Ergoblog

B-12 Deficiency Can Cause Numbness & Tingling in Hands (Among Other Symptoms)

I'm always interested in causes behind symptoms that often get lumped in under "repetitive stress injuries" (RSI).  We blame typing and poor ergonomics for a lot of our woes, but when I was having a lot of trouble with hand pain, it was a matter of changing my diet, not my desk configuration.  Of course, it took a couple doctors before someone thought to have me tested for food allergies (first I had to suffer through the here-take-some-drugs-and-wear-wrist-splints phase followed by the let's-sign-you-up-for-expensive-physical-therapy-you-can't-afford phase).  That's when I found out I was intolerant to gluten and dairy and that eliminating them helped tremendously.

If you're in the same boat where you've tried a lot of the common fixes for hand/wrist/joint pain etc. and haven't found them all that helpful, it's definitely worth trying to get to the bottom--figuring out what's causing the symptoms rather than just trying to treat them.

I was recently surfing around the web and found a list of the common symptoms of vitamin B12 deficiency.  The fact that numbness/tingling in the hands was on the list, of course, caught my eye.  Here's a list of some of the typical symptoms:

1. Itchy or tingling tongue. The tongue suddenly itches from time to time without warning. This occurs on the edge of the tongue, along one side or the other or at the tip. Some individuals experience stinging, pain, or tingling instead of itching.

2. White spots in the skin, resulting from melanin becoming absent in the area. These often occur on the outside of the forearm, but may occur in other places. The longer these spots are there, the whiter they get. As time goes by, the spots become very dry and flaky to the extent that small raw spots of skin may be exposed.

3. Sharp stabbing, tingling pain in the palm of one or both hands. This occurs suddenly and for no apparent reason in a spot directly below the ring finger, approximately where the first palm crease is. If B12 deficiency is not treated, a tingling pain may begin to occur along the outside edge of the hand, starting from the wrist. This pain occurs when the wrist is extended.

4. Sores at the corners of the mouth, sometimes extending along the edge of the lip. These are raw spots, not blisters, and they tend to come and go.

5. Nerve shock in the side of the body. It can be felt coming on a few seconds before it hits, and then it hits almost like a mild but deep electric shock and quickly subsides. It can occur at the side of either hip or on either side of the upper body, along the ribs. It can occur consecutively in at least two or three locations, one right after the other.

6. Shortness of breath, but without chest pain. This can occur when walking just a few yards.

7. Eye twitch, usually in one eye or the other. It can occur on the eyelid or just below the eye.

8. Facial pain, usually on only one side of the face at a time. This pain varies so much that it would be difficult to describe all the possibilities. This can present as a dull pain in the cheek bone right underneath an eye, or a sharp shooting pain across the forehead, sometimes coming downward from the scalp to the edge of the nose by the eye.

9. Tingling along the back of one or both thighs, starting at the hips and shooting downward.

10. Memory loss and/or disorientation.

11. Migraine headaches. These may be preceded by a temporary blind spot in the center of the field of vision, usually lasting about ten minutes, and sometimes followed by facial pain under the eyes. After the blind spot vanishes, there may be zigzag streaks through the vision that may last up to hours. Even in the same person, there may be extreme variations in the headaches themselves. They may be quite severe with nausea or they may be virtually nonexistent.

This list is from the wikipedia article on Vitamin B12 Deficiency.  I assume not everyone is going to have all of the symptoms (I know I had a couple of the less common gluten intolerance symptoms and few of the common ones when I was tested for that, but eliminating it from my diet was key in getting over my RSI).  Another article on B12 anemia (from WebMD) mentions simply "Numbness or tingling in your fingers and toes."

If any of this stuff sounds familiar, it's definitely worth getting a blood test. 

There are several causes of B12 deficiency including simply not eating enough meat (vegans and vegetarians may have the problem and can take a vitamin to overcome it) or not being able to digest it sufficiently (such as may happen with celiac disease or bacteria overgrowth in the intestines). 

Taking vitamin pills may not be that effective if you're having trouble digesting B12.  Alternatives are B12 shots (which you can give yourself after a doctor shows you how and writes a prescription) or B12 patches which you can buy over the counter (or even over the web--I saw some at Amazon).

Laptops vs. Ergonomics

I've had laptops for years, and I love the convenience of being able to tote my computer around, doing a few blog posts from the couch, penning a story from bed, or just sitting on the floor next to the fireplace for some web surfing.  But I of all people should know this isn't a great idea when it comes to ergonomics.

As Wall Street Journal article, "Is your laptop a big pain?" points out, "Laptops are inherently unergonomic -- unless you're 2 feet tall."

"Most users simply set their laptops on a desk or table. The keyboard is too high, which makes your arms reach up, your shoulders hunch and your wrists bend down. The monitor is too low, which pulls your head and neck forward and down and puts a strain on your back."

And those are just the possible problems for using a laptop at a desk.  Boy, they'd have some real cuss words for me and my habit of typing from the bed, couch, floor, etc.

Fortunately, as the article points out, "That's OK if you use your laptop occasionally, for short periods."  And I use my main computer at my desk with my ergonomically-friendly Herman Miller Aeron chair most of the time.  "But if you use one for hours at a stretch -- as do millions of college students, business travelers, telecommuters, video-gamers and growing numbers of office workers -- you're setting yourself up for muscle problems that can make your entire upper body hurt."

If you're a frequent laptop user, and you're experiencing aches and pains (which could run the gamut from Carpal Tunnel Syndrome and other hand-related RSIs to headaches and back or neck pain), you may want to take a look at your choice of computer (and how you use it) and see if its a contributor to your problems. 

The Benefits of Taking Breaks Throughout Your Computing Day

When you're writing your bestselling novel, pounding out code, or raiding a dungeon in World of Warcraft (hey, we don't judge here), it's easy to sit at the computer for hours on end, barely moving more than your fingers and eyes. 

You might not think that such an innocuous position as "sitting" could be detrimental to your health, but long periods spent like this can make you vulnerable to eyesight deterioration, back and hand pain, headaches and eye problems.  And let's not forget our old friend, repetitive stress injuries (such as Carpal Tunnel Syndrome).

Breaks Bring Benefits

An easy way to combat these problems is to take "micro breaks" several times an hour while you're at the computer.  These breaks don't need to be long--even 30 seconds is better than nothing--and you'll probably find they increase your mental alertness and productivity.

Try some stretching exercises that involve the whole body and get the blood flowing.  If you can, try jumping up and down or running in place or even a few pushups. 

If you're busy working for The Man, you might not be able to get up and wander around (or start a boot-camp workout at your desk), but there are many stretches you can do while still sitting in your chair.  You can even find computer yoga programs meant to be done at your desk.

Lastly, pick up a break reminder program (just Google that for several free options) to give you a little nudge and let you know it's time to stop working.  If you're like I was, you'll be shocked at how quickly 15 or 30 minutes go by, so don't just rely on yourself to remember to take those breaks.

7 Signs It's Time to Try Voice Recognition Software

It took me a while to get used to the idea of "typing" with voice recognition software.  When I ordered Dragon Naturally Speaking (the most popular Windows-based software), I didn't have a lot of money to spare, so it wasn't an easy decision.  Also, I was afraid I'd sound stupid talking to the computer (I was right but the cats and dogs have stopped snickering behind their paws at least).

It turned out to be worth buying the software for me, and I got over feeling stupid talking to the computer (most of the time). 

Is voice recognition software for you?  This list (not to be taken too seriously) might help you decide...

7 Signs It's Time to Try Voice Recognition Software

1. Your Carpal Tunnel Syndrome is so bad, you've got the mouse on the floor and your shoes off so you can point and click with your toes (yes, I really did this).

2. You have dyslexia and you're tired of squiggly red lines appearing under every other word you type (as long as the software can recognize your words, it can spell them).

3. You couldn't type slower if you tried.  There must be something wrong with those nerds who zip along at 90 wpm and don't even have to look at the keyboard--they're probably pumped on Rockstar or something.

4. You've always dug the idea of talking to your computer and even now, you're remembering all those Star Trek episodes where they just say, "Hello, computer" and never have to weary themselves touching actual buttons.  

5. You'd like to be able to take "notes" in the car without cussing because your pen flew under/between the seats, never to be seen again (for the 8374th time).  Many voice recognition software packages can allow you to upload recordings you do with portable devices.

6. You have the patience to spend a couple weeks training the software to recognize your voice.  You can start using it on Day 1 (my version of Dragon had me read a couple pages out loud first), but these programs do take time to learn your voice nuances.  There will be more errors in your first days using it (errors that are somewhat tedious to correct).

7. You don't have cats who will chew through the cords of your headphones (been there... twice), or you're prepared to cat-proof your home office (good luck with that and let me know how it goes).

If any of these signs apply to you, and you're a PC user ready to give voice recognition a try, you can pick up Dragon from Amazon for less than $100:

Dragon NaturallySpeaking 9 Preferred

That's a link to an older version--there's a 10 out, but many reviewers at Amazon are reporting technical snafus with it.

If you're a Mac user, you can give MacSpeech Dictate a try.  I'll actually be buying this and checking it out soon myself, as I finally dumped my last Windows computer and bought an iMac last week.

Does anyone have experience with these programs that they'd like to share?  Or are there others you've tried and liked?  Please post in the comments below.

Before You Buy an Ergonomic Keyboard... Is Your Typing Style Causing Your Pain?

I've had several ergonomic keyboards over the years, some costing as much as $300, eep.  An ergonomic keyboard was actually the first thing I tried when I started having hand problems.  (Yeah, I'm one of those folks who never thought of anything ergonomic until after I started having pain.) 

I've since learned (several keyboards later) that a keyboard may not be the answer for everyone.  In fact, equipment may have little to do with your problems at all.

Hours at the computer and our posture while there can play a big role in our problems.  Heck even our typing style may be the problem (or at least part of it).

Do you have a problem typing style?

Here are some common typing/mousing techniques that can lead to repetitive strain injury problems:

• Resting the base of your hand on the wrist rest or desk -- this places pressure on the now infamous carpal tunnel and also isolates the small hand muscles, forcing them to do work that's better off shared with the larger shoulder and elbow muscles.
• Leaning your elbow on the desk or chair arms -- this puts unnecessary pressure on the elbow's ulnar nerve.
• Gripping the mouse too firmly -- unless you're surfing the web on a particularly turbulent airplane flight, that mouse isn't going anywhere... don't hold on tightly or use excessive force for gripping. 
• Pounding on the keyboard -- This can lead to tingling in the finger tips and joints (or in my case, all around achy hands).  I blame this one a bit on keyboards, as some require an undue amount of force to depress the keys... I can always tell these guys because my hands will ache after a short time using them.  I imagine that they can be troublesome even for healthy hands.  If you're pounding or clacking, see if it's your keyboard or just a bad habit. 
• Extending your thumb or pinkie finger -- Do you tend to stick one finger out stiffly when you type?  Maybe one of those ones that doesn't get used that often?  Separating these fingers from the rest can cause strain on the tendons of all the fingers.

Okay, enough on the wrong ways to type.  What does an ergonomically correct typing style look like?

Proper typing technique

• When typing, keep your fingers relaxed and slightly curled as if over a ball (Remember taking piano lessons as a kid?  Similar stuff!)
• Avoid a wrist rest or only use it as a guide that the wrists slide over (rather than laying on)
• Keep your fingernails short (that means you too guys!) so you can type with the pulps of your fingers.
• Hold the mouse loosely and move it with the larger elbow and shoulder muscles rather than just the wrist.
• Use the whole arm to reach keys that are farther from home row (don't stretch fingers awkwardly).
• Keep the wrist in a neutral position (your hands shouldn't tilt up to reach the keys)
• Don't stretch the fingers awkwardly to perform shortcuts that require hitting multiple keys at once (instead use a finger from each hand).

Just take some time and be aware of how you're typing on a daily basis.  You might be surprised at how much tension you hold in your shoulders, neck, wrists, and arms.  If you need to, take breaks to stretch at your desk (if you can, get up and walk around and get all your muscles moving) and get the blood flowing a bit.  This can help ease some of that tension that gathers over a day of computing.

Remember, just getting an ergonomic keyboard probably won't fix your hands if the problem is with the way you type!

Source: Typing Style

The RSI-Gluten Connection--Is Your Diet Causing Your Pain?

Long time readers of Ergoblog (or those who have mastered the art of browsing the archives) will know that I started out having all sorts of trouble with repetitive stress injuries in my hands, as well as some other health problems (acne, acid reflux, migrains, insomnia, and back pain for starters--I sure was a wreck!).  After paying way too much for mediocre medical advice, drugs, and physical therapy (read: big time debt for someone who couldn't work because she couldn't use her hands without pain), I found a natural doctor who thought to have me tested for food allergies. 

My results were almost off the charts for sensitivies to gluten, dairy, and eggs.  When I eliminated these foods from my diet, my symptoms improved vastly, as in 100% if I was very good about avoiding these foods. 

And when I'm not good?  As you can imagine, it's hard to avoid all those foods all the time.  Gluten and whey (a milk product) show up in a lot of foods.  I recently went on a cruise to Mexico, and I decided I'd let myself break some of the rules, instead of just eating fruit, fish, and vegetables (they try to accommodate food allergies on cruises, but don't expect them to have a lot of specialty gluten-free foods). I let myself be particularly bad for some of the extra yummy treats (hello, chocolate buffet cannot be avoided!). 

Needless to say, my hands were pretty achy by the time I got back, and some of my acid reflux symptoms were showing up at night.  Sometimes I almost envy those folks who go into anylphylactic shock when they eat a food they're allergic to, because they have to avoid it (no, I don't really envy them, but it can be hard to be good all the time when there aren't any immediate dire results).

All this just emphasizes the food intolerances-RSI connection for me.  When I've done research, I've found that gluten intolerance in particular is very common for folks (something like 1 in 8 people are suspected of having a sensitivity, enough though they may not know it).

For those who don't know, gluten is found in wheat (which is almost as pervasive as soy and pops up in all sorts of food products you wouldn't suspect), rye, and barley. 

Today, for your reading pleasure, I'm providing some links to articles on gluten intolerance.  If you have RSI, or any other chronic health symptoms that your doctor can't pin down, you may want to do some reading.  I also highly encourage you to get tested for food allergies (it only cost me about $100 to have a blood test done, which checked me for sensitivities to the 100 most common foods in the western diet). 

While it's possible to do an elimination diet on your own, but solid results can be elusive if you end up having multiple food sensitivities.  (Many gluten free foods use soy, corn, or other grain substitutes, but soy and corn are also foods that many people have trouble with).

Further reading on gluten intolerances:

Gluten Intolerance FAQ -- This page starts out with answers to commonly asked questions and goes into some more information on gluten and celiac disease.

Signs & symptoms of gluten intolerance -- My symptoms aren't the most common, so check here to see if any others plague you. 

Could you have undiagnosed food allergies? -- Even more symptoms that can be caused by undiagnosed food allergies (gluten isn't the only thing that could be causing your pain)--even those dark circles under your eyes could be from your diet!

Please leave a comment and tell us your story if you've found a connection between gluten (or other foods) and your health problems.

Apple MacBook Pro Review (from the ergonomic perspective)

I bought an Apple Macbook Pro this summer, and I've been meaning to post a review for a while, so how does today work for everyone? ;)

I'm a writer, not a techie type, so I won't go into specifications and hardware and the like.  I'm going to hit on the ergonomics perspective.  Is this laptop friendly to hands and eyes (and any other body parts you may employ when typing)?

Ergonomics is one of the reasons I've been drifting more and more toward Apple products.  I have an Ipod (a couple) and an iPhone, and I find them to be a pleasure to work with (ergonomically speaking) compared to other devices I've had that perform similar functions.  I am impressed with the simplicity and user-friendliness of the iPod and iPhone, and it is a big reason I settled on the MacBook Pro.  Also... the laptop is sleek and pretty (hey, I'm a girl--what do you expect?).

So, let's talk ergonomics (from the viewpoint of someone who has had trouble with RSI over the years).

MacBook Pro Keyboard and Mouse

The keyboard and the mouse are the features of a computer that are most likely to make me complain. 

I've used keyboards that take way too much force to press down the keys, and it'll have my hands aching before long (this is my RSI Achilles heel).  And on many laptops, where the keyboards are smaller than traditional, I'll often feel that I have to hold my hands unnaturally in order to type.

I'm pleased to be able to say that the keyboard on the MacBook Pro is a pleasure to type on.  Keys respond to a light touch, and even though I got the smaller of the two screen size versions, the keyboard doesn't feel too small.

I will say that as a long-time Windows user, I do find myself missing the home/end keys a lot.  Some of the two-finger keyboard shortcuts I'm used to on Windows keyboards take three on the Mac which feels a bit awkward to me.  I'm still learning how to use the MacBook efficiently though, so it may be that I will find better workarounds. 

I also like the mouse (touchpad).  I've hated touchpads in the past (and don't get me started on those pencil-eraser-looking pointers on earlier laptops), so I'm always ready to glare at that feature on a new laptop.

Initially I thought the button was a bit tough to press on the Macbook Pro touchpad, but I hunted around and found that you can set the touchpad to respond to a tap (my previous experience with the no-longer-made iGesture touchpad made me think of this).  So now I just tap the touchpad once to "click" the mouse, and I ignore the button. 

The MacBook Pro touchpad also shares some of the other gestures from the old iGesture (I couldn't tell you whether this is by accident or design).  For example, you can sweep a couple fingers across the pad to move forward or back in your browser window. You can also scroll up or down this way.

This is the first laptop I've had where I didn't feel the need to carry an external mouse along to plug in.

One bonus feature that I didn't know about until I got the laptop home is that the keyboard is light sensitive and illuminates in a dark room.  Now, I would never advocate typing in the dark (eyestrain, people!), but if you've got to do it (working on an airplane during the night or some such), having the letters on the keys illuminate sure makes it easy.  Hey, even touch-typists can lose home row in the dark. 

I also dig that the little Apple logo on the case glows in the dark too (no ergonomic function here, but it's still cool).

MacBook Pro Weight

While I don't travel as much as many people, I do board planes a couple times a year (hey, a professional blogger needs her vacations!), and I like to take my laptop with me, so weight is always a consideration.  This is another of the reasons I was drawn to the MacBook Pro.

I bought the 15 inch display (I avoid larger screened laptops because they're too hard to open fully and use well on an airplane), and it is 1 inch thick and under 5 and a half pounds.  I use a backpack to tote my laptop and related gear around, and I barely notice the weight. 

MacBook Pro Display

This is probably my one gripe with the MacBook (and if a techie type reads this and has a solution to fix this for me, I'm all ears!): the default display is 1440 by 900 resolution which makes things small. 

I'm used to a 19" monitor that runs a 1024 x 768 resolution, which is just right for me (alas I don't have perfect eyes any more).  I often find myself hitting the keyboard combo that increases the font size on the screen, which tends to make web pages look funky.

You can, of course, adjust the resolution of the MacBook Pro, but when I tried other settings, the text lost its sharpness and things were noticeably blurry.  If anyone has suggestions on how to make the display a little more eye-friendly, I'd love to hear them.

Overall, though, I'm pleased with the MacBook Pro, and when it's time for me to upgrade my desktop computer, I'll probably switch to a Mac in that department too. 

What Do You Want to See from Ergoblog?

After a year or so of not posting here much, I've been wanting to get back to this topic and post more often (and maybe even give this site a needed design update!). But what I'd really like to know is what you all want to read about?

I've gone from having repetitive stress injuries and joint problems to the point that I could barely work at the computer to getting that largely resolved (for more on the how, read my old post on how undiagnosed food allergies were causing my RSI and several other health issues). I've read quite a few books on Carpal Tunnel Syndrome/RSI and office ergonomics, and I've tried lots of funky ergonomic chairs, computer peripherals, keyboards, etc.

Given my background, is there anything in particular you'd like to get information on as this blog goes forward?