Bad mouse grip leading to chronic pain?

Bop

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I've been PC gaming since the mid 90s, but over the past few years I've been encountering some chronic pain in my right hand and wrist (no numbness or tingling) that is not going away no matter what I do. I've seen a doctor and I've tried long breaks, various stretches and exercises, arthritis cream, and cortisone injections to no effect. I gets lots of crackling and popping when rotating my wrist. Exploratory surgery is the next step according to the doc.

I've learned to mouse left handed for work and web browsing at home several years ago when the pain first started, so my game time / right handed mouse use is generally limited to just 2-5 hours a week.

I was wondering if anyone here has dealt with similar issues or can assist me in tapping into the collective intelligence of the internet for ideas. I've attached some photos of where I feel pain and how I hold my gaming mouse. I don't "think" I'm contorting my hand in any crazy way.


Orange is where I feel pain. Red is where it is most severe. MRI showed only "minor" TFCC degradation.
hand-pain-1.jpg


Mouse grip from above:
grip-top-1.jpg

Bottom view. I let my ring and pinky finger drag on the mat for control:
grip-bottom-1.jpg


Any ideas appreciated.
 
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sharknice

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What DPI, and other mouse settings do you use? Do you mainly just move your wrist when using the mouse?

Using high DPI and sensitivity (which is basically the default settings now days) is much, much harder on your hands and wrists than using lower sensitivity and arm movements.
Using lower sensitivity and DPI is also better for accuracy. It's just better in every way assuming you have at least a square foot of room for your mouse surface.


Another big thing is the height your mouse surface is at. Ideally you want it just barely above your legs.

People usually have the arm rests on their chair way too high which has a big affect too.

This is what it should look like
20210522_162303.jpg
 

toast0

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How long is a long break, and do you not have pain when you're on a break, but it starts back right if you start right mousing again?

At one of my jobs, we had a real ergo department, and you could go down there and try all the things (desk height, keyboard and mouse surface height, monitor height, different keyboards and pointing devices, chairs, foot stools, etc, etc) and they'd order you stuff to use day to day. I don't know if you can get that experience from a free agent ergo consultant, but it's worth looking around to see if you can find someone in your area with this body of knowledge.

But I'd really suggest trying as many mouse shapes and trackballs and stuff as you can get your hands on. Adjusting the surface height and reach so your elbow is close to 90 degrees and your forearm is close to parallel with the ground is a good start, and then you want your wrist neutral. You'll probably need to try a bunch of mice to find one that fits you, which is a pain because it's hard to find a lot of mice in one place. And everyone seems to like tiny ass mice these days.
 

doubletake

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Knew a person who used to use a weightlifting wrist strap (though there are better things to use for this purpose) to help compress and immobilize his wrist while mousing, which alleviated a lot of discomfort. He used it as an interim solution while still using regular mice before eventually making the switch to some other ergo solution, I think a trackball (large multi-finger type, not the side-mounted thumb type).
 

trick0502

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I find for me personally I like to have my arm on the desk. I put my monitor as far back as I can and put my mouse pad all way forward. This way my elbow is almost on the desk. I feel no stress in my wrist.
 

michalrz

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cortisone injections

Exploratory surgery
No. That's how you START having serious problems.

As I'm looking at the photos showing how your grip is, I have this impression you seem to have to actively maintain a high amount of strain of all the individual muscles. Also, your fingers extend well beyond the front of the mouse, and those two things suggest your mouse is actually too small.
I have small everything and a MX518 on which I can't even reach the left-side front thumb 'arrow'. But, my whole wrist area also rests on the mousepad, my arm rests on the armrest, and it's mainly the fingers that do the work.

BTW, you might want to look at your setup as a whole, chair included. Weird back arching and all that can actually cause overcompensation strain in other parts of the body.
 
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Bop

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I'll try to answer questions and comments in order:

What DPI, and other mouse settings do you use? Do you mainly just move your wrist when using the mouse?
400 DPI. I try to normalize the sensitivity in all FPS games to the equivalent to CS:GO's value of 2.1. ~50cm/360. At that value I have to use my arm. I do make small adjustments with my fingers and wrist for precision. However, when I was younger and the high DPI mice first started coming out I spent too much time with bad grips and high sensitivity in Q3 and UT.

Another big thing is the height your mouse surface is at. Ideally you want it just barely above your legs.
This is something I learned just a few years back. I have a sit/stand desk now and the desk height is just above my legs. As a general response to the comments regarding setup, here is a picture:
desk-1.jpg


How long is a long break, and do you not have pain when you're on a break, but it starts back right if you start right mousing again?
I had a really long break after my first kid was born. Talking 3 weeks until I started work again and at least month before I started gaming again. Then and now I do still have some pain during breaks. It almost always aches during the night. Gaming sessions do ramp the pain up immediately, undoubtedly.

get a more ergo mouse or track ball.
I have a left handed vertical mouse for light gaming and browsing, but for anything remotely competitive (PUBG, CS, Warzone) I need my thumb, pinky, and preferably my ring finger dragging on the mat for control. I haven't found an ergo mouse yet that lets me do that. I'm trying to learn how to not use my ring finger for control and let it hang on the side of the RMB. The Zowie EC2 was the closest semi-ergo mouse that I still felt I had some control with.

As I'm looking at the photos showing how your grip is, I have this impression you seem to have to actively maintain a high amount of strain of all the individual muscles. Also, your fingers extend well beyond the front of the mouse, and those two things suggest your mouse is actually too small.
I paid more attention to what I do to my hand while gaming. I definitely tense my fingers up way too much when I see a target. I think it's even detrimental competitively, because I crushed my AimLabs records when I forced my hand to relax. I wouldn't be surprised if this is a big part of the problem (especially if it is tendonitis). My current mouse is too small if I attempt to full-palm it. My hands are pretty small, however. 17 x 9cm. I've never found a mouse that I would call comfortable.

I had a MX518 for years when it first launched, but I would stretch my ring finger over the side for control. Bad in hindsight. When I take a good look at my hand, the way my middle and ring finger are jointed they naturally want to stick next to each other compared to my other fingers. Zero gap compared to the middle/index and pink/ringy. I've probably been unnaturally stretching them for decades. The Finalmouse UL2 is great for my old grip until the pain kicks into high gear. And I managed to nab a small Starlight-12 at launch :( The hunt continues.
 

sharknice

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Maybe arm rests on your chair would help. My elbow rests on the chair arm rest and not only relieves a lot of strain from my muscles, but forces my forearm to be parallel with the surface. If you don't use an arm rest your elbow can easily drop below the mouse surface which will cause extra strain on your wrist. You want your elbow even with your hand or if anything slightly above.

Also I'm not sure if it's just how it's setup at the time of the picture, but you want your mouse more centered so your arm and wrists aren't forced at an angle. The right side of your keyboard should be at the center of your monitor. You have a spit keyboard so you could just move the right side out of the way while you game. Keeping your arm straight puts the least amount of stress on it, angling your arm outward to the right puts the most strain on it, if it's pointing toward the middle it isn't as bad.
Basically you want to be sitting facing straight ahead, upper arms at a slight angle away from your body, and forearms facing straight ahead.
 
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I find resting the elbow on an arm rest helps a LOT, and keeping a natural wrist posture while using the mouse. That may interfere with your arm-mouse movements, but try this experiment while sitting: try to keep your hand pointed in the same place in the air and move it left to right a couple feet, you'll see the wrist is the pivot point. You can point your index finger straight forward, try to keep it from tilting while moving that hand side to side. All of those side to sides' with a mouse could be aggravating the area.

I personally use wrist pivot with higher sensitivity, resting my pinky and ring and wrist GENTLY on the mouse pad. I find the finer pivoting less aggravating than using a whole-arm low DPI grip. A wrist brace may help reduce the amount of bending you do at the wrist, but you may find your side to sides arching since you can't compensate for mouse twisting by bending at the wrist. A lower Y sensitivity will help reduce the arching, as will angle snapping but that can take a lot of practice to get dialed right and most gamers prefer it off.

The goal regardless is to keep the most natural wrist positioning you can throughout use, with minimal pressure applied to it or through it. If you are shoving the mouse down to keep your wrist and elbow hovering, you still transfer that load through the wrist. From your photos it looks like you have your hand bent towards the pain, if you move the mouse horizontally away from your body it would open that side up more.

Either way, good luck. If it isn't a competitive FPS I would also recommend trying out a controller. I've found some games are more enjoyable with the controller than a keyboard and mouse - albeit they are single player games.
 

Bop

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Maybe arm rests on your chair would help.
I'm not sure how effective this would be since I rest my whole forearm on the desk during gaming. It does bring my arm out of a 90 degree alignment with my body, though so maybe not the best position ergonomically. The chair came with arms so I can always put them back on.
You have a spit keyboard so you could just move the right side out of the way while you game
Already do ;)

I personally use wrist pivot with higher sensitivity, resting my pinky and ring and wrist GENTLY on the mouse pad.
I'm beginning to realize how important it is to be more gentle handling the mouse. I think I've been holding it too tensely, which jacks up to 11 when I play a game and see a threat. I've moved my ring finger off the mat because that requires a stretch and I'm trying to keep it next to my middle finger.
 

sharknice

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I'm not sure how effective this would be since I rest my whole forearm on the desk during gaming. It does bring my arm out of a 90 degree alignment with my body, though so maybe not the best position ergonomically. The chair came with arms so I can always put them back on.

Already do ;)


I'm beginning to realize how important it is to be more gentle handling the mouse. I think I've been holding it too tensely, which jacks up to 11 when I play a game and see a threat. I've moved my ring finger off the mat because that requires a stretch and I'm trying to keep it next to my middle finger.

My grip is basically the same as yours. My pinky touches my mouse but the tip of my finger drags on the mat, my ring finger stays on the side of the mouse and sometimes the tip touches the mat. I'm don't grip hard or particularly light. Resting your elbow on the arm rest versus your forearm on the desk might help loosen your grip.

Since the tense grip is more of a subconscious thing because you're focusing on gaming. You might just need to focus a lot on making sure you're not gripping too hard. Set some sort of timer that goes off every 5 minutes reminding you to relax your grip while you're gaming. Eventually you'll get used to it and a more relaxed grip will be your default.
 

Bop

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My grip is basically the same as yours. My pinky touches my mouse but the tip of my finger drags on the mat, my ring finger stays on the side of the mouse and sometimes the tip touches the mat. I'm don't grip hard or particularly light. Resting your elbow on the arm rest versus your forearm on the desk might help loosen your grip.

Since the tense grip is more of a subconscious thing because you're focusing on gaming. You might just need to focus a lot on making sure you're not gripping too hard. Set some sort of timer that goes off every 5 minutes reminding you to relax your grip while you're gaming. Eventually you'll get used to it and a more relaxed grip will be your default.
Seems like grip tension is the most likely cause right now. I actually just had a follow-up appointment with the orthopedic doctor. He said the most likely diagnosis is tendonitis, but he's referring me to another doctor for a second opinion. I'm going to try to take it easy for a few days and practice keeping my ring finger off the mat and keep it as close to my middle finger as I can. My pinky will probably start getting sore once that is the only control finger on the right hand side.

The next thing I'm trying to experiment with is the proper grip width for the mouse. In my experience smaller mice equals better control with the possibility of cramping the hand. I have a wider hand with shorter fingers so finding a good shape is almost impossible.
 
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Amazon has a good return policy, you could always throw a couple versions on credit and find what fits your hand the best.

Or just make a neutral hand shape and measure the width of your palm area, then compare it to mouse options. If you have to open or close your hand too far from it's natural position that'll cause strain too.
 

mda

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I have had pain exactly where you described - the outermost fingers where you feel it but no pressure or anything seems to alleviete it for long.

If our condition is the same (cubital tunnel syndrome), try the following:

Youtube videos of (Ulnar) nerve flossing, follow the exercises, repeat the most painful ones daily for a few weeks (the ok sign exercises hurt the most for me), and hopefully it will work for you as it did for me. You'll know if this is working almost immediately when performing the exercises when it hurts more on your mouse hand/arm side than the other.

Hopefully will save you some bucks on doctor consultations and other treatment as well. If this solves your problem, kindly send a 3080 my way (3090 also accepted). Kidding aside, I sincerely hope this fixes your issue. Surgery as an alternative is not something I'd want, and I also tried everything from replacing mice to 'resting' and reducing PC time while this 'fixed' my issue within a month of exercises, which are very easy to do.
 
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Wiz33

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As everyone have already said. Posture is very important. but I have also learn a few other tricks when I was dealing with the same problem. Do not use any of the weight they give you for many gaming mouse. they're suppose to add weight and give you better control but they also increase stress to you hand muscles. Use a loose grip to hold your mouse. don't try to hold your mouse to tight.

If changing you seat/table height and posture does not fix things. Try a vertical mouse but they are usually not made for gaming except a few

https://www.amazon.com/ZLOT-Vertica...07T3PFWCB/ref=cm_cr_arp_d_product_top?ie=UTF8

https://www.amazon.com/J-Tech-Digit...0759V6FZC/ref=cm_cr_arp_d_product_top?ie=UTF8

https://www.amazon.com/Logitech-Ver...keywords=vertical+mouse&qid=1622229270&sr=8-3

Another possible fix is a armrest extension that attach to your table:

https://www.amazon.com/SUNNY-HEART-...07ZDGNYDP/ref=cm_cr_arp_d_product_top?ie=UTF8

You can also get a Gel, Memory Foam wrist rest or a mouse pad with a wrist rest built in:

https://www.amazon.com/VANKEY-Mouse...09258ZHM2/ref=cm_cr_arp_d_product_top?ie=UTF8

https://www.amazon.com/Kensington-D...018GFBCO8/ref=cm_cr_arp_d_product_top?ie=UTF8
 
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Bop

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I have had pain exactly where you described - the outermost fingers where you feel it but no pressure or anything seems to alleviete it for long.

If our condition is the same (cubital tunnel syndrome), try the following:

Youtube videos of (Ulnar) nerve flossing, follow the exercises, repeat the most painful ones daily for a few weeks (the ok sign exercises hurt the most for me), and hopefully it will work for you as it did for me. You'll know if this is working almost immediately when performing the exercises when it hurts more on your mouse hand/arm side than the other.

Hopefully will save you some bucks on doctor consultations and other treatment as well. If this solves your problem, kindly send a 3080 my way (3090 also accepted). Kidding aside, I sincerely hope this fixes your issue. Surgery as an alternative is not something I'd want, and I also tried everything from replacing mice to 'resting' and reducing PC time while this 'fixed' my issue within a month of exercises, which are very easy to do.
Thanks for the video recommendation. I tried those exercises and I actually had a decent day in terms of pain levels yesterday. The tai chi motion and the waiter's exercise definitely caused more pain on my mousing side. I had a visit with the other specialist for a second opinion and he believes it is nerve related. Wants to conduct an EMG test next.

Amazon has a good return policy, you could always throw a couple versions on credit and find what fits your hand the best.

Or just make a neutral hand shape and measure the width of your palm area, then compare it to mouse options. If you have to open or close your hand too far from it's natural position that'll cause strain too.
Did that. :) I keep many of them as well because I'm constantly changing my mind. I'm going between the Finalmouse UL2 and the Logitech G Pro X right now. The UL2 gives my pinky a workout because of the smaller width so I'm using the G Pro X right now. I'm going to try the Starlight-12 when it comes in, but I'm wondering now if I should've order M instead of S.

As everyone have already said. Posture is very important. but I have also learn a few other tricks when I was dealing with the same problem. Do not use any of the weight they give you for many gaming mouse. they're suppose to add weight and give you better control but they also increase stress to you hand muscles. Use a loose grip to hold your mouse. don't try to hold your mouse to tight.

If changing you seat/table height and posture does not fix things. Try a vertical mouse but they are usually not made for gaming except a few
I cannot go back to any mouse over 65g after using a Finalmouse Ultralight! I use vertical mice for light gaming and work, but for anything competitive I need a traditional mouse.
 
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SmokeRngs

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I almost guarantee the issue is nerve related because it sounds like what I have. When I was diagnosed it was called Ulnar Nerve Neuropathy although they call it something else now. It's an issue with a nerve in your elbow which runs all the way down the arm to those two fingers. The nerve is also colloquially known as the "funny bone". When you smack your elbow against something and it hurts like hell shooting pain down your arm, you've hit your "funny bone" which is the nerve I was talking about.

Your symptoms aren't the same as what I tend to run into but there's enough similarity to make me think it's the same thing. When I have issues with it I tend to have more numbness but if the numbness lasts a while pain will set in. In my case it tends to happen most often when the elbow is bent and I have pressure on the elbow such as lying down on my side and my hand holding up my head. It also will happen if I lean forward with elbows on the desk and my head resting on my hands. I used to do that quite a bit at work years ago which is likely how the issues started for me. There's not a whole lot you can do about it other than to avoid actions, movements, etc. which aggravate the condition. Surgery can be done to relocate the nerve so it's less likely to have issues but it's not 100% effective and it's not truly a fix as the problem almost always comes back eventually if you don't fix what was causing the problem in the first place. Also, it usually needs to be very bad before they will do surgery for it.

I also recently had an issue with my thumb and wrist with many of the same symptoms as yours. My thumb and wrist would pop a lot with quite a bit of pain for both. It was a nerve issue as well but not related to my other nerve issue. Using the mouse, especially for gaming caused quite a bit of pain. It took a while to track down what was causing it and it was how I had my hand positioned to support my head when I slept. I stopped sleeping like that, cut down on gaming for several days and had a prescription for a steroid (which was prescribed for a different issue) which mostly knocked it out. A few more days of resting the hand from most but basic tasks and it healed up on its own and shouldn't be a problem as long as I don't use that hand to support my head while sleeping.

You might be able to get a prescription which can help with the pain but it's not a solution and will only cover up the pain. You'll need to look at every little thing you do and adjust how you do things with that arm and hand in order to reduce and maybe eliminate the stress which is causing the problem. And I mean evaluate everything you do with that hand and arm. The way I was supporting my head with my hand didn't cause pain on its own so it didn't look like the cause but that's exactly what the original problem was.
 

mda

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I almost guarantee the issue is nerve related because it sounds like what I have. When I was diagnosed it was called Ulnar Nerve Neuropathy although they call it something else now. It's an issue with a nerve in your elbow which runs all the way down the arm to those two fingers. The nerve is also colloquially known as the "funny bone". When you smack your elbow against something and it hurts like hell shooting pain down your arm, you've hit your "funny bone" which is the nerve I was talking about.

Your symptoms aren't the same as what I tend to run into but there's enough similarity to make me think it's the same thing. When I have issues with it I tend to have more numbness but if the numbness lasts a while pain will set in. In my case it tends to happen most often when the elbow is bent and I have pressure on the elbow such as lying down on my side and my hand holding up my head. It also will happen if I lean forward with elbows on the desk and my head resting on my hands. I used to do that quite a bit at work years ago which is likely how the issues started for me. There's not a whole lot you can do about it other than to avoid actions, movements, etc. which aggravate the condition. Surgery can be done to relocate the nerve so it's less likely to have issues but it's not 100% effective and it's not truly a fix as the problem almost always comes back eventually if you don't fix what was causing the problem in the first place. Also, it usually needs to be very bad before they will do surgery for it.

I also recently had an issue with my thumb and wrist with many of the same symptoms as yours. My thumb and wrist would pop a lot with quite a bit of pain for both. It was a nerve issue as well but not related to my other nerve issue. Using the mouse, especially for gaming caused quite a bit of pain. It took a while to track down what was causing it and it was how I had my hand positioned to support my head when I slept. I stopped sleeping like that, cut down on gaming for several days and had a prescription for a steroid (which was prescribed for a different issue) which mostly knocked it out. A few more days of resting the hand from most but basic tasks and it healed up on its own and shouldn't be a problem as long as I don't use that hand to support my head while sleeping.

You might be able to get a prescription which can help with the pain but it's not a solution and will only cover up the pain. You'll need to look at every little thing you do and adjust how you do things with that arm and hand in order to reduce and maybe eliminate the stress which is causing the problem. And I mean evaluate everything you do with that hand and arm. The way I was supporting my head with my hand didn't cause pain on its own so it didn't look like the cause but that's exactly what the original problem was.
Hi sir,

Not sure if you read my above post but if you are still having symptoms, I can't recommend the exercises enough (it's free and just about 0 risk) to anyone with similar symptoms.
 
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Bop

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My update after a few weeks of trying some new things: I did the exercises in the video, but things were hit or miss improvement wise. I was still subconsciously gripping the mouse too hard during tense moments even when I tried not to. It got pretty bad with the Starlight 12 so I went back to my G Pro X and the pain decreased.

I think the additional width prevents me from tensing too hard with my pink and ring finger. I play worse with the G Pro X, but I'd rather have less pain. I'll try the medium size SL12 when Finalmouse releases the next wave, because I really like the shape and weight. I remeasured my hand and it actually seems wider than average, but I have shorter fingers which makes finding the ideal mouse shape a PITA. I'm continuing to do the exercises.
 
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