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Wednesday, March 25, 2009

Rheumatoid arthritis pain: 7 ways to protect your joints

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By Mayo Clinic staff

Joint protection is one strategy to help you manage your rheumatoid arthritis pain. Taking the time to think ahead and plan ways to avoid unnecessarily stressing your joints may help you reduce your rheumatoid arthritis pain. Arthritic joints can't tolerate as much stress, so pushing, pulling or twisting motions can be painful. Though you may want to work through your rheumatoid arthritis pain, doing so can aggravate the situation.

Joint protection: 7 techniques to manage rheumatoid arthritis pain

To avoid unnecessary joint strain and increased rheumatoid arthritis pain, follow these seven steps.

Step 1: Move each joint through its full pain-free range of motion at least once a day
This will help you maintain freedom of motion in your joints. The amount you're able to move each joint without rheumatoid arthritis pain may vary from day to day — take care not to overdo it. Keep movements slow and gentle — sudden jerking or bouncing can hurt your joints.

Step 2: Learn to understand and respect your rheumatoid arthritis pain
Understand the difference between the general discomfort of rheumatoid arthritis and the pain from overusing a joint. By noting the activity that stressed a joint, you can avoid repeating that movement. Pain that lasts more than an hour after an activity may indicate that the activity was too stressful. Think of ways that you can modify the action. Remember that you're more likely to damage your joints when they're painful and swollen.

Step 3: Be careful how you use your hands
You use your fingers in many day-to-day activities. Stressful positions and techniques may increase the risk of pain. You can perform most tasks in easier ways that put less deforming forces on your joints.

Avoid positions that push your other fingers toward your little finger. For instance, avoid tasks that require forceful or prolonged gripping or pinching. Finger motions should be in the direction of your thumb whenever possible. For example, don't brush crumbs off a table with your palm flat on the table. Instead, turn your hand so that the little finger is resting on the table and the palm is facing you. Then push the crumbs off the table.
  • Avoid making a tight fist. Use tools with thick or ergonomically designed handles, which make them easier to hold.
  • Avoid pinching items between your thumb and your fingers. Hold a book, plate or mug in the palms of your hands.
  • If you're reading for long periods, use a book holder. Instead of a clutch-style purse, select one with a shoulder strap.

Step 4: Use good body mechanics
The way you position your body largely affects how much strain you put on your joints. Proper body mechanics allow you to use your body more efficiently and conserve energy.

When you're sitting, the proper height for a work surface is 2 inches below your bent elbow.

  • Make sure you have good back and foot support when you sit. Your forearms and upper legs should be well supported, resting level with the floor.
  • If you type at a keyboard for long periods and your chair doesn't have arms, consider using wrist or forearm supports. An angled work surface for reading and writing is easier on your neck.
  • When you're standing, the height of your work surface should enable you to work comfortably without stooping.
  • Increase the height of your chair to decrease stress on your hips and knees as you get up and down.
  • To pick up items from the floor, stoop by bending your knees and hips. Or sit in a chair and bend over.
  • Carry heavy objects close to your chest, supporting the weight on your forearms.
  • Maintain good posture. Poor posture causes uneven weight distribution and may strain your ligaments and muscles.
Step 5: Use the strongest joint available for the job
Save your weaker joints for the specific jobs that only they can accomplish. Throughout the day, favor large joints. For example, carry objects with your palm open, distributing the weight equally over your forearm. Slide objects along a counter or workbench rather than lifting them. When opening cabinets or heavy doors, use a loop that you can pull with your wrist or forearm to decrease stress on your fingers.

Step 6: Avoid keeping your joints in the same position for a prolonged period of time
Don't give your joints the chance to become stiff — keep them moving. When writing or doing handwork, release your grip every 10 to 15 minutes, or when your hand feels fatigued. On long car trips, get out of the car, stretch and move around at least every hour. While watching television, get up and move around every half-hour.

Step 7: Balance periods of rest and activity during the day
Effectively managing your workload throughout the day can help you avoid overworked joints. Work at a steady, moderate pace and avoid rushing. Rest before you become fatigued or sore. Alternate light and moderate activities throughout the day. And take periodic stretch breaks.

One step at a time
Remember, you don't have to make all of these changes at once. By gradually incorporating these methods into your day-to-day activities, you're more likely to stick with them.

Keep an open mind about how you do everyday tasks. You might have to change some old habits, but the reward is that your joints may cause you less pain.

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