Most of us spend a significant portion of our computer activity using the mouse as an interface.  Although typing excessively has been linked to carpal tunnel syndrome, recently I have been treating more tendinitis and nerve injuries caused by mousing activity rather than by keyboard use.  Using the mouse improperly can cause tendinitis at the wrist or at the elbow.  It can also cause a nerve compression in the forearm muscles known as radial tunnel syndrome.  Here are some tips that may help ease mousing pain.

• Hold the mouse lightly.  Most of us tend to grip the mouse tightly.  Try to relax the grip and use only as much force as is necessary to maintain control. 
  
• Place the mouse close to your body.  If you do not use the 10-key function of the keyboard, consider using a mouse bridge that positions the mouse over the 10-key section of your keyboard. 
  
• Place the mouse at the same level as the keyboard.  Due to space constrictions, most people place the mouse up on the desk rather than on a keyboard tray.  Reaching for the mouse in this manner can cause pain in the elbow and shoulder.
  
• Use a mouse and place it in a position that allows you to maintain a neutral wrist position.  The wrist should be flat, not bent forward or back; the middle finger should be in a straight line with the forearm so that the wrist is not angled to one side or the other.
  
• Move the mouse by using the larger muscles of the forearm and elbow rather than swiveling the wrist.  The elbow and shoulder muscles are larger and tolerate more activity than the smaller wrist muscles.  You will also reduce friction in the tendons as they pass through the wrist by reducing the amount of movement in the wrist.
  
• Avoid resting on the wrist rest.  Use the wrist rest as a guide to helping keep the wrist neutral.  Float over it while typing or mousing.  Actually resting upon the wrist rest can cause pressure over the carpal tunnel and restrict blood flow.  Avoid leaning on the desk or arm rests for the same reasons. 
  
• Avoid wearing a tight watch, bracelets or sleeves with tight elastic so that circulation is not compromised.
  
• Try an ergonomic mouse.  There are numerous mice on the market now that allow you to place your forearm in a neutral position (the “hand shake” position) instead of palm down or semi-neutral position.  These ease the stress at the elbow.
  
• Click Gently.  Most of us tend to use a lot of force when clicking the mouse.  Use only as much force as is necessary.  Let the fingers relax gently on the mouse buttons.  Do not hover the index and/or middle finger stiffly over the buttons.
  
• Take frequent stretch breaks.  Stretch the forearm muscles.  Turn palm up.  Stretch the arms open out to the side.  Stretch the muscles into the opposite position of your working position.

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing at the Hand Therapy & Occupational Fitness Center in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.