Rheumatoid Arthritis & Computing

AbilityNet & NRAS
Original article: 19/12/2006
Reviewed: 29/09/2009
Next review due: 29/09/2012

This document describes rheumatoid arthritis and how it can affect an individual’s access to a computer. AbilityNet and the National Rheumatoid Arthritis Society have worked together to produce this factsheet, which describes the steps that can be taken to help overcome some of the possible difficulties when accessing a computer.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) can occur at any age. There are around 400,000 adults in the UK with the condition and around 12,000 children under the age of 16 are affected. Many people experience disabling pain, stiffness and reduced joint function as well as severe fatigue, which can have a huge impact on quality of life for them and their families. It can affect organs as well as joints. RA is an autoimmune disease and quite different from osteoarthritis, which most people are probably familiar with.

The most common problems

The most common difficulties in using computers occur from restricted mobility in hands, wrists, elbows, shoulders and neck. A typical example is pain and swelling in the wrist caused by long periods of keyboard and mouse use.

Get Round

A person with RA may well be able to continue with some or all of their computer use activities using an alternative technique, while still following medical advice and continuing with treatment. We call this 'getting round the problem' and we have found it to be a very useful and under-used approach. Among the alternatives we work with are:

• Alternatives to a mouse.
• Small, light, standard-layout keyboards.
• Ergonomically designed keyboards.
• Voice input; now a reliable and highly developed technology. (Windows Vista now comes with voice recognition as standard). 
• Alternative key input devices with radically different designs.

Example solutions

Not everyone experiences the same level of pain or discomfort when using a computer and so there is not a ready-made solution available. The following is a list of examples which have been provided by individual computer users affected by rheumatoid arthritis and some of the steps they have taken to alleviate their difficulties.

Pain and swelling in the wrists when using a mouse or keyboard for long periods.

1 . When using the mouse,the user found that a mouse Gel Pad made matters worse, because the pad lifts up the wrist too high, causing more pain. A smaller laptop mouse (Logitech V200) made it easier, once the user became used to it. Its small size allowed the base of the hand to rest on the mouse mat, which kept the wrist straight. They also use a separate keyboard with their laptop, which has allowed for a better angle for the wrist and enabled the screen to be placed at a more convenient distance.

2 . The user has started using Microsoft keyboard shortcuts and now hardly needs the mouse at all. It’s a slower process but less painful. They also use a navigator keyboard with pre-programmed buttons on it: email, internet, save, print etc. This helps to reduce the number of keystrokes used.

3 . Physical stiffness caused the user to consistently miss keys or hit the wrong keys. They had a workplace assessment. Recommendations included a ‘keyguard.’ Keyguards have two main functions: they provide a platform which the user can rest their hands on without pressing keys down and they make it difficult to accidentally hit more than one key at a time.

4 . The user obtained a wrist rest, which is attached to the mouse pad. They also obtained a footrest and lumber support to provide better posture when seated at the computer.

5 . The user has tried several types of trackball but eventually found that their laptop touchpad was the best solution. Typing on a keyboard was difficult and they moved to using Voice Activated software.

6 . The user has trouble using a standard mouse. They purchased a roller ball to use with one hand. They also manage to cope with a standard keyboard by typing with just two fingers.

Where to Get Help

Most of the examples have cited pain and discomfort associated with using a keyboard and mouse but the users have alleviated their difficulties by trying alternative solutions. You can view a list of these in a fact sheet on ‘keyboard and mouse alternatives’ and in the ‘MyWay’ skillsheets on keyboard and mouse adjustments. Just click the ‘view our Factsheets and Skillsheets’ link on the AbilityNet website www.abilitynet.org.uk for a full list of both factsheets and skillsheets.

Trial and error appears to be the most common way that many computer users find an acceptable solution to their difficulties, but this can be time consuming, expensive and no guarantee of success. In addition to factsheets and skillsheets, AbilityNet can help you in a number of other ways too.

Advice and Information

AbilityNet are available, through this service, to anybody with a question or a concern. They can give factual information, explain their services, or simply discuss concerns. You can access this service either by phoning the freephone helpline 0800 269545 or by sending an email to enquiries@abilitynet.org.uk

Assessment

AbilityNet assessments integrate personal and technical considerations to arrive at sound and realistic suggestions, documented in a report. The process includes discussion, evaluation of all relevant circumstances and trial use of alternative devices.

AbilityNet believes that individual attention is vital. Superficially similar cases may demand quite different approaches.

Awareness Training and Courses

AbilityNet offers training designed for professionals with interests and responsibilities in adaptive hardware and software. These address prevention and management and effective DSE workstation assessment as well as individual cases.

Employment

AbilityNet are frequently asked to work with employers to take a broad, long term view of computer system and work process design to help them to work towards safe, healthy and effective working procedures.

If your employer would like more information they can contact AbilityNet on 0800 269545.

Useful References

AbilityNet:

AbilityNet is a national charity helping disabled adults and children to use computers and the internet by adapting and adjusting their technology.

Tel: 0800 269545

Email: enquiries@abilitynet.org.uk 

Web: www.abilitynet.org.uk

National Rheumatoid Arthritis Society (NRAS):

NRAS provides support and information for people with rheumatoid arthritis and juvenile idiopathic arthritis, their families, friends and carers and health professionals with an interest in rheumatoid arthritis. More information available from:

National Rheumatoid Arthritis Society, Unit B4 Westacott Business Centre, Westacott Way, Maidenhead , SL6 3RT

Tel: 0845 458 3969 (Helpline: 0800 298 7650) 

Email: enquiries@nras.org.uk

Web: www.nras.org.uk

Fit to Work:

Leaflet about reducing computer related aches and pains. Available from:

The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED

Tel: 020 7306 6666

Web: www.csp.org.uk 

HSE Publications:

The following leaflets have information on making adjustments in line with the Health and Safety (Display Screen Equipment) Regulations 1992.

Available from:

HSE Books, PO Box 1999, Sudbury, Suffolk CO10 2WA

Tel: 01787 881165

Health and Safety (Display Screen Equipment) Regulations 1992

DSE Work. Guidance on Regulations

VDUs. An Easy Guide to the Regulations

Working with VDUs 

Health & Safety Executive public enquiry service:

Tel: 0845 345 0055

Web: www.hse.gov.uk