AbilityNet Factsheet - June 2019

Rheumatoid Arthritis and Computing

RA is an auto-immune disease and quite different from osteoarthritis, the ‘wear-and-tear’ form of arthritis which many people get to some degree, particularly as they get older. People with RA 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.

Given that many people with Rheumatoid Arthritis find it painful to use a standard keyboard and mouse, AbilityNet have produced this factsheet to cover some of the options that can help make computers, laptops, tablets and smartphones easier to use.

This factsheet is part of AbilityNet’s free Advice and Information service. If you have any questions at all about anything in this factsheet, or any other aspect of assistive technology, please contact us.

Free Helpline: 0800 269545
Email: enquiries@abilitynet.org.uk
Web: www.abilitynet.org.uk/expert-resources

Last updated: June 2019

1. What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is a long-term condition that primarily causes pain, swelling and stiffness in the joints.

RA is an auto-immune disease and is different from osteoarthritis, the ‘wear-and-tear’ form of arthritis which many people get to some degree, particularly as they get older. RA is the most common form of inflammatory arthritis and is characterised by flare-ups even when managed.

People can get it at any age even from the age of 14, when it is described as early onset RA, but most commonly people develop it between the ages of 30 and 60.

Rheumatoid arthritis is a systemic disease and can affect a person’s organs as well as joints. If it is not treated properly it can cause irreversible damage to joints and lead to disability. Things are improving for people with RA and there are now many more effective treatments. The management of RA today is better than it was and although there is no cure, once controlled it can be possible to live a relatively full and active life. It is important to get a diagnosis as soon as symptoms occur.

Find more information at www.nras.org.uk.

2. How does RA affect computer usage?

RA can affect people in many different ways which can have a direct effect on their ability to use a computer, tablet or smartphone.

The most common problems 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. A common complication of RA is carpal tunnel syndrome.

3. What sort of technology can help people with RA?

A person with RA may well be able to continue with some or all of their computer usage by 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 that could be tried are:

  • Alternatives to a mouse
  • Small, light, standard-layout keyboards
  • Ergonomically designed keyboards
  • Word prediction
  • Voice input - now a reliable and highly developed technology
  • Alternative key input devices with radically different designs.

For some time most desktop computers used a traditional mouse, keyboard and screen. The specialist options recommended often required additional hardware or software, much of which could be very expensive.

The good news is that the options today are very different. Laptops, tablets and smartphones offer a very affordable range of very flexible options that are not tied to a specific location.

And powerful tools such as voice commands and dictation software are built into all mainstream systems.

Specialist solutions may be required but they are often only needed as a supplement to the options that are already built in.

4. One size does NOT fit all

AbilityNet supports thousands of people every year and everybody’s needs and preferences are different. Not everyone experiences the same level of pain or discomfort when using a computer so there is not a ready-made solution available.

The solution may reflect the tasks being performed and the setting – from note-taking in lectures to sharing updates on social media or preparing reports in a busy open plan office.

The following examples are based on real computer users affected by Rheumatoid Arthritis and some of the steps they have taken to alleviate their difficulties.

EXAMPLE 1: Wrists get very painful when using the keyboard and mouse

A keyboard Gel Pad has helped the person reduce the pain they feel when typing, although a mouse Gel Pad made matters worse, because the pad lifts up the wrist too high causing more pain.

M187 MouseA smaller laptop wireless mouse (Logitech M187) is helpful because the smaller size allows the base of the hand to rest on the mouse mat, which keeps the wrist straight.

A separate Bluetooth keyboard has been added when using their laptop. It has allowed for a better angle for the wrist and enabled the screen to be placed at a more convenient distance.

EXAMPLE 2: Pain and swelling in the wrists when using the mouse for long periods.

The person started using Microsoft keyboard shortcuts and now hardly uses the mouse at all. It’s slower at first but much less painful and for many people it becomes much easier than reaching for a mouse.

Logitech Internet NavigatorThey also use an internet navigator keyboard with pre-programmed buttons on it – email, internet, save, print etc. This helps to reduce the number of keystrokes.

EXAMPLE 3: Swelling, pain and stiffness through keyboard and mouse use.

KeyguardThe stiffness caused the user to consistently miss or hit the wrong keys. This was causing problems when preparing reports and using email at work so a workplace assessment was carried out and the 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. However before using a keyguard try the inbuilt settings for filter (mcmw.abilitynet.org.uk/windows-10-changing-keyboard-settings-using-filter-keys) and/or sticky keys (mcmw.abilitynet.org.uk/windows-10-using-your-keyboard-one-handed-0)

Different keyboards can make a significant difference from low profile to compact.

EXAMPLE 4: Sore wrists from using a mouse

Pillow Mouse PadFor some people a wrist rest can significantly reduce pain. This is a simple solution that is attached to the mouse pad.

The person who used this solution also started to use a footrest and lumbar support to provide better posture when seated at the computer.

EXAMPLE 5: Pain to the wrists from using a mouse.

Handshoe mouseThe handshoe mouse is often recommended to support the hand, wrist and thumb preventing gripping and pinching, the arm is supported at a relaxed 25-30 degree angle. The Corsair range  of gaming mice (see Corsair M65) also provide a thumb rest if pain is concentrated in the base of the thumb and less so elsewhere. These are comparatively low cost but are mainstream mice rather than specialist ergonomic mice.

EXAMPLE 6: Touchpad and dictation options

A person based in a law firm had tried several types of trackball mice but eventually found that their laptop touchpad was the best solution.

Dragon Professional IndividualTyping on a keyboard was also difficult and they so they switched to dictation software. Having tried the built in options they chose Dragon Professional because of its specialist dictionaries which include a legal edition.

The only discomfort now experienced is from wearing a headset for any lengthy period, so they switch to keyboard use for short periods. Blue tooth headsets can offer an alternative and increasingly it is worth trying onboard microphones. It is worth noting that Dragon is no longer supported on the Apple platform. It is now possible to get different vocabulary plugins without major cost (see: Spellex or Medincle)

EXAMPLE 7: Using a non-standard mouse.

Traxys Rollerball II MouseOne person we supported recently purchased a roller ball mouse to use with one hand, while they work with the other.  They also manage to cope with a standard keyboard by typing with just two fingers.

5. Useful contacts

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:

Helpline: 0800 298 7650

General enquiries: 01628 823524

Ground Floor
4 The Switchback
Gardner Road
Maidenhead
Berkshire
SL6 7RJ

Website: www.nras.org.uk

Email: Helpline@nras.org.uk

6. How AbilityNet can help you

My Computer My Way

My Computer My Way is an AbilityNet run website packed with articles explaining how to use the accessibility features built into your computer, tablet or smartphone. The site is routinely updated as new features and changes are made to the Windows, MacOS, iOS, Chrome OS and Android operating systems. The site is broken down into the following sections:

  • Vision – computer adjustments to do with vision and colour
  • Hearing – computer adjustments to do with hearing, communication and speech
  • Motor – computer adjustments to do mobility, stamina and dexterity
  • Cognitive – computer adjustments to do with attention, learning and memory

Use it for free at mcmw.abilitynet.org.uk

Advice and information

If you have any questions please contact us at AbilityNet and we will do all we can to help.

IT support at Home

If you’re looking for in-person support, you can book a free visit from one of our disclosure-checked volunteers. Many of our volunteers are former IT professionals who give their time to help older people and people with disabilities to use technology to achieve their goals. Our friendly volunteers can help with most major computer systems, laptops, tablet devices and smartphones.

https://abilitynet.org.uk/at-home

Copyright information

This factsheet is licensed by AbilityNet under the Creative Commons Attribution-Non Commercial-ShareAlike 3.0 Unported License. View a copy of this license at creativecommons.org/licenses/by-nc-sa/3.0/

 
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