Voice Recognition Software ?

Ow. That really hurts. Shoulder, back, forearm. Ouch. 

Self medicate. Ibuprofen (doesn’t help) Alleve (double over the counter dosage) Flexaril (prescription). 

IlistenWait a month.

Doesn’t get better.

Go to the doc.

Hmmm, I don’t like that popping sound.

X-rays, MRI.


Torn rotator cuff (minor), torn shoulder cartilage (major), compressed vertebrae  (minor), pinched nerve  (could go either way), major pain in shoulder, down the right arm.

Ask Orthopedist "Surgery?"

Doc Shapiro (real name) says "Well, let’s do everything we can to avoid it."

Physical therapy, massage therapy, acupuncture.

Doc ‘s Advice: "Get yourself an ergonomic mouse, make sure you have good chair and desk at work, oh, and see if you can stop typing 5000 words a day, you idiot. We use voice recognition software in the medical office."


Which leads me to ask the assembled multitude a question:

I need a dictation/transcription program. In the office, a Dell running XP (no plans for Windows Vista anytime soon). Fujitsu Lifebook P1510d touchscreen laptop (also XP). 

At home, an Apple iMac and a iBook.

The two pictured nearby seem pretty well reviewed: For the Macs, iListen, and for the Windows PCs, Dragon Naturally Speaking.

Does anyone have any specific pros or cons about these, and or any other suggestions?

(My shoulder/arm thanks you . . . )

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  1. Tim commented on Aug 22

    You mean, YOU have to type all of your own posts? I’m shocked! I had the image that BR has a legion of long legged beauties at the ready to type and post for him. Then plays golf rest of the day.

  2. Marty commented on Aug 22

    The Dragon product is very good. Accuracy is excellent and will improve over time as it “learns” your particular speech patterns.

  3. Bob A commented on Aug 22

    1. You are very lucky to have a doctor who doesn’t just say “we can get you into surgery on Friday!”

    2. I’ve had both shoulders at different times and they do get better. It takes time. I’ve had good luck with Glucosamine/chondroitin. It might not work but it can’t hurt.

  4. zell commented on Aug 22

    I’d suggest you contact organizations for the blind who use these stuff on all levels……They’d probably be a good resource of info.

  5. Rob Dawg commented on Aug 22

    Mrs. Dawg is an RPT (Physical Therapist). She formerly worked for a world famous back specialist. He too was a surgey = failure type for the most part. The best thing she ever did for me that can be repeated and/or shared in public is the gift purchase of a real chair. Real office chairs cost at least $500 and that’s for utilitarian models. The HP-4MV printer and the chair are both a dozen years old and they remain the only items who’s cost is long forgotten but who’s value endures.

    Oh, this Mac consultant says; the iListen works. Having heard your voice and cadence and intonation under the extreme duress of being Kudlowed I venture it will work even better for you. The only problem I’ve encountered is with the phrase “the past is no guarantee of future performance.” For some reason it types out “…greatest story never told.” ;-)

  6. HankP commented on Aug 22

    My clients who use Dragon Naturally Speaking are very happy with it, as long as you understand a few things about it:

    1. Get a powerful PC with plenty of RAM – Core 2 Duo or above of the CPU, at least 1 Gb and preferably 2 Gb RAM.

    2. Get a good microphone, not a $10. POS.

    3. Be prepared to train it – not just the initial training, that only takes a half hour or so – and understand that the accuracy really improves after the first month or so of using it.

    4. Be prepared for difficulties if your voice changes significantly for some reason (sore throat, stuffed nose, etc.)

    If these conditions are acceptable, you should be happy with the results. Most of my clients who have used it for over a year say they can’t imagine going back.

  7. JohnnyB commented on Aug 22

    I have a possible solution for you. It’s called copytalk. We use it in our office. talk into a voicemail and a word document is then emailed to you. You will still need to edit it.


  8. Tim T commented on Aug 22

    I was heavily involved with Dragon Systems back in the early 90s when they were just getting traction. The software has made major advances and works very well. The toughest part is the actual use – getting over sitting and talking to your monitor. If you work alone, it’s a piece of cake, but if you are around people, it’s a different story.

    Good luck.

  9. Pool Shark commented on Aug 22

    fwiw Barry,

    Mrs. Shark is a doctor who (like Mrs. Dawg’s former employer) believes surgery is only for the worst cases.

    She strongly recommends seeking high-quality PT (like Mrs. Dawg?), but avoid chiropracters at all costs.

  10. Charlotte A. commented on Aug 22

    First thing I’d do is switch the mouse to your other hand. Takes some getting used to, but in my long experience with computers, all of my wrist/shoulder/arm pain has been caused not by typing, but by the mouse. If typing caused it, you’d have the problem in both arms, right?

    Then take a vacation from your computers.

  11. whipsaw commented on Aug 22

    I haven’t messed with any speech to text stuff in years and it’s probably gotten better, but it used to be just inaccurate enough to not bother with. Anyway, text to speech was far more entertaining, you could spend hours in a sea of filth.

    Your symptoms sound more like Home Depot DIY syndrome than computer related, but I would offer that there is nothing ergonomic about using laptops unless you supplement them with a real keyboard and monitor. Chairs are important and I am reminded that maybe 20 years ago, there was somebody who was selling Recaro seats that had been converted into office chairs. Very cool and very expensive, but I doubt if you can find them any more. At least you would never fall out of one.


  12. RW commented on Aug 22

    Add a good trackball to the ergonomic mouse: Switching occasionnally from one to the other eased my wife’s repetitive motion (cubital tunnel) problems so completely she was full-motion/pain-free within a month and ever since, no surgery required.

  13. some guy commented on Aug 22


    I am currently in PT for bi-lateral shoulder problems relating to shoulder instability from abnormally lose tendons. Obviously your problems are different than mine but sitting at a desk and typing all day takes a big toll on my shoulders and PT is, and has, helped tremendously. I would recommend at least giving it a try.

  14. Jeff commented on Aug 22

    I just recently got symptoms – I was using a Trackball Explorer, but scrolling with my thumb eventually got me a lot of hurt at the base of my thumb. When it started to burn up my arm I made the switch. I got Dragon Preferred 9. I have been using it for a month and it has already paid for itself 3 times. I’m not even using most of the commands – you can cut your typing about 80% and avoid using the mouse when possible.

    The tip about the microphone is correct. The only problem I had with Dragon 9 was the cheap mike that came with it. You need a headset that sits comfortably and positively
    on your head, and a mike gooseneck that bends away from your mouth in case you want to eat something or wipe your mouth, etc., without taking off the headset.

    Dragon doesn’t just listen to your voice. It reads your writing. Make sure Your Documents only contains things you wrote when you load up Dragon the first few times. I had a bunch of foreign language documents, and Dragon sometimes very unobtrusively wonders if I want a French word (it doesn’t put it in, but I can see what it’s thinking in a little box). I don’t think it does this all the time so you can switch back later.

    You can do macro commands, and there’s an add-on called Know-Brainer that claims to give you much more powerful commands, but I don’t mind doing light editing on the keyboard as I dictate.

    Just as important, the ergonomic mice. My choice was the Airobic Mouse (formerly Quill Mouse). It’s big. You lay your hand loosely IN it (it’s like a hand “holster”) and your fingers wrap around what amounts to a vertical mouse. You move the cursor with your arm instead of your hand – look at the pictures of it and you’ll see. Then you click very gently without counter-pressure from the thumb (the buttons are very light). There’s a scroll wheel in the middle you operate with your long finger. The thumb does nothing at all.

    Even better, what used to be called Mouse Tool is now called NIB and it can be purchased with this mouse. Nib is optical clicking. You position the cursor in a time window of about a half-second (adjustable) and IT CLICKS. No button at all. For right clicks, you pass the cursor over a little toolbar that makes the next click a right click (or double click). For surfing this is the coolest because left clicks are 80% of clicking, and they’re easy to operate. The only trick is “parking” your cursor in a neutral (non-clickable) part of the web page (and some of these pages hardly have any blank space). When the Nib is on blank space it “clicks” but nothing happens.

    You can even use a “gesture”, a little jog right or left, to generate a click. Clicks only happen when you stop moving the cursor. It’s easier than it sounds and you can get so used to it that clicking feels funny.

    I haven’t even tried out the drag-and-drop feature. The trick is that you have to know where the cursor is going to go pretty exactly while the “hold” is on. But supposedly all the product material was done “clicklessly” so it does work. The easy part is getting rid of all your left clicks. The Nib can be turned off with one click in case you want to go back to clicking.

    There’s also a thing called the Zero Tension Mouse. This is similar to the Quill, another vertical mouse, but you wrap your whole hand around it like a joystick and the buttons are on the back. It also has a big dish that your hand rests in, and your arm moves the cursor. I liked the looks of this but the scroll wheel is on top for the thumb so I passed. If your thumb is OK you might like this one even more.

    The back-grip no-thumb design is taken to its extreme point with the Alpha Grip. This thing looks like a BIG game controller, but it is a complete keyboard in a radically different form. You grip it with both hands. Your thumbs hit some keys in front, but most keys are on the back – and you have to hit them without looking. Obviously this takes some retraining, and certain keystrokes require two buttons (there is a little trackball in front for your thumbs too, dead center). But the QWERTY principle is still SORT OF there, and I want to try this because you can type lying down – anywhere, as long as you can see the monitor. And instead of pronating your wrists parallel to the keyboard (bad) you’re holding things like you hold a glass (good).

    Less radical but still on my get list is the Roller Mouse. This is a front-lip-of-the-keyboard attachment that features a roller bar. You can “roll” the cursor up and down, and then by moving a finger from side to side on the bar move the cursor right and left (as with a laptop touchpad). By rolling and sliding you can approximate diagonal movement. Then normal mouse buttons are under that. I assume you can drag things with two fingers, one on the bar and one on a button – but all of these gimmicks emphasize that arm movement is good for you. They recommend short breaks when you are mousing a lot, and I find that to be good advice too.

    You’re welcome! Now how ’bout some good financial advice for a poor man?

  15. Dave commented on Aug 22

    I’ve had similar shoulder problems, it can be horrible. At worst, I went a couple weeks with only two or three hours sleep each night. I’d advise:

    * learn to mouse with the other hand. It took me a month or two.

    * get into PT and work really hard.

    * don’t use the damn mouse wheel.

    * Ibuprofen. Lots of ibuprofen.

    * get a keyboard tray for your desk.

    * work really hard at PT. As much pain as you can take as many times per day as you can make time for.

  16. George commented on Aug 22

    The biggest thing I recommend is a trackball mouse and SWITCH HANDS. You can quickly learn to use the opposite hand with a trackball mouse. I did, and it worked wonders for shoulder problem. Dragon is OK but there is a learning curve and it will probably test your patience.

  17. Johnny commented on Aug 22

    I have tried trackballs and they caused a lot more repetitive motion stress than did mice; my wrist was killing me and I had to return it within a couple of days. Tried a thumb-ball mouse with similar results. You’re offloading the pushing with shoulder + elbow to smaller joints and it just caused more pain for me.

    The wife got me a wireless keyboard with a touchpad last year so no more mice for me:

    You should have good luck with Dragon if you select it. I recommend at least double whatever the minimum required specs are. Avoid Vista like the plague it is, at least until Service Pack 1 is out…I have had significant and extremely annoying problems with it, especially in the realm of USB devices and drivers. Partly this is due to poor manufacturer support to date, and partly due to poor implementation by MSFT, but the end result is: many things that worked flawlessly under XP work poorly or not at all under Vista.

  18. Aeolus commented on Aug 22

    If you don’t have a high-end ergonomic chair, and know how to adjust the chair and your workspace, start there.

    I have a high-end ($1400.00 MSRP) chair that I bought for a fraction of its retail price at a charity auction, and that has been the best single investment in my life.

    Start with a chair, and someone who understands the relationship between chair, work surface, and mouse.

    I’ve worked with voice software, even recently, and it’s hateful if you know how to type.

  19. Todd commented on Aug 22

    Barry, I have had excellent success with similar problems by spending time with a massage therapist. I recommend you try it. As a bonus, it feels great.

  20. paul commented on Aug 22

    As a horse person – who will ride out a bucking horse – a one particular horse really would leave the ground and make a turn at the same town. Before I finally left the saddle
    I held on to the horn and did my shoulder in
    I actually heard something coming loose as i was launched into the air. I elected not to have surgery – or pt – I thought I would just live it out (the surgeon said natural healing takes longer than surgery) It was certainly more than several months until the pain was tolerable. That was in the fall of 2004 by the fall of 2005 I was 85%
    better. My shoulder today is stronger than ever. In the fall of 2004 I was 62 years old – age might have something to do with it. By the way – I had a hamburger at Peter Luger’s yesterday (at your suggestion) before I left for the west – you were correct – one of the best ever.

  21. alexd commented on Aug 22

    In addition to all the good suggestions already made I would like to add getting a foot rest to go along with the good chair. I have a plastic one made by Rubbermaid. It allows you to adjust the angle of your feet as you move. It has more of an effect on the lower back than the shoulders but we are talking strain reduction here, right?

    Also get up at least once an hour and stretch a bit. Get pt suggestions on what is best.

  22. DCM commented on Aug 22

    I sit in a Herman Miller Aeron Chair all day long and it’s done my back a lot of good. Regarding your software dilemma, I think Dragon Systems is probably better than the Apple equivalent. With that in mind, why not pick up some extra RAM and a copy of Parallels for OS X and you can use Dragon for both home and work.

  23. Aaron commented on Aug 22


    I recommend a wired, optical gamer mouse.

    A chair you can kneel in saved my back (not specifically that one).

    But most important, when you are better, go to the gym…

  24. Greg0658 commented on Aug 22

    Thanks for the LOL Rob Dawg.

    I’ve had good luck with chiropractors. Prefer the impact hammer users, and I fear the jump on you practitioners.

    I have an old Dragon v3.5 copy. Don’t have to type that much (and learn my voice) so it got shelved. Thanks for the info all.

    I was hoping the concept would have grownup by now and wouldn’t need each individuals voice recognition warmup. One of these days, these machines will be listening to a crowd and tell a user everything everybody is talking about, just like my ear and a directional mic.

  25. MichaelM commented on Aug 22

    All the comments about using a “good Microphone” are accurate…to be specific – I use a Plantronics DSP400. It has good noise canceling and since it has its own DSP – it is easier on the computer’s cpu and memory… still should have 2GB of system ram to keep as much of the program in memory as possible.

    The software (Dragon Naturally Speaking 9) is amazing and one can speak at normal speed and the program will follow along.

  26. Jon H commented on Aug 22

    Instead of a mouse get a trackball. I use the kind where you roll a ball with your thumb.

    I have a Microsoft Trackball Optical (out of production, apparently) and a Logitech trackball. Both work with my Macs or with PCs.

    It takes a few days to get proficient, but it’s worthwhile because you don’t need to move your arm at all.

    If you’re a lefty, I’m not sure what to suggest. Perhaps the kind of trackball with a large ball in the middle. I never liked those, and they seem to require more arm/hand motion (it’s kind of like playing centipede on the old arcade games.)

  27. cm commented on Aug 23

    I cannot advise on speech software, but resting the injured parts (other than prescribed PT exercises that should be taken seriously) esp. from lasting even if low-intensity stresses (posture or habit induced tensed muscles, leaning/pressing on surfaces, …) is key.

    Shifting load to the other arm bears the risk of injuring that too (possibly in a different way so the symptoms may not be the same), and it may be already weakened to begin with.

    When pain recurs/flares up, ease off immediately. It may be difficult to arrange affairs such that you will actually be in a position to do that (e.g. work implications).

    And develop awareness of posture. Getting used to better posture takes time and effort.

    Also get enough sleep or you will be compelled to slouch or lean on tables, armrests, or other surfaces, putting stress on the shoulder(s) and/or the elbow if you have to support your head (don’t laugh).

    Finally, increase your font sizes, possibly get a larger monitor, so you will not feel compelled to lean close to the screen. That (leaning forward) is one thing I see a lot in the office.

    All pretty much obvious stuff, but all too easily disregarded.

  28. Stuart Staniford commented on Aug 23

    I used iListen extensively for about a month. It takes a major effort to train it and get used to its quirks. It’s a bit buggy and crashes occasionally. OTOH, I *was* able to get it to work to a useable level, and when I could barely type, it was an absolute godsend.

    The Mac also has built in speech command recognition (check under “Speech” in preferences). It only does commands, not dictation, but it works pretty well with no training.

    At this point, I have a great PT, who has managed to get me back into good enough shape that I can type long days without needing the voice recognition.

  29. Ritchie commented on Aug 23

    What somebody else said: SWITCH HANDS!

    It has never failed to work for me and anyone I’ve suggested it to.


    Of course, don’t wait till its so bad you have to see a doctor.

  30. blowncue commented on Aug 23

    I used to be a paralegal in a big firm. Nerve conduction studies, MRI negative. So no workers comp. Now I get to go through vocational rehab. Two years of this crap so listen up: stick your keyboard and mouse in a file cabinet and lock it so you’re not tempted

    I have Dragon nine essentials from target for 30 bucks and a headset for 20 bucks from Best Buy, ViaVoice was crap on my system, get the fastest processor and RAM that you can get, after you install it practice dictation, then say mouse one…mouse two through nine, then mouse window, and speak a number and say click, then do it again and say right-click, then again and say double-click. Other commands include move mouse down, etc. at the end of the paragraph if you say drag mouse up you will highlight the paragraph.

    Think about standing and moving around while you are dictating, be careful about staying locked in one position especially when setting.

    I’ve tried various massage therapies and acupuncture. I have found physicians who have cross training in Western medicine and acupuncture a good place to start. I see a physiatrist who does acupuncture. Different people respond to different modalities, I’ve had good experience with a style originated by someone named Upledger (visceral manipulation). In the absence of a clear picture I started with the least intense intervention to avoid compounding injury.

    If you actually have to have a keyboard try a numerical keyboard that plugs into a USB port and then hit the shift button five times on Windows. Go to Mouse Keys and activate the numerical keypad allowing you to move the cursor when the number lock is off. Put in your lap. Try using a pencil to tap.

    typically you can get an ergonomic evaluation by prescription from a doctor or go to your state rehabilitation commission to get guidance on the most appropriate assistive technologies for your situation.

  31. Jon H commented on Aug 23

    Addendum: My microsoft trackball (which would be hard to find as it’s not made anymore) has a scroll wheel in the middle, two largish buttons, and then slim buttons on the outer edges of the large buttons.

    I configure those two slim buttons to perform page up and page down. That’s useful in that it avoids using the scroll wheel, which has occasionally caused problems for me when I did it a lot.

  32. strenor commented on Aug 23

    If you use a desktop, you should consider a $100 wacom tablet. they are much easier on the upper extremities than mice. I also recommend the goldtouch ergonomic keyboard. A little piece of software called RSIGuard will also automatically do clicks for you and force you to take little breaks and show you stretches throughout the day. Really good for chronic pain and injury. Good luck and get well soon!

  33. Jason R commented on Aug 23

    Dragon works well. If you go through its training and use it, you will become very proficient with it. My wife used it to create a several hundred page document. I would say that it saved her from weeks of typing.

    Keep in mind, not only will you train it, it will train you. There is a specific syntax to dictating. It is not as simple as “just speaking” b/c it needs style cues too. But I would say if you give it a month, you will never go back.

    Supposedly, Windows has voice recognition built into it and it is technology licensed from Dragon…but why be frustrated?

    I would be very curious to know about “I Speak” as I have just switched recently to the Mac platform…

  34. Bill commented on Aug 23

    I too rec a track ball , really easy on wrist. Try switching your click key on the track ball from rt to lt , vice versa too – you will use other tendons and muscles in hand/wirst lower arm . So more will get sore and you will need a triple dose . I did this same near damage to my right shoulder at work many yrs ago . No surgery , but took about 4 yrs before I could sit comfortably in any chair . LONG HEALING PROCESS. Neat stuff on voice recog sfwre – I’m gonna watch these.

  35. Orson commented on Aug 23

    I have tried numerous mouses to alleviate my wrist and fore-arm stress.

    The only solution that I found to work is very simple and cheap. Use 2 mouses. Use your right hand to move the cursor and your left hand to click (tape off the bottom of the left-hand mouse so that movement in your left hand does not move the cursor). If you want to go further, there are foot pedals that you can buy for the mouse click operation.

    This immediately relieved my stress and it has not recurred since. Everyone that I have recommended this to has been amazed.

    The theory is that the stress occurs from the click-drag operation which requires one to grasp the mouse tightly while moving it. Separating the clicking and moving operations avoids the click-drag with one hand.

    This is initially very inconvenient (you’ll have to figure out how you want to shift-click or cntrl-click), but one gets used to it quickly.

  36. sanjosie commented on Aug 23

    Caught too many big bass up in Maine, eh?

    I’ve used DragonDictate over the lifespan of three laptops. It works, but you have to correct the errors by typing. And therein lies the rub, if your hands are in great pain. I use a Wacom pen tablet ($99). This functions as both mouse and input device. Then I use an on screen keyboard with the pen. The pen software has handwriting recognition also.

    In sum, voice gets you part way, the pen helps correct errors in voice, and pen replaces mouse for navigation.

    I own two Aeron chairs, one at home and one I take to the job.

    My sympathies Barry. Please recoup your health.

  37. Richard commented on Aug 23

    INTU-FLOW: Moderate, Sustainable Exercise for Pain-Free Health and Longevity by Scott Sonnon and Nikolay Travkin (DVD – Nov 1, 2005)

    Injured martial artist presents a method that is fun and will fix the problems you are having.

  38. KP commented on Aug 23

    1.) Get a trackball

    I like and use this one:


    Had it for 5 years and it still works very well. Never had any problems either with the device or me.

    2.) Exercise!!
    Contrary to popular belief it is not optional. Your body is a biological machine that needs nutrition and exercise (AKA Maintenance) or it will adapt to its new operating environment(inactivity)

    3.) Take regular breaks while on the puter. Every 20-30 minutes get up and out of your chair and take a brief walk. It will not only help your body but your mind as well.

  39. corey commented on Aug 23

    I had serious RSI problems for a year (I was doing 60+ hours a week as a programmer)

    PT saved me. Mostly because they recommended the use of a foam roller http://www.power-systems.com/nav/closeup.aspx?c=3&g=1299&Foam/Rollers

    Laying on that and doing th exercises the PT gave me (three times a day) stopped my shoulder from hurting within a month.

    Also, keep a little egg timer next to your computer and set it for 50 minutes. When it goes off just stand up and walk around for awhile. That keeps you from tensing your back muscles for too long.

  40. HeatherHeather commented on Aug 23

    I had horrible problems with my shoulder until I moved my computer and keyboard back so that my elbows could rest on the table. Now I have no problems at all! I also love my chair, it’s called the hula hoop chair and it is amazingly comfortable.

  41. Mike commented on Aug 23

    Sorry for your pain Barry.

    All good advice above and I’ve benefited from most; wireless mouse for easy hand switching, good chair (life form chairs – really good), foot rest, orthopedist, various eastern med/new age solutions, traditional PT and maybe some I don’t remember. I have no experience with voice recog stuff – sorry.

    But the single best experience and ultimately the last avenue I had to go down for a solution was the one that allowed me to cancel surgery that was scheduled because I’d reached, what was for me, the outer limits of my pain threshold. My neighbor suggested it to me and I laughed it off as just another new age crap solution, but desperate times etc…I went to see them. The name of the therapy is Egoscue. Google it – make a visit to their clinic in NYC or CT if that works for you. I’m in SF and its roots are in SD but I’ve sent 2 people to the clinic on Madison in NYC and they report that the guy knows his stuff.

    Good luck – I wish you a speedy recovery.

  42. Beth commented on Aug 23

    I got what is probably the worlds most expensive and weirdest looking keyboard: http://www.datahand.com/ … but my hands don’t hurt anymore (except when I use the laptop too much). I also got the coolest mouse: http://www.contourdesign.com/rollermouse/ which didn’t do as much good for my hands as the DataHand, but works better as a mouse. I found that the regular mouse got to be almost too painful to use and the roller mouse is ok.

  43. pg commented on Aug 23

    spring for a secretary dude

  44. Todd commented on Aug 23

    Having had similar issues, my advice to you would be to try various things and see what works. Most helpful to me has been physical therapy, ergonomic keyboard, and now chiropractor. The chiropractor lately has been working wonders. Also make sure that your mattress and pillow are good – surprisingly they cause a lot of problems. Best of luck.

  45. KP commented on Aug 23

    Plan B

    Hot intern.

  46. Dean commented on Aug 23

    All good comments here – most importantly, get yourself a good chair and an ergonomic evaluation of your workspace. They provide them for us here at the office and it made a huge difference. I wound up raising my monitors and keyboard, getting an IMAK wrist rest for my mouse and adjusting my chair so that my legs were supported better. I also wound up getting a larger monitor and can now run slightly larger font sizes so I’m not leaning forward so much. The dual 19″ setup I’m running now is especially nice.

    One other suggestion I didn’t see in the comments – if you’re on the phone a lot, and you don’t already, get a good wireless headset for your phone. Holding the phone between my head and shoulder was also causing a lot of problems with my neck and upper back.

  47. joe jones commented on Aug 23

    Intern/recent grad to do the typing for you. Or, retired old person looking for extra cash?

    It might be easier to get actual work done if the typist is not at all very “hot”.

  48. Ken Strom commented on Aug 23

    I am 62 years old. I use an arm support that has an elevated mouse pad and it is called an “Ergo Rest”.
    It was pretty costly but worth it since I haven’t had shoulder trouble or carpal symptoms for years!

  49. alon commented on Aug 23

    I see you have a lot of comments so maybe you heard this but:
    TRACKBALL vs. mouse. 100% better. I have a logitech marble mouse (good for lefties too) at home and a Microsoft trackball explorer for work. Theyre especially easy on shoulder as movement is limited to wrist and fingers. DONT GET A THUMB BALL – thumb scroll is ok. ball s/b in center. see links below:
    also an old-school wrist squeeze exerciser is good to keep around the desk area. Good Luck – i hope you avoid surgery – Alon


  50. Valor commented on Aug 23

    Heard of Rolfing? It’s truly amazing. I’m not one for alternative medicine, but check it out. Seriously.

    It’s essentially a combination of massage & physical therapy. Took care of my Carpal Tunnel perfectly–no surgery. Also, unlike Chiropractic work, it’s not impact-based, and gentle.


    Let me know if you try it!

  51. The Psychology Lounge commented on Aug 23

    Hi Barry,

    I’m heavily invested in your getting better, as I love your blog.

    I write my blog with Dragon NS. Version 8.0. 9 is even better, apparently.

    Here’s the key:

    1. Fast computer.
    2. Lotsa memory: 1gb to 2gb
    3. Fast hard drive preferably SATA 300.
    4. High quality headphone, USB with DSP sidesteps your sound card and can be better esp. if you have crappy integrated sound.

    5. Speak clearly without slurring words together. But–don’t–speak–like–Captain–Kirk–of–the–USS–Enterprise. Just speak normally, but actually pronounce all the words (hard to do if you like me are from New Jersey).

    6. Correct mistakes and the program gets smarter.

    7. Run your current writing thru the recognition wizard, this will make the program much smarter.

    8. Avoid homonyms, as the program can’t distinguish them.

    with DNS you can write very fast, and with zero stress on your hands.

    BTW, I think that both the mouse and the trackball is problematic. I use trackpads on all my machines, including my desktop, and I like them.

    Good luck my friend, and get better soon so I can continue to enjoy your good work.

  52. Estragon commented on Aug 23

    Just a thought, but does anyone find that dictating rather than typing subtly changes the idea being expressed?

    Verbal communication carries emotional and other content which I suspect we anticipate as we form the idea itself.

  53. Gary commented on Aug 23

    BR – I had similar problems but mostly with compressed vertebrae. I’m guessing the problem isn’t just the typing, but the typing AND the reading — the total time spent in front of the PC.

    When you spend hours focused on the computer screen with few breaks and little head movement, you start a nasty little cycle of muscle tension. The neck/shoulder muscles start pulling that 12 pound bowling ball on top of the neck downward. If you have an MRI make sure you look at it; seeing that disc squeeze out of your spine will change your mind.

    Of course, by this time not only does your shoulder hurt, but you think you’re having a heart attack cause the damn bowling ball is pinching a nerve causing pain and loss of feeling in your left arm.

    * Avoid surgery if at all possible
    * Take whatever medication they give you
    * Go to PT religiously
    * Do the exercises they tell you to do
    * Break from the damn PC every 45 minutes
    * Break your focus from the system every so often and look around

    Get better!

  54. Mike commented on Aug 23

    I evaluated voice recognition software several years ago as part of an effort to use it in the largest call center in the world.

    After doing a trial with over 20 people in a test environment, we found:

    1) it works 90% of the time if it likes your voice

    2) it works only 10% of the time if it doesn’t like your voice, even after you spend several hours going through the voice training module.

    Leo Laporte did a segment on voice recognition software on one of his television programs at that time. He said that the technology is about 95% accurate (circa 2001) and that it will take another 5 years to make the software so that it is 100% accurate.

    I haven’t evaluated any of the packages since, but I can tell you that neither of the top two packages at the time like my voice. After spending two hours training two different programs, it was frustrating to me that the accuracy was less than 20%.

    It will be interesting to find out how well you do.

    Let us know.

  55. Bruce commented on Aug 23

    Lots of good advice here, the meta being you have to find out what works for you– which means paying more attention to your body than you have been.

    For exercises I recommend http://www.amazon.com/Somatics-Reawakening-Control-Movement-Flexibility/dp/0738209570/ref=pd_bbs_sr_1/103-8252399-8692608?ie=UTF8&s=books&qid=1187905844&sr=8-1
    The book is good, but the audio CDs are =excellent= and will do much more good for you than “just” helping out your RSI.

    FWIW, my personal story is ulnar nerve RSI, 6 weeks of PT, which was great, 5 years of accupuncture, which was great, reducing work, keyboard tray, kneeling chair, left hand marble mouse, which were all great, rolfing, which was super great, now the somatics and nei gung http://www.stillnessinmotion.com/. As a result, I am BETTER than when I was injured :-)

  56. francine commented on Aug 23

    Two comments:
    1)Try yoga before surgery. Range of motion exercises will help. The surgery has a very long recovery time (my brother had it).
    2)Dragon 9 is really terrific. I tested it for a physician’s office and was stunned at how well it works. I think I used it on a PC.

  57. BDG123 commented on Aug 24

    Everyone has an opinion. I’ve tried all of them. Myofascial trigger point therapy is your best form of relief. Your shoulders, neck, back, arms and even head muscles are involved in this. A good stretching routine might also help with maintenance. But, a trained physical therapist in the above discipline is your best relief. Been there done that.

  58. DavidB commented on Aug 26

    Buy a slave. They’re still relatively cheap. Inflation hasn’t really hit that market hard yet

  59. alexd commented on Aug 26

    I have read but not tried it, but the “Jawbone bluetooth device has great circuitry for reducing background noise and that people who have used it with vr make it their device of choice. Plus it is cheap and a beautiful design. I intend to get dragon 9 and this device so i will vote with my $

  60. Jason R commented on Aug 26

    Still in the corner of Dragon. It works. A lot of the suggestions are very good, but as far as software, get Dragon. In fact, buy Parallels for your Mac and run Dragon on that too. I have been finding out the hard way that not all software for the Mac is up to speed. Even from software companies that were thought to be Mac-centric, like Adobe. Their Photoshop Elements for Mac is probably 2 versions behind the Elements for PC. Intuit’s Quicken for Mac is a joke. I’d sell it to you for half price, but I’d feel bad doing that to you. I use the latest verion of Quicken in the Parallels environment. The best thing that Apple ever did was add the Intel chipsets. Now the benefit of owning a Mac is that you are completely unfettered. Buy the best software regardless of platform… So, enough of slamming other pieces of software…buy Dragon. It works.

  61. Jim commented on Aug 26

    I second doing yoga. My memory of your image is not strong but, if it applies, lose a few pounds. I’d add some aerobic exercise if you’re not already doing it. I use the Humanscale Freedom chair with headrest, which I love (same chair used in the conference room on “24”–take that you over-rated Aeron chair). Also, if you can pry yourself away, enjoy some time at Canyon Ranch. You can have a team of doctors, and therapists from every discipline, give you a second opinion and more. Not only are they an elite group–the doc that first recommended glucosamine and chondroitin came from CR–I find them to be focused on progressive treatments, stuff that only, ahem, rich people can afford because it’s probably not coverd by health insurance.

  62. Jim commented on Aug 26

    I second doing yoga. My memory of your image is not strong but, if it applies, lose a few pounds. I’d add some aerobic exercise if you’re not already doing it. I use the Humanscale Freedom chair with headrest, which I love (same chair used in the conference room on “24”–take that you over-rated Aeron chair). Also, if you can pry yourself away, enjoy some time at Canyon Ranch. You can have a team of doctors, and therapists from every discipline, give you a second opinion and more. Not only are they an elite group–the doc that first recommended glucosamine and chondroitin came from CR–I find them to be focused on progressive treatments, stuff that only, ahem, rich people can afford because it’s probably not coverd by health insurance.

  63. Bryan Price commented on Aug 26

    I feel your pain. :(

    I was going to bed and almost falling asleep when my shoulder started hurting. I had to stop playing Solitaire (to get me to the point where I could sleep) because I was locking my arm from my wrist to my shoulder and putting all my weight on the base of my palm. The weak point in all that turned out to be my shoulder.

    I will 19th or whatever and say don’t use a mouse, use a trackball. I broke mine, the wife wouldn’t let me touch/use hers (and she’s had surgery for carpal tunnel), and the one that I did have isn’t made any more (Microsoft Explorer 1.0 USB 1.0 Trackball).

    I tried using a gaming mouse at high precision, thinking that minimizing as much as possible might delay my symptoms. But after a year, I’m feeling those old sharp pains up my thumb and up my palm. I broke down and bought one on Ebay (for about twice the cost that I last remember seeing it on a store shelf). It’s only been a week, but the shooting pain has gone away.

    Jeff, I’ve never noticed any problems with my thumb using my trackball.


    That trackball is no longer being manufactured. You’re going to have to pay >$100 on Ebay for one. I wasted a week and ended up saving $15, instead of doing an instant buy for $120. :( I’m surprised that MS hasn’t come out with a new one, ANY kind of trackball for that matter.

    And yeah, I spend way too many hours in front of a computer screen.

  64. Jim Gibbons commented on Aug 26

    I tore my rotator cuff three years ago and could not mouse for more thaqn 20 seconds before I would have to quit. I decided to learn to mouse with my left hand. I’m still doing it and have freed my right hand for other multi-tasks.

  65. Gus commented on Sep 10

    Been There, Done That for much of the above – problems started in 1991.
    Some of my learnings:
    1) Everyone’s case is different – I’ve tried heat, cold, splints, exercise, meds, surgery, ergonomics (very helpful), assistance (parents, coworkers, spouse, friends)
    2) Software and hardware gets better – started with Dragon PowerSecretary -$2,400 and the words were discrete. I’ve used DNS 2, 5, 7 – soon expect to try DNS 9. Prices drop and performance improves – wish more things were like that.
    3)Don’t wait until the pain is unbearable – make small changes early, invest in yourself. You may be replacable to others, but not to yourself.
    4) Some solutions that currently work FOR ME – a) Cirque Touchpad; b) Adjustable Keyboard Tray (height and angle); c) armless chair; d) Meds (NSAID (Voltaren), anticonvulsants (Neurontin), thyroid med (Synthroid); e) Phone Headset (Plantronics S12); f)Gel Keyboard and mouse cushions (Fellows).

    I kept trying the reversable stuff, even if it meant buying my own work equipment – though my employers have been great. Meds, splints, hardware, software are all reversable. Surgery delayed as much as possible – some improvement – not first nor last step. Some pain in tests (EMG, nerve conduction, etc.).
    Tried many types of doctors (neurologist, rheumatologist, psychiatrist, neurosurgeon, endocrinolist).
    Some have it worse, some have it better – only one person has it worst, and one person has it best – and that could be the same person, at different moments in time.

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