4db94f0ca55a066d2

I’ve written a complete step-wise guide on how you can manage flare-ups you can check out here

Hope this helps!

Matt

--
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I've been struggling with pain in my hands and fingers for about six months. I'm trying to switch over at least partially to voice dictation, but I share an office with four other people, and my mic picks up their speech. Does anyone have recommendations on how to get around this? Are there special mics that don't pick up outside noise? I also know there are stenographer's masks, but have never even seen one in person, so i don't know how well it works.

Starting Saturday I’ve had some pain in my left wrist, like a really tight feeling whenever moving it or making a fist.

The pain was pretty bad and I was thinking about skipping my workout. Instead, I wrapped my left hand and went on with my workout and most of the pain is now gone entirely.

Would wearing a brace to sleep tonight be a good idea or of any benefit?