I had made a couple of comments about workplace ergonomics, voice to text/dictation and RA accommodations and got a couple DMs for more information so I thought I would make a larger post here with the information as I know it 😊.

Occupational Therapist

First and foremost, I cannot recommend Occupational Therapists (OT) enough. We all know that RA is tricky and quite different for everybody, so the personalized attention and help that you can get from an OT is second to none. In my experience, my Rheumatologist is there to manage my medication. The OT is there to help me live my life. They provide support with braces; but also, other tools, exercises and general advice on how to live your life with this disease. Here in Ontario, an OT is covered by OHIP with referral from your rheumatologist, or simply free through the Arthritis Society.

Accommodations

I want to acknowledge that I live and work in Ontario Canada, I think it is the same in other provinces, but I can't really speak to what things are like in other countries as far as accommodations. Here, once you are hired, your workplace has a duty to accommodate your needs (excepting some cases when a request would cause “undue harm” to the company) AODA In my experience, most companies I have worked for been pretty good with accommodating my needs, but I'm sure some of you have some horror stories.

All the ergonomic stuff I have ever requested have always been approved, without me ever having to provide any rationale. Honestly, IMO any “forward thinking” workplace should want to buy their employees ergonomic equipment as requested as in the long run it is much cheaper to buy the equipment then have employees on disability with soft tissue issues, tendonitis etc. Depending on your employer or location, you should not need to disclose your RA to request I know that may not be the case everywhere, so just like to acknowledge my privilege in the access to this sometimes-expensive equipment.

Workspace Ergonomics

I want to start here since it is foundational and really is advice for everybody, not just those with RA.

this site has a nice visual of how you should should strive for in your workspace. I find the biggest thing was getting my elbows into the right position by adjusting both desk and chair height. Since I'm short I had to add a footrest.

Use a wrist rest with your mouse hand. Your wrists should be in a neutral position which is hard to do that without something elevating your forearm.

Find a mouse that works for you! I have issues with my pointer and index finger. My problem working long days at a desk is from clicking dragging and dropping in using a scroll wheel. For this I ended up with a mouse that was very sensitive to these touches. I also have small hands, so I needed a small mouse. This is the most I use Other people end up with wrist or forearm pain from heavy mouse use. If this is your problem, you should try a “handshake” style mouse

USE AN URGONOMIC KEYBOARD!!! Nobody at all, let alone anybody with RA should be using a regular keyboard. Again, find a keyboard that you like, this is the one I use currently. The mouse that comes with it is gigantic for my tiny hands, so I use that Microsoft arc mouse above. I have also used the “Truly ergonomic Keyboard” which I really liked, but you have to relearn how to type, and then it messes you up when you are trying to type on a regular keyboard. Also, nobody else in my house could use the keyboard at all. Its mechanical system so some of the switches started to die I could not get support for my model, so I ended up going in a different direction. It is also super expensive.

Dictation/Voice to Text

Even after making sure my ergonomics were perfect and getting the best mouse and keyboard for me, I still continue to have problems with my RA from overuse, clicking and typing, so I started to look at other options to reduce this strain.

(I'm sorry, I don't know much about Apple products, but I'm sure the newer versions are coming out with “accessibility” features similar to what I am discussing below.)

In the Microsoft office 365 suite of tools, Microsoft Word, PowerPoint and Outlook all come with a “dictation” feature (I am using it now). For simplicities sake, the links I'm going share are for Microsoft Word. Dictation for MS Word 356

You can also enable this in Word and PowerPoint 2016

If you don't have the office suite of programs, but have a computer operating a Windows 10 operating system, you can still use dictation in any text field. Simply press the windows key H and start speaking (after some setup). Here is the setup

Here is an article with more info

As you noted in the articles, you can use your voice to add punctuation and formatting. In the Windows 10 operating system version, you can also use your voice to control your computer.

I would also note, for either of these tools it is essential that you get a headset. For these tools to work they really need to hear your voice clearly and that is impossible to do if you are just relying on your computer microphone.

It also interestingly changes the way that you talk and/or “write”. We tend to speak with an understandably conversational tone, but usually write a little bit more formally. Doing a lot of dictation, I am trying to speak more formally and also very clearly to maintain my writing style.

It's not a perfect solution, you're still going to have to go over what you've dictated and proofread it because it will get it wrong. Sometimes what it gets wrong is hilarious, sometimes I've realized that I'm really not pronouncing a word correctly, sometimes it's just bonkers. I do find that it lifts some of the strain off my hands and provides them a chance to rest.

Like I mentioned, part of the Windows 10 Accessibility is that you can control your computer through the operating system. If you want to get really fancy with dictation and controlling your computer, you can see if your organization will buy dragon for you

I understand the price is steep and so is the learning curve, but it's the gold standard for controlling your computer without your hands. I hope this helps! If you have other tips for office work with RA, but in the comments and maybe we can make a master “office work with RA advice” that the mods can post (?).

TL;DR 1. See an OT, they are better than your Rhumy for living life past drug mgmt. 2. sort out your ergonomics at work. 3. Dictation is great for relieving strain on hands, MS 365 has it build into Word, PPT and outlook; Windows 10 has it baked into the operating system.

Edit: fixed a link