I had a terribly scary run-in with RSI about 20 months into my working career, or about 2 months into my new job. Like the author, I had it bad: I found it excruciatingly painful to open doors, or do pretty much anything. In the evenings I would sit in front of the TV with a pillow in my lap, resting my hands on the pillow—that too would be painful. Even resting my hands on the top of the duvet in bed was painful.
I seriously considered leaving IT, but I persevered as I couldn't think of anything I'd want to do that didn't involve a lot of typing. (Even going back to study would require quite a lot of typing.) So I talked to my boss, who I knew had also struggled with RSI periodically. He gave the same advice as @kel: change things up. That was 11 years ago, and I guess it was sage advice because I am still programming, but mostly pain free these days.
In addition to the wrist pains, that went all the way up to the elbow and beyond (on the left) I had other symptoms. One of the most persistent ones is that my fingertips, and the first joint on the fingers, would have stabbing pains from pressing the keys.
Some things that helped me, probably in order of importance:
- Throw away the wrist rest. "Resting" my wrists on a gel-pad while typing constricted the blood vessels just under the skin, and made me prone to bending the wrists to read far-away keys rather than moving my whole arm from the shoulder. This was possibly the hardest, but most effective thing I did: learn to type without resting my forearms on the table / wrist rest.
- Getting a proper external split keyboard. The first two months at that job I was typing on the laptop keyboard. (MacBook Pro.) I switched to using a Microsoft split keyboard for a while, but I found the keys too hard to press down. I soon moved to the Fujitsu Siemens Butterfly one and haven't looked back. A split keyboard allows a much more normal position of my arms, leading to more natural positions of the wrists. (For me, at least.)
- I joined a gym (lucky me: work sponsored gym membership across the road) and worked on upper back and arm strength to improve my posture and have the strength to let my underarms hover over the table rather than resting on it the whole day. (See the first point.)
- Pair programming. My team was very understanding. We did a lot of pairing, though not on everything, and I probably ended up pairing more during this process. On days when my RSI was very bad I would sometimes be doing the driving, but without holding the keyboard. I am forever grateful to my very understanding colleagues. (Who were all senior to me.)
Some things that didn't help:
- I could not switch to Dvorak layout, because I was already using it. I now wonder if that hid my symptoms for a while, until it got completely out of hand? Who knows. It's anyway the only way I can touch type. (Because if I look at the keys I just get confused: they don't type what they say on them.)
- Taking holidays. I took a two-week break from touching a computer, and felt absolutely fine. However, within minutes of sitting down in front of a keyboard my hands were in agony again. That was not a great day.
It took months getting over the pain. For a long time fear of the pain itself probably caused me to tense up and make things worse than they could have been. But, with the help of an understanding boss I did eventually manage to get back to a pain-free existence.
Over the years since I have had bouts with RSI again, sometimes very bad, but I now know that I don't need to panic. I do need to double down on discipline though.